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. Basics of particle therapy: introduction to hadrons.

    PubMed

    Welsh, James S

    2008-10-01

    With the arrival of 3-dimensional conformal radiation therapy and intensity modulated radiation therapy, radiation dose distributions in radiation oncology have improved dramatically over the past couple of decades. As part of a natural progression there recently has been a resurgence of interest in hadron therapy, specifically charged particle therapy, because of the even better dose distributions potentially achievable. In principle, using charged particle beams, radiation dose distributions can be achieved that surpass those possible with even the most sophisticated photon radiation delivery techniques. Certain charged particle beams might possess some biologic advantages in terms of tumor kill potential as well as this dosimetric advantage. The particles under consideration for such clinical applications all belong to the category of particles known as hadrons. This review introduces some of the elementary physics of the various hadron species previously used, currently used or being considered for future use in radiation oncology. PMID:18838888

  5. 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.

  6. Accelerators for charged particle therapy

    NASA Astrophysics Data System (ADS)

    Flanz, Jacob

    2015-04-01

    History has shown that energetic particles can be useful for medical applications. From the time, in 1895 when Roentgen discovered X-rays, and in 1913 when Coolidge developed the vacuum X-ray tube, energetic particles have been an important tool for medicine. Development of the appropriate tool for effective and safe radiotherapy requires an in-depth understanding of the application and constraints. Various solutions are possible and choices must be analyzed on the basis of the suitability for meeting the requirements. Some of the requirements of charged particle therapy are summarized and various accelerator options are described and discussed.

  7. Review of Particle Physics

    NASA Astrophysics Data System (ADS)

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

    2006-07-01

    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 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 110 reviews are many that are new or heavily revised including those on CKM quark-mixing matrix, Vud & Vus, Vcb & Vub, top quark, muon anomalous magnetic moment, extra dimensions, particle detectors, cosmic background radiation, dark matter, cosmological parameters, and big bang cosmology. 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.

  8. Review of Particle Physics

    NASA Astrophysics Data System (ADS)

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

    2008-09-01

    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 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 108 reviews are many that are new or heavily revised including those on CKM quark-mixing matrix, V ud & V us, V cb & V ub, top quark, muon anomalous magnetic moment, extra dimensions, particle detectors, cosmic background radiation, dark matter, cosmological parameters, and big bang cosmology. 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.

  9. 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…

  10. Dose monitoring in particle therapy

    NASA Astrophysics Data System (ADS)

    Faccini, Riccardo; Patera, Vincenzo

    2015-04-01

    Ion therapy is an emerging technique used for the treatment of solid cancers. The monitoring of the dose delivered during such treatments and the on-line knowledge of the Bragg Peak (BP) position is still a matter of research. This paper reviews the current understanding of which radiation is produced during the interaction of the beam with the patient, the corresponding techniques developed to detect it and the level of understanding of the conversion between the emission spectra and the dose profile. It also performs a comparison between the different approaches.

  11. 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.

  12. Massage therapy research review.

    PubMed

    Field, Tiffany

    2014-11-01

    Moderate pressure massage has contributed to many positive effects including increased weight gain in preterm infants, reduced pain in different syndromes including fibromyalgia and rheumatoid arthritis, enhanced attentiveness, reduced depression and enhanced immune function (increased natural killer cells and natural killer cell activity).Surprisingly, these recent studies have not been reviewed, highlighting the need for the current review. When moderate and light pressure massage have been compared in laboratory studies, moderate pressure massage reduced depression, anxiety and heart rate, and it altered EEG patterns, as in a relaxation response. Moderate pressure massage has also led to increased vagal activity and decreased cortisol levels. Functional magnetic resonance imaging data have suggested that moderate pressure massage was represented in several brain regions including the amygdala, the hypothalamus and the anterior cingulate cortex, all areas involved in stress and emotion regulation. Further research is needed to identify underlying neurophysiological and biochemical mechanisms associated with moderate pressure massage. PMID:25172313

  13. 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

  14. Motion in radiotherapy: particle therapy

    NASA Astrophysics Data System (ADS)

    Bert, C.; Durante, M.

    2011-08-01

    Charged particle beam radiotherapy requires dedicated measures to compensate for the dosimetric influence of inter- and intra-fractional target motion. Independent of the delivery technique, these measures have to incorporate the strong influence of the radiological depth on the delivered dose. For scanned beam delivery, interference effects of target motion and scanned beam can further cause under-dosage of the clinical target volume despite using margins. Within the scope of this review, published data with respect to motion management in scattered as well as scanned beam treatment delivery will be summarized. Based on a section covering the dosimetric impact of organ motion, motion management during treatment planning, patient positioning, treatment delivery and treatment validation will be summarized. For scattered beam delivery, the concepts and data are often based on clinical usage since treatment of moving tumors has been performed for several years. In the field of scanned beam delivery, the report focuses on the results of research on countermeasures of the interference effect. Clinical application of these techniques can be expected in the near future.

  15. Veterinary photodynamic therapy: a review.

    PubMed

    Buchholz, Julia; Walt, Heinrich

    2013-12-01

    Whereas in human medicine photodynamic therapy represents a well-known and recognized treatment option for diverse indications, it is still little known and unfortunately not yet established treatment option for pets. Various photosensitizers and light sources have been used and clinical results have been published. The main indication is a frequently occurring skin tumor in cats: in situ carcinoma/squamous cell carcinoma, mainly found in not or only slightly pigmented areas of the head. For early stages of this tumor, promising results have been published, partly using new, selective drugs to decrease light sensitivity after systemic administration and to increase response rates. Other possible indications are urinary tract neoplasia of dogs and equine sarcoids, the latter representing very common tumors in horses where no effective treatment is known so far. This review article summarizes the role of photodynamic therapy in veterinary medicine. PMID:24284083

  16. NCI support for particle therapy: past, present, future.

    PubMed

    Deye, James A

    2012-11-01

    In light of the rising worldwide interest in particle therapy, and proton therapy specifically in the United States, the National Cancer Institute (NCI) is being asked more often about funding for such research and facilities. Many of the questions imply that NCI is naive to the exciting possibilities inherent in particle therapies, and thus they wish to encourage NCI to initiate and underwrite such programs. In fact, NCI has a long track record of support for the translation of hadrons from the physics laboratory to the therapy clinic by way of technology development and scientific investigations of physical and biological processes as well as clinical outcomes. Early work has included continuous funding since 1961 of proton treatments for more than 15,000 patients and facility construction at the Harvard/Massachusetts General Hospital (MGH) site; treatment of 227 patients with the pi-meson facility at Los Alamos between 1974 and 1981; funding of more than $69M for seven neutron therapy centers between 1971 and 1989; many funded projects in boron neutron capture radiation therapy through the present time; and numerous radiobiology projects over the past 50 y. NCI continues to play an active role in the incorporation of protons into randomized clinical trials through the Children's Oncology Group, Radiation Therapy Oncology Group, and the Program Project Grant (P01), which is co-directed by the MGH and MD Anderson Cancer Center. This has required funding development and implementation of guidelines that enable intercomparison of dosimetry and treatment between facilities. NCI has also funded recent efforts to develop new physical processes for the production of particles such as protons. With regard to the future, while it is true that there are no specific funding opportunity announcements directed to particle therapy research, it is also true that NCI remains open to reviewing any research that is compatible with an established mechanism. However, given the very substantial resources that these facilities currently require along with the highly competitive economic environment that now exists, it is clear that scientific review of such grant applications will look to leverage the scientific pursuits that are the NCI mandate with the reality of the clinical practices, just as is the case for photon radiation research. Such leveraging should be enhanced by the growing opportunities and need for international collaborations. On the other hand, these collaborations are complicated by the fact that these particle therapies are now fully reimbursable modalities, which makes it difficult to separate research (the NCI mission) from clinical practice development. This paper seeks to illuminate these new realities in order to encourage the pursuit and funding of the scientific underpinnings of physical methods, radiobiology, and clinical practice with particle therapy. PMID:23032896

  17. Motion in radiotherapy: particle therapy

    Microsoft Academic Search

    C. Bert; M. Durante

    2011-01-01

    Charged particle beam radiotherapy requires dedicated measures to compensate for the dosimetric influence of inter- and intra-fractional target motion. Independent of the delivery technique, these measures have to incorporate the strong influence of the radiological depth on the delivered dose. For scanned beam delivery, interference effects of target motion and scanned beam can further cause under-dosage of the clinical target

  18. Review of Particle Physics

    E-print Network

    Nakamura, Kenzo

    2010-01-01

    and ?(f f ) are the electron and fermion partial widths ofhanded incident electron to produce a fermion f traveling infermions, are their own antiparticles. An electrically charged particle (like the electron)

  19. [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

  20. Pet therapy research: a historical review.

    PubMed

    Hooker, Shirley D; Freeman, Linda Holbrook; Stewart, Pamela

    2002-10-01

    From its unpretentious beginnings in pastoral England to the current interest in scientific research and trials of its use, pet therapy is clearly drawing attention to its benefits. Throughout the 40-year history of pet therapy, nursing and nursing research has been at the very heart. The growing body of research in pet therapy reflects nursing's own evolutionary process. This article reviews the history of pet therapy and discusses the growing body of research illustrating the healing power of animal use. PMID:12465214

  1. Photodynamic therapy in endodontics: a literature review.

    PubMed

    Trindade, Alessandra Cesar; De Figueiredo, José Antônio Poli; Steier, Liviu; Weber, João Batista Blessmann

    2015-03-01

    Recently, several in vitro and in vivo studies demonstrated promising results about the use of photodynamic therapy during root canal system disinfection. However, there is no consensus on a standard protocol for its incorporation during root canal treatment. The purpose of this study was to summarize the results of research on photodynamic therapy in endodontics published in peer-reviewed journals. A review of pertinent literature was conducted using the PubMed database, and data obtained were categorized into sections in terms of relevant topics. Studies conducted in recent years highlighted the antimicrobial potential of photodynamic therapy in endodontics. However, most of these studies were not able to confirm a significant improvement in root canal disinfection for photodynamic therapy as a substitute for current disinfection methods. Its indication as an excellent adjunct to conventional endodontic therapy is well documented, however. Data suggest the need for protocol adjustments or new photosensitizer formulations to enhance photodynamic therapy predictability in endodontics. PMID:25719896

  2. 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.

  3. 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

  4. Modelling and Dosimetry for Alpha-Particle Therapy

    PubMed Central

    Sgouros, George; Hobbs, Robert F.; Song, Hong

    2015-01-01

    As a consequence of the high potency and short range of alpha-particles, radiopharmaceutical therapy with alpha-particle emitting radionuclides is a promising treatment approach that is under active pre-clinical and clinical investigation. To understand and predict the biological effects of alpha-particle radiopharmaceuticals, dosimetry is required at the micro or multi-cellular scale level. At such a scale, highly non-uniform irradiation of the target volume may be expected and the utility of a single absorbed dose value to predict biological effects comes into question. It is not currently possible to measure the pharmacokinetic input required for micro scale dosimetry in humans. Accordingly, pre-clinical studies are required to provide the pharmacokinetic data for dosimetry calculations. The translation of animal data to the human requires a pharmacokinetic model that links macro- and micro-scale pharmacokinetics thereby enabling the extrapolation of micro-scale kinetics from macroscopic measurements. These considerations along with a discussion of the appropriate physical quantity and related units for alpha-particle radiopharmaceutical therapy are examined in this review. PMID:22201712

  5. REVIEW OF PARTICLE PHYSICS* ParticleDataGroup

    E-print Network

    , Office of Science, Office of High Energy and Nuclear Physics, the Division of High Energy Physics; and by the Italian National Institute of Nuclear Physics (INFN). #12;2 Particle Data Group K. Nakamura,1,2 K1 REVIEW OF PARTICLE PHYSICS* ParticleDataGroup Abstract This biennial Review summarizes much

  6. 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.

  7. 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

  8. Acne therapy: A methodologic review

    Microsoft Academic Search

    Harold P. Lehmann; Karen A. Robinson; John S. Andrews; Victoria Holloway; Steven N. Goodman

    2002-01-01

    Background: Acne is a very common problem with significant physical and psychological morbidity. The evidence basis for its treatment had not been systematically reviewed. Therefore, we performed an evidence review to provide researchers a basis for further studies, and to provide clinicians the background needed to interpret current and future clinical studies. Objective: We summarize the methodologic state of the

  9. Targeted ?-particle therapy of bone metastases in prostate cancer.

    PubMed

    Jadvar, Hossein; Quinn, David I

    2013-12-01

    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

  10. 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

  11. Molecular Pathways: Targeted ?-Particle Radiation Therapy

    PubMed Central

    Baidoo, Kwamena E.; Yong, Kwon; Brechbiel, Martin W.

    2012-01-01

    An ?-particle, a 4He nucleus, is exquisitely cytotoxic, and indifferent to many limitations associated with conventional chemo- and radiotherapy. The exquisite cytotoxicity of ? radiation, the result of its high mean energy deposition (high linear energy transfer, LET) and limited range in tissue, provides for a highly controlled therapeutic modality that can be targeted to selected malignant cells (targeted ?-therapy (TAT)) with minimal normal tissue effects. There is a burgeoning interest in the development of TAT that is buoyed by the increasing number of ongoing clinical trials worldwide. The short path length renders ?-emitters suitable for treatment and management of minimal disease such as micrometastases or residual tumor after surgical debulking, hematological cancers, infections, and compartmental cancers such as ovarian cancer or neoplastic meningitis. Yet, despite decades of study of high-LET radiation, the mechanistic pathways of the effects of this modality remain not well defined. The modality is effectively presumed to follow a simple therapeutic mechanism centered on catastrophic double strand (ds) DNA breaks without full examination of the actual molecular pathways and targets that are activated that directly impact cell survival or death. This Molecular Pathways article provides an overview of the mechanisms and pathways that are involved in the response to and repair of TAT induced DNA damage as currently understood. Finally, this article highlights the current state of clinical translation of TAT as well as other high-LET radionuclide radiation therapy using ?-emitters such as 225Ac, 211At, 213Bi, 212Pb and 223Ra. PMID:23230321

  12. A Comprehensive Review of Retinal Gene Therapy

    PubMed Central

    Boye, Shannon E; Boye, Sanford L; Lewin, Alfred S; Hauswirth, William W

    2013-01-01

    Blindness, although not life threatening, is a debilitating disorder for which few, if any treatments exist. Ocular gene therapies have the potential to profoundly improve the quality of life in patients with inherited retinal disease. As such, tremendous focus has been given to develop such therapies. Several factors make the eye an ideal organ for gene-replacement therapy including its accessibility, immune privilege, small size, compartmentalization, and the existence of a contralateral control. This review will provide a comprehensive summary of (i) existing gene therapy clinical trials for several genetic forms of blindness and (ii) preclinical efficacy and safety studies in a variety of animal models of retinal disease which demonstrate strong potential for clinical application. To be as comprehensive as possible, we include additional proof of concept studies using gene replacement, neurotrophic/neuroprotective, optogenetic, antiangiogenic, or antioxidative stress strategies as well as a description of the current challenges and future directions in the ocular gene therapy field to this review as a supplement. PMID:23358189

  13. Acne scarring: a review of cosmetic therapies.

    PubMed

    Lanoue, Julien; Goldenberg, Gary

    2015-05-01

    Acne vulgaris is one of the most commonly encountered skin conditions and frequently is seen in both adolescent and adult populations. Scarring is a common result of acne and may take the form of atrophic or hypertrophic scars. Acne scarring often occurs in highly visible areas such as the face, thus resulting not only in an un-desirable cosmetic appearance but also potential impairment of mental health, social functioning, and overall well-being. There is a wide variety of medical and surgical therapies available for treatment of acne scarring. In this article, we review some of the most commonly used cosmetic therapies for acne scarring, including dermabrasion, laser resurfacing, radiofrequency (RF), subcision, skin needling, punch techniques, chemical peels, soft-tissue augmentation, intralesional therapy, cryotherapy, and silicone dressings, with a focus on cosmetic outcomes. PMID:26057505

  14. NSAIDS in Dermatologic Therapy: Review and Preview

    Microsoft Academic Search

    Edward S. Friedman; Nicole LaNatra; Matthew J. Stiller

    2002-01-01

      Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been an important therapy in the treatment of a large number\\u000a of cutaneous pathologies for more than three decades. Objective: In this retrospective review, we document the use of NSAIDs\\u000a in more than 15 common and uncommon dermatoses, including acne, psoriasis, sunburn, erythema nodosum, cryoglobulinemia, Sweet's\\u000a syndrome, systemic mastocytosis, as well as urticarial, livedoid,

  15. 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…

  16. 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

  17. Emerging targeted therapies for melanoma treatment (Review)

    PubMed Central

    RUSSO, ANGELA; FICILI, BARTOLOMEA; CANDIDO, SAVERIO; PEZZINO, FRANCA MARIA; GUARNERI, CLAUDIO; BIONDI, ANTONIO; TRAVALI, SALVATORE; McCUBREY, JAMES A.; SPANDIDOS, DEMETRIOS A.; LIBRA, MASSIMO

    2014-01-01

    Cutaneous melanoma is an aggressive cancer with a poor prognosis for patients with advanced disease. The identification of several key molecular pathways implicated in the pathogenesis of melanoma has led to the development of novel therapies for this devastating disease. In melanoma, both the Ras/Raf/MEK/ERK (MAPK) and the PI3K/AKT (AKT) signalling pathways are constitutively activated through multiple mechanisms. Targeting various effectors of these pathways with pharmacologic inhibitors may inhibit melanoma cell growth and angiogenesis. Ongoing clinical trials provide hope to improve progression-free survival of patients with advanced melanoma. This review summarizes the most relevant studies focused on the specific action of these new molecular targeted agents. Mechanisms of resistance to therapy are also discussed. PMID:24899250

  18. Emerging targeted therapies for melanoma treatment (review).

    PubMed

    Russo, Angela; Ficili, Bartolomea; Candido, Saverio; Pezzino, Franca Maria; Guarneri, Claudio; Biondi, Antonio; Travali, Salvatore; McCubrey, James A; Spandidos, Demetrios A; Libra, Massimo

    2014-08-01

    Cutaneous melanoma is an aggressive cancer with a poor prognosis for patients with advanced disease. The identification of several key molecular pathways implicated in the pathogenesis of melanoma has led to the development of novel therapies for this devastating disease. In melanoma, both the Ras/Raf/MEK/ERK (MAPK) and the PI3K/AKT (AKT) signalling pathways are constitutively activated through multiple mechanisms. Targeting various effectors of these pathways with pharmacologic inhibitors may inhibit melanoma cell growth and angiogenesis. Ongoing clinical trials provide hope to improve progression-free survival of patients with advanced melanoma. This review summarizes the most relevant studies focused on the specific action of these new molecular targeted agents. Mechanisms of resistance to therapy are also discussed. PMID:24899250

  19. REVIEW Open Access Stereotactic body radiation therapy for abdominal

    E-print Network

    Paris-Sud XI, Université de

    REVIEW Open Access Stereotactic body radiation therapy for abdominal oligometastases: a biological of stereotactic body radiation therapy (SBRT) as an alternative treatment of extracranial oligometastases. New. Keywords: Cancer, Gastrointestinal, Liver, Radiotherapy, Radiation biology, Surgery Introduction

  20. Ultrasound therapy for musculoskeletal disorders: a systematic review

    Microsoft Academic Search

    Daniëlle A. W. M. van der Windt; Geert J. M. G. van der Heijden; Suzanne G. M. van den Berg; Gerben ter Riet; Andrea F. de Winter; Lex M. Bouter

    1999-01-01

    Background: Ultrasound therapy is used frequently to reduce pain and related disability, mainly by physiotherapists. The objective of this review was to evaluate the effectiveness of ultrasound therapy in the treatment of musculoskeletal disorders. Methods: Published reports of randomized clinical trials investigating the effects of ultrasound therapy on pain, disability or range of motion were identified by a systematic search

  1. MIRD Pamphlet No. 22 (Unabridged): Radiobiology and Dosimetry of alpha-Particle Emitters for Targeted Radionuclide Therapy

    SciTech Connect

    Sgouros, George; Roeske, John C.; McDevitt, Michael S.; Palm, Stig; Allen, Barry J.; Fisher, Darrell R.; Brill, Bertrand A.; Song, Hong; Howell, R. W.; Akabani, Gamal

    2010-02-28

    The potential of alpha-particle emitters to treat cancer has been recognized since the early 1900s. Advances in the targeted delivery of radionuclides, in radionuclide conjugation chemistry, and in the increased availability of alpha-emitters appropriate for clinical use have recently led to patient trials of alpha-particle-emitter labeled radiopharmaceuticals. Although alpha-emitters have been studied for many decades, their current use in humans for targeted therapy is an important milestone. The objective of this work is to review those aspects of the field that are pertinent to targeted alpha-particle-emitter therapy and to provide guidance and recommendations for human alpha-particle-emitter dosimetry.

  2. Preterm infant massage therapy research: a review.

    PubMed

    Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria

    2010-04-01

    In this paper, preterm infant massage therapy studies are reviewed. Massage therapy has led to weight gain in preterm infants when moderate pressure massage was provided. In studies on passive movement of the limbs, preterm infants also gained significantly more weight, and their bone density also increased. Research on ways of delivering the massage is also explored including using mothers versus therapists and the added effects of using oils. The use of mothers as therapists was effective in at least one study. The use of oils including coconut oil and safflower oil enhanced the average weight gain, and the transcutaneous absorption of oil also increased triglycerides. In addition, the use of synthetic oil increased vagal activity, which may indirectly contribute to weight gain. The weight gain was associated with shorter hospital stays and, thereby, significant hospital cost savings. Despite these benefits, preterm infant massage is only practiced in 38% of neonatal intensive care units. This may relate to the underlying mechanisms not being well understood. The increases noted in vagal activity, gastric motility, insulin and IGF-1 levels following moderate pressure massage are potential underlying mechanisms. However, those variables combined do not explain all of the variance in weight gain, highlighting the need for additional mechanism studies. PMID:20137814

  3. STFC 2012 PARTICLE PHYSICS REVIEW -EXPERIMENTS AND EXPERIMENTAL CONSOLIDATED GRANTS

    E-print Network

    1 STFC 2012 PARTICLE PHYSICS REVIEW - EXPERIMENTS AND EXPERIMENTAL CONSOLIDATED GRANTS Guidelines................................................................................................. 1 Particle Physics Grants Panel ............................................................................................................................. 3 Part A: 2012 Review of Experimental Particle Physics Consolidated Grants ­ Guidelines

  4. Clinical evidence of particle beam therapy (carbon).

    PubMed

    Kamada, Tadashi

    2012-04-01

    Carbon ion radiotherapy (CIRT) is unique as it possesses well-localized and superior-depth dose distribution in addition to less repairable radiobiological effects. The use of CIRT for various diseases has been explored as clinical trials at the Heavy Ion Medical Accelerator in Chiba (HIMAC), Japan. Since 1994, when the first clinical study of cancer therapy with carbon ion beams was started, about 50 clinical studies have been completed safely and effectively. These studies revealed that intractable cancers such as inoperable bone and soft-tissue sarcomas can be cured safely in a shorter overall treatment time, as can cancers in the head, neck, lung, liver, prostate, and postoperative pelvic recurrence of rectal cancer. The number of patients receiving CIRT has reached 6,000, and the therapy was approved as a highly advanced medical technology in 2003. Based on these experiences, we embarked on the research and development of new-generation beam delivery facilities such as a 3D scanning method with a pencil beam and a compact rotating gantry. Clinical research using pencil-beam scanning has been in operation since May 2011. PMID:22426888

  5. 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

  6. Particle radiation therapy: current status and future potential.

    PubMed

    Parker, R G

    1977-02-01

    Radiation therapy with "heavy" particles offers potential biological and physical advantages compared to irradiation with low LET photons. Clinical studies are in progress with proton beams, which have dosimetric advantages, and fast neutron beams, which have potential biologic advantages. Clinical studies with negative pi mesons and heavy nuclei, which have combined dosimetric and biologic advantages are about to start. PMID:402196

  7. Volatiles in interplanetary dust particles: a review.

    PubMed

    Gibson, E K

    1992-03-25

    The paper presents a review of the volatiles found within interplanetary dust particles. These particles have been shown to represent primitive material from early in the solar system's formation and also may contain records of stellar processes. The organogenic elements (i.e., H, C, N, O, and S) are among the most abundant elements in our solar system, and their abundances, distributions, and isotopic compositions in early solar system materials permit workers to better understand the processes operating early in the evolutionary history of solar system materials. Interplanetary dust particles have a range of elemental compositions, but generally they have been shown to be similar to carbonaceous chondrites, the solar photosphere, Comet Halley's chondritic cores, and matrix materials of chondritic chondrites. Recovery and analysis of interplanetary dust particles have opened new opportunities for analysis of primitive materials, although interplanetary dust particles represent major challenges to the analyst because of their small size. PMID:11537855

  8. 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

  9. Review of Eligibility for Cardiac Resynchronization Therapy.

    PubMed

    Hawkins, Nathaniel M; Bennett, Matthew T; Andrade, Jason G; Virani, Sean A; Krahn, Andrew D; Ignaszewski, Andrew; Toma, Mustafa

    2015-07-15

    Cardiac resynchronization therapy (CRT) is underused. Recent guidelines have expanded indications for CRT to include less severe symptoms but now favor left bundle branch block morphology in patients with moderate QRS prolongation. The prevalence of CRT eligibility according to historical and current guidelines is uncertain. The aim of this review was to identify and synthesize all existing published research reporting the prevalence of CRT eligibility. A systematic review of electronic databases including MEDLINE, Embase, and the Cochrane Library was performed. The primary outcome was the proportion of patients eligible for CRT according to historical and current criteria. Secondary outcomes included the individual components of eligibility (the ejection fraction, symptoms, and QRS duration and morphology). Eligibility estimates were pooled using random-effects models because of marked heterogeneity in between-study variance. Thirty studies were identified. No study used current guideline criteria. On the basis of historical criteria, 11 ± 3% of ambulatory and 9 ± 3% of hospitalized patients are eligible for CRT. However, New York Heart Association class II in current guidelines is at least as frequent as New York Heart Association III or IV. Approximately 1/3 of patients have QRS prolongation, 2/3 of whom have left bundle branch block. Only a few patients have non-left bundle branch block with QRS duration <150 ms. Medical contraindication or ineligibility was rarely assessed. In conclusion, current estimates of need are outdated. Inclusion of milder symptoms potentially doubles the eligible population. Studies in unselected cohorts are needed to accurately define the individual components of eligibility, together with the prevalence and reasons for ineligibility. PMID:25975724

  10. Review Future therapies for hepatitis C

    Microsoft Academic Search

    Jean-Michel Pawlotsky; Robert G Gish

    Although pegylated interferon-? plus ribavirin has become the standard for treating chronic hepatitis C virus infection, a substantial number of patients do not tolerate therapy and require dose reduction or discontin- uation, or do not respond to this combination therapy. Thus, new therapeutic options are needed. An increased knowledge of the hepatitis C virus and an understanding of its replication

  11. [Schema therapy for personality disorders. A critical review].

    PubMed

    Roediger, E; Zarbock, G

    2015-01-01

    In the 10 years since schema therapy was first recognized in Germany it has become widespread among practitioners and has taken a place among the so-called third wave therapies. The overall goal of schema therapy is conceptualizing and treating personality disorders or traits reinforcing axis I disorders. Early maladaptive schemas result from a child's unmet emotional core needs. In a limited reparenting therapy relationship these interpersonal situations are re-experienced and rescripted under the therapist's control. Schema therapy integrates elements of existing models and techniques into a consistent case conceptualization as the bedrock for understanding and changing maladaptive coping behavior. This review article gives a comprehensive overview about the model, the therapy relationship and the application of the experiential techniques in relation to already developed approaches (including the current evidence). The strengths and weaknesses are briefly discussed. PMID:24676551

  12. Photodynamic therapy in neurosurgery: a review

    Microsoft Academic Search

    Herwig Kostron; Alois Obwegeser; Rosanna Jakober

    1996-01-01

    Photodynamic therapy (PDT) has been investigated extensively, both experimentally and clinically, as an adjunctive treatment in the neuro-oncological field. It is based on the more selective accumulation of a photosensitizer in malignant than normal tissue with low systemic toxicity. Subsequent light activation induces photo-oxidation, followed by selective tumour destruction via vascular and direct cellular mechanisms. Malignant brain tumours carry a

  13. Gene therapy for the mucopolysaccharidoses (review)

    Microsoft Academic Search

    Donald S. Anson

    1998-01-01

    Summary The mucopolysaccharidoses (MPS) are a group of lysosomal storage disorders in which the storage material is glycosaminoglycan. Each MPS is caused by the genetic deficiency of a single lysosomal enzyme. Due to the nature of these diseases and the characteristics of the enzymes that are deficient most of the MPS are good candidates for gene therapy. Studies in animal

  14. Review Article Gene Therapy in Cardiac Arrhythmias

    Microsoft Academic Search

    Johnson Francis

    Gene therapy has progressed from a dream to a bedside reality in quite a few human diseases. From its first application in adenosine deaminase deficiency, through the years, its application has evolved to vascular angiogenesis and cardiac arrhythmias. Gene based biological pacemakers using viral vectors or mesenchymal cells tested in animal models hold much promise. Induction of pacemaker activity within

  15. 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

  16. Occupational therapy interventions for shoulder conditions: a systematic review.

    PubMed

    von der Heyde, Rebecca L

    2011-01-01

    The objectives of this systematic review were (1) to identify, evaluate, and synthesize the research literature of relevance to occupational therapy regarding interventions for work-related shoulder conditions and (2) to interpret and apply the research literature to occupational therapy. Twenty-two studies were reviewed for this study-16 of Level I evidence, 2 of Level II evidence, and 4 of Level III evidence. In this systematic review, limited evidence from Level I studies was found to support exercise for shoulder pain; manual therapy and laser for adhesive capsulitis; conservative management of shoulder instability; early intervention without immobilization for specific, nondisplaced proximal humerus fractures; and exercise, joint mobilizations, and laser for patients with shoulder impingement. Further prospective studies are necessary for the delineation of specific surgical and therapeutic variables that facilitate positive outcomes in the treatment of patients with shoulder conditions. PMID:21309367

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

    E-print Network

    STFC 2009 PARTICLE PHYSICS REVIEW - EXPERIMENTS AND EXPERIMENTAL ROLLING GRANTS Guidelines for Applicants CONTENTS PAGE Introduction and Timetable 1 Particle Physics Grants Panel 1 Enquiries 2 Part A ­ 2009 Review of Experimental Particle Physics Rolling Grants 3 ­ Guidelines for Applicants 1 Procedures

  18. A Current Review of the Behavioral Frame of Reference and Its Application to Occupational Therapy

    Microsoft Academic Search

    F. Stein

    1983-01-01

    The historical roots and current trends in behavior therapy and their relationship to psychiatric occupational therapy are reviewed. Key concepts in behavior therapy are defined, case study examples in various psychiatric disorders are cited and examples of applying behavior therapy to occupational therapy are described. Social skills training and a model for developing an occupational therapy program to decrease stress

  19. Hyperbaric Oxygen Therapy for Malignancy: A Review

    Microsoft Academic Search

    Jurstine Daruwalla; Chris Christophi

    2006-01-01

    One unique feature of tumors is the presence of hypoxic regions, which occur predominantly at the tumor center. Hypoxia has\\u000a a major impact on various aspects of tumor cell function and proliferation. Hypoxic tumor cells are relatively insensitive\\u000a to conventional therapy owing to cellular adaptations effected by the hypoxic microenvironment. Recent efforts have aimed\\u000a to alter the hypoxic state and

  20. 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

  1. Wound healing after radiation therapy: Review of the literature

    PubMed Central

    2012-01-01

    Radiation therapy is an established modality in the treatment of head and neck cancer patients. Compromised wound healing in irradiated tissues is a common and challenging clinical problem. The pathophysiology and underlying cellular mechanisms including the complex interaction of cytokines and growth factors are still not understood completely. In this review, the current state of research regarding the pathomechanisms of compromised wound healing in irradiated tissues is presented. Current and possible future treatment strategies are critically reviewed. PMID:23006548

  2. A Comprehensive Literature Review of Mode Deactivation Therapy

    ERIC Educational Resources Information Center

    Houston, Marsha Ann; Apsche, Jack A.; Bass, Christopher K.

    2007-01-01

    In this article literature published on Mode Deactivation Therapy (MDT) was reviewed in depth. Several studies were identified that used a common outcome measure of reduction of physical and sexual aggression, other risk related behaviors. Comparisons of MDT and, other standardized approaches typically used in treating aggression in juveniles,…

  3. 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

  4. Complementary spiritist therapy: systematic review of scientific evidence.

    PubMed

    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

  5. Nanodosimetry-Based Plan Optimization for Particle Therapy

    PubMed Central

    Casiraghi, Margherita; Schulte, Reinhard W.

    2015-01-01

    Treatment planning for particle therapy is currently an active field of research due uncertainty in how to modify physical dose in order to create a uniform biological dose response in the target. A novel treatment plan optimization strategy based on measurable nanodosimetric quantities rather than biophysical models is proposed in this work. Simplified proton and carbon treatment plans were simulated in a water phantom to investigate the optimization feasibility. Track structures of the mixed radiation field produced at different depths in the target volume were simulated with Geant4-DNA and nanodosimetric descriptors were calculated. The fluences of the treatment field pencil beams were optimized in order to create a mixed field with equal nanodosimetric descriptors at each of the multiple positions in spread-out particle Bragg peaks. For both proton and carbon ion plans, a uniform spatial distribution of nanodosimetric descriptors could be obtained by optimizing opposing-field but not single-field plans. The results obtained indicate that uniform nanodosimetrically weighted plans, which may also be radiobiologically uniform, can be obtained with this approach. Future investigations need to demonstrate that this approach is also feasible for more complicated beam arrangements and that it leads to biologically uniform response in tumor cells and tissues. PMID:26167202

  6. 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

  7. 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

  8. 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

  9. Brake wear particle emissions: a review.

    PubMed

    Grigoratos, Theodoros; Martini, Giorgio

    2015-02-01

    Traffic-related sources have been recognized as a significant contributor of particulate matter particularly within major cities. Exhaust and non-exhaust traffic-related sources are estimated to contribute almost equally to traffic-related PM10 emissions. Non-exhaust particles can be generated either from non-exhaust sources such as brake, tyre, clutch and road surface wear or already exist in the form of deposited material at the roadside and become resuspended due to traffic-induced turbulence. Among non-exhaust sources, brake wear can be a significant particulate matter (PM) contributor, particularly within areas with high traffic density and braking frequency. Studies mention that in urban environments, brake wear can contribute up to 55 % by mass to total non-exhaust traffic-related PM10 emissions and up to 21 % by mass to total traffic-related PM10 emissions, while in freeways, this contribution is lower due to lower braking frequency. As exhaust emissions control become stricter, relative contributions of non-exhaust sources-and therefore brake wear-to traffic-related emissions will become more significant and will raise discussions on possible regulatory needs. The aim of the present literature review study is to present the state-of-the-art of the different aspects regarding PM resulting from brake wear and provide all the necessary information in terms of importance, physicochemical characteristics, emission factors and possible health effects. PMID:25318420

  10. Bioethical conflicts of gene therapy: a brief critical review.

    PubMed

    Freire, José Ednésio da Cruz; de Medeiros, Suelen Carneiro; Lopes Neto, Antônio Viana; Monteiro Júnior, José Edvar; Sousa, Antônio Juscelino Sudário; Rocha, Antônio José; de Menezes, Léa Maria Bezerra

    2014-01-01

    Methods and techniques employed in gene therapy are reviewed in parallel with pertinent ethical conflicts. Clinical interventions based on gene therapy techniques preferentially use vectors for the transportation of therapeutic genes, however little is known about the potential risks and damages to the patient. Thus, attending carefully to the clinical complications arising as well as to security is essential. Despite the scientific and technological advances, there are still many uncertainties about the side effects of gene therapy. Moreover, there is a need, above all, to understand the principles of bioethics as both science and ethics, in accordance with its socioecological responsibility, in order to prioritize the health and welfare of man and nature, using properly natural resources and technology. Therefore, it is hard to determine objective results and to which extent the insertion of genes can affect the organism, as well as the ethical implication. PMID:25650850

  11. Peyronie's disease: evaluation and review of nonsurgical therapy.

    PubMed

    Abern, Michael R; Levine, Laurence A

    2009-01-01

    The purpose of our study was to outline the evaluation of the Peyronie's disease (PD) patient and review the available nonsurgical treatments. A review of the literature on oral, intralesional, external energy, iontophoresis, and mechanical therapies for PD was performed. PubMed was utilized to find all published articles, and several meeting abstracts were reviewed for data ahead of publication. Our medical evaluation of the PD patient is described. The published results of available treatment options are reviewed, with recommendation by the authors for appropriate nonsurgical management of PD. There are no available validated questionnaires for PD, but a thorough history and focused physical examination, including measurement of erect penile deformity, will help the clinician make the diagnosis and guide treatment options. Although there are many published reports that show efficacy of nonsurgical therapies for PD, there is a lack of large-scale, multicenter, controlled clinical trials, which makes treatment recommendations difficult. Careful review of the literature does suggest that there are treatment options that make scientific sense and appear to stabilize the disease process, reduce deformity, and improve function. Offering no treatment at all will encourage our patients to pursue alternative treatments that may do harm, and misses the opportunity to do some good. Clearly, further work is necessary to develop safe and effective nonsurgical treatments for PD. PMID:19649505

  12. Electroconvulsive therapy use in adolescents: a systematic review

    PubMed Central

    2013-01-01

    Background Considered as a moment of psychological vulnerability, adolescence is remarkably a risky period for the development of psychopathologies, when the choice of the correct therapeutic approach is crucial for achieving remission. One of the researched therapies in this case is electroconvulsive therapy (ECT). The present study reviews the recent and classical aspects regarding ECT use in adolescents. Methods Systematic review, performed in November 2012, conformed to the PRISMA statement. Results From the 212 retrieved articles, only 39 were included in the final sample. The reviewed studies bring indications of ECT use in adolescents, evaluate the efficiency of this therapy regarding remission, and explore the potential risks and complications of the procedure. Conclusions ECT use in adolescents is considered a highly efficient option for treating several psychiatric disorders, achieving high remission rates, and presenting few and relatively benign adverse effects. Risks can be mitigated by the correct use of the technique and are considered minimal when compared to the efficiency of ECT in treating psychopathologies. PMID:23718899

  13. TOPICAL REVIEW: The physics, biophysics and technology of photodynamic therapy

    NASA Astrophysics Data System (ADS)

    Wilson, Brian C.; Patterson, Michael S.

    2008-05-01

    Photodynamic therapy (PDT) uses light-activated drugs to treat diseases ranging from cancer to age-related macular degeneration and antibiotic-resistant infections. This paper reviews the current status of PDT with an emphasis on the contributions of physics, biophysics and technology, and the challenges remaining in the optimization and adoption of this treatment modality. A theme of the review is the complexity of PDT dosimetry due to the dynamic nature of the three essential components—light, photosensitizer and oxygen. Considerable progress has been made in understanding the problem and in developing instruments to measure all three, so that optimization of individual PDT treatments is becoming a feasible target. The final section of the review introduces some new frontiers of research including low dose rate (metronomic) PDT, two-photon PDT, activatable PDT molecular beacons and nanoparticle-based PDT.

  14. Evaluating the Effectiveness of Family Therapies: An Integrative Review and Analysis

    Microsoft Academic Search

    Mark D. Hazelrigg; Harris M. Cooper; Charles M. Borduin

    1987-01-01

    A number of previous reviews of studies evaluating the effectiveness of family therapy have varied in their conclusions. This review is the first attempt at an integrated statistical analysis of family therapy effectiveness research. Family therapy was found to have positive effects compared with both no-treatment and alternative treatment controls, as measured by family interactions and behavior ratings. Follow-up data

  15. 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.

  16. BOOK REVIEW: The Dynamics of Fluidized Particles

    Microsoft Academic Search

    Roy Jackson

    2001-01-01

    When a bed of rigid particles, supported below by a porous plate, is subjected to an increasing upward flow of air, at first nothing happens. Then as the flow increases, the bed can expand slightly and particles can move in relative motion. At higher velocities, large voids (bubbles) can appear which rise like bubbles to the top of the bed,

  17. 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...

  18. 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.

  19. Heuristic optimization of the scanning path of particle therapy beams.

    PubMed

    Pardo, J; Donetti, M; Bourhaleb, F; Ansarinejad, A; Attili, A; Cirio, R; Garella, M A; Giordanengo, S; Givehchi, N; La Rosa, A; Marchetto, F; Monaco, V; Pecka, A; Peroni, C; Russo, G; Sacchi, R

    2009-06-01

    Quasidiscrete scanning is a delivery strategy for proton and ion beam therapy in which the beam is turned off when a slice is finished and a new energy must be set but not during the scanning between consecutive spots. Different scanning paths lead to different dose distributions due to the contribution of the unintended transit dose between spots. In this work an algorithm to optimize the scanning path for quasidiscrete scanned beams is presented. The classical simulated annealing algorithm is used. It is a heuristic algorithm frequently used in combinatorial optimization problems, which allows us to obtain nearly optimal solutions in acceptable running times. A study focused on the best choice of operational parameters on which the algorithm performance depends is presented. The convergence properties of the algorithm have been further improved by using the next-neighbor algorithm to generate the starting paths. Scanning paths for two clinical treatments have been optimized. The optimized paths are found to be shorter than the back-and-forth, top-to-bottom (zigzag) paths generally provided by the treatment planning systems. The gamma method has been applied to quantify the improvement achieved on the dose distribution. Results show a reduction of the transit dose when the optimized paths are used. The benefit is clear especially when the fluence per spot is low, as in the case of repainting. The minimization of the transit dose can potentially allow the use of higher beam intensities, thus decreasing the treatment time. The algorithm implemented for this work can optimize efficiently the scanning path of quasidiscrete scanned particle beams. Optimized scanning paths decrease the transit dose and lead to better dose distributions. PMID:19610293

  20. Improved Efficacy of ?-Particle–Targeted Radiation Therapy

    PubMed Central

    Milenic, Diane E.; Brady, Erik D.; Garmestani, Kayhan; Albert, Paul S.; Abdulla, Alia; Brechbiel, Martin W.

    2009-01-01

    BACKGROUND Human epidermal growth factor receptor–2 (HER-2) and tumor-associated glycoprotein 72 (TAG-72) have proven to be excellent molecular targets for cancer imaging and therapy. Trastuzumab, which binds to HER-2, is effective in the treatment of disseminated intraperitoneal disease when labeled with 213Bi or 212Pb. 213Bi-humanized CC49 monoclonal antibody (HuCC49?CH2), which binds to TAG-72, inhibits the growth of subcutaneous xenografts. A next logical step to improve therapeutic benefit would be to target tumors with both molecules simultaneously. METHODS Athymic mice bearing intraperitoneal human colon carcinoma xenografts were treated with a combination of trastuzumab and HuCC49?CH2 labeled with 213Bi administered through an intraperitoneal route. The sequence of administration also was examined. RESULTS Before combining the 2 monoclonal antibodies, the effective doses of 213Bi-CC49?CH2 and 213Bi-trastuzumab for the treatment of peritoneal disease were determined to be 500 ?Ci for each labeled antibody. Treatment with 213Bi-HuCC49?CH2 resulted in a median survival of 45 days and was comparable to the median survival achieved with 213Bi-trastuzumab. Each combination provided greater therapeutic efficacy than either of the agents given alone. However, the greatest therapeutic benefit was achieved when 213Bi-HuCC49?CH2 and 213Bi-trastuzumab were coinjected, and a median survival of 147 days was obtained. CONCLUSIONS Dual targeting of 2 distinct molecules in tumors such as TAG-72 and HER-2 with ?-particle radiation resulted in an enhanced, additive, therapeutic benefit. The authors also observed that this radioimmunotherapeutic strategy was well tolerated. PMID:20127951

  1. 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

  2. Acanthamoeba encephalitis: A Case Report and Review of Therapy

    PubMed Central

    Zamora, A.; Henderson, H.; Swiatlo, E.

    2014-01-01

    Background: Acanthamoeba is a rare cause of encephalitis yet is associated with high mortality. Treatment protocols vary greatly and generally include combination therapy across a wide spectrum of antiinfective classes. Case Description: A 63-year-old male who underwent renal transplantation presented 6 months after transplantation with depressed level of consciousness. Imaging of the head with computerized tomography showed an enhancing lesion suspicious for brain abscess. Biopsy of the lesion showed Acanthamoeba cysts. The patient was treated with sulfadiazine, fluconazole, flucytosine, azithromycin, and miltefosine but without success. We review recently published cases of Acanthamoeba encephalitis with an emphasis on treatment protocols and outcomes. Conclusion: Free-living protozoans such as Acanthamoeba are ubiquitous in the environment and should be suspected in immunosuppressed persons who present with central nervous system findings and brain abscess. Biopsy is critical to establish the etiology so that appropriate combination therapy can be deployed. PMID:24991471

  3. Formation of polymer particles with supercritical fluids: A review

    Microsoft Academic Search

    Sang-Do Yeo; Erdogan Kiran

    2005-01-01

    Recent developments on particle formation from polymers using supercritical fluids have been reviewed with an emphasis on articles published during 2000–2003. First, a brief description of the basic operating principles of the various particle formation processes is presented. These include the rapid expansion of supercritical solutions (RESS), the gas antisolvent process (GAS), supercritical antisolvent process (SAS) and its various modifications,

  4. Retrieval of biomedical reviews: a comparative evaluation of online databases for reviews of drug therapy

    Microsoft Academic Search

    Mary Sayers; John Joice; David Bawden

    1990-01-01

    The retrieval of review articles in the biomedical area is examined, by a case study approach, using two test queries, relating to aspects of drug therapy, for a comparative evalua tion of six online databases. It is concluded that a variety of sources must be searched in combination for comprehensive retrieval, lack of indexing of the \\

  5. Spinal manual therapy interventions for pediatric patients: a systematic review

    PubMed Central

    Vaughn, Daniel W; Kenyon, Lisa K; Sobeck, Corey M; Smith, Robyn E

    2012-01-01

    Objective: Although much has been written about the efficacy of manual therapy interventions for adults with headaches or spinal pain, little research has focused on the use of these interventions in pediatric patients. The purpose of this systematic review was to evaluate the evidence for spinal manual therapy (SMT) interventions in patients 4–17 years old with headaches and/or mechanical spinal pain. Methods: A search for relevant studies published in the past 15 years was conducted on MEDLINE, CINAHL, Cochrane Central Register of Randomized Control Trials, PEDro, PubMed, and Sports Discus. Only English language articles were reviewed. Studies had to include at least one outcome measure for pain, function, or quality of life. Studies evaluating post-operative interventions, or those in which the interventions were directed at influencing excessive spinal curvatures, were excluded. Case reports and studies that did not limit analysis of the results to the pediatric population were also excluded. Results: Two randomized control trials and two studies offering lower levels of evidence were identified in the literature search. The latter studies were prospective cohort studies. The four studies were evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. Discussion: There are very little data in the literature to support or refute the use of SMT interventions in pediatric patients. Further research is required to establish a strong evidence-based foundation for use of these interventions in children. PMID:23904755

  6. 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

  7. Disagreement in primary study selection between systematic reviews on negative pressure wound therapy

    Microsoft Academic Search

    Frank Peinemann; Natalie McGauran; Stefan Sauerland; Stefan Lange

    2008-01-01

    BACKGROUND: Primary study selection between systematic reviews is inconsistent, and reviews on the same topic may reach different conclusions. Our main objective was to compare systematic reviews on negative pressure wound therapy (NPWT) regarding their agreement in primary study selection. METHODS: This retrospective analysis was conducted within the framework of a systematic review (a full review and a subsequent rapid

  8. 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

  9. Emory Researchers Publish Review on Targeting Protein-Protein Interactions for Cancer Therapy

    Cancer.gov

    Published on Office of Cancer Genomics (https://ocg.cancer.gov) Home > Emory Researchers Publish Review on Targeting Protein-Protein Interactions for Cancer Therapy Emory Researchers Publish Review on Targeting Protein-Protein Interactions for Cancer

  10. Emory Researchers Publish Review on Targeting Protein-Protein Interactions for Cancer Therapy

    Cancer.gov

    Published on Office of Cancer Genomics (http://ocg.cancer.gov) Home > Emory Researchers Publish Review on Targeting Protein-Protein Interactions for Cancer Therapy Emory Researchers Publish Review on Targeting Protein-Protein Interactions for Cancer

  11. The Outcomes of Manipulation or Mobilization Therapy Compared with Physical Therapy or Exercise for Neck Pain: A Systematic Review

    PubMed Central

    Schroeder, Josh; Kaplan, Leon; Fischer, Dena J.; Skelly, Andrea C.

    2013-01-01

    Study Design?Systematic review. Study Rationale?Neck pain is a prevalent condition. Spinal manipulation and mobilization procedures are becoming an accepted treatment for neck pain. However, data on the effectiveness of these treatments have not been summarized. Objective?To compare manipulation or mobilization of the cervical spine to physical therapy or exercise for symptom improvement in patients with neck pain. Methods?A systematic review of the literature was performed using PubMed, the National Guideline Clearinghouse Database, and bibliographies of key articles, which compared spinal manipulation or mobilization therapy with physical therapy or exercise in patients with neck pain. Articles were included based on predetermined criteria and were appraised using a predefined quality rating scheme. Results?From 197 citations, 7 articles met all inclusion and exclusion criteria. There were no differences in pain improvement when comparing spinal manipulation to exercise, and there were inconsistent reports of pain improvement in subjects who underwent mobilization therapy versus physical therapy. No disability improvement was reported between treatment groups in studies of acute or chronic neck pain patients. No functional improvement was found with manipulation therapy compared with exercise treatment or mobilization therapy compared with physical therapy groups in patients with acute pain. In chronic neck pain subjects who underwent spinal manipulation therapy compared to exercise treatment, results for short-term functional improvement were inconsistent. Conclusion?The data available suggest that there are minimal short- and long-term treatment differences in pain, disability, patient-rated treatment improvement, treatment satisfaction, health status, or functional improvement when comparing manipulation or mobilization therapy to physical therapy or exercise in patients with neck pain. This systematic review is limited by the variability of treatment interventions and lack of standardized outcomes to assess treatment benefit. PMID:24436697

  12. 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

  13. A review on vital pulp therapy in primary teeth.

    PubMed

    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

  14. The benefits and risks of testosterone replacement therapy: a review.

    PubMed

    Bassil, Nazem; Alkaade, Saad; Morley, John E

    2009-06-01

    Increased longevity and population aging will increase the number of men with late onset hypogonadism. It is a common condition, but often underdiagnosed and undertreated. The indication of testosterone-replacement therapy (TRT) treatment requires the presence of low testosterone level, and symptoms and signs of hypogonadism. Although controversy remains regarding indications for testosterone supplementation in aging men due to lack of large-scale, long-term studies assessing the benefits and risks of testosterone-replacement therapy in men, reports indicate that TRT may produce a wide range of benefits for men with hypogonadism that include improvement in libido and sexual function, bone density, muscle mass, body composition, mood, erythropoiesis, cognition, quality of life and cardiovascular disease. Perhaps the most controversial area is the issue of risk, especially possible stimulation of prostate cancer by testosterone, even though no evidence to support this risk exists. Other possible risks include worsening symptoms of benign prostatic hypertrophy, liver toxicity, hyperviscosity, erythrocytosis, worsening untreated sleep apnea or severe heart failure. Despite this controversy, testosterone supplementation in the United States has increased substantially over the past several years. The physician should discuss with the patient the potential benefits and risks of TRT. The purpose of this review is to discuss what is known and not known regarding the benefits and risks of TRT. PMID:19707253

  15. Blood pressure targets for vasopressor therapy: a systematic review.

    PubMed

    D'Aragon, Frederick; Belley-Cote, Emilie P; Meade, Maureen O; Lauzier, François; Adhikari, Neill K J; Briel, Matthias; Lalu, Manoj; Kanji, Salmaan; Asfar, Pierre; Turgeon, Alexis F; Fox-Robichaud, Alison; Marshall, John C; Lamontagne, François

    2015-06-01

    Physicians often prescribe vasopressors to correct pathological vasodilation and improve tissue perfusion in patients with septic shock, but the evidence to inform practice on vasopressor dosing is weak. We undertook a systematic review of clinical studies evaluating different blood pressure targets for the dosing of vasopressors in septic shock. We searched MEDLINE, EMBASE, CENTRAL (to November 2013), reference lists from included articles, and trial registries for randomized controlled trials (RCTs) and observational and crossover intervention studies comparing different blood pressure targets for vasopressor therapy in septic shock. Two reviewers independently selected eligible studies and extracted data on standardized forms. We identified 2 RCTs and 10 crossover trials but no observational studies meeting our criteria. Only one RCT measured clinical outcomes after comparing mean arterial pressure targets of 80 to 85 mmHg versus 65 to 70 mmHg. There was no effect on 28-day mortality, but confidence intervals were wide (hazard ratio, 95% confidence interval [95% CI] 0.84 - 1.38). In contrast, this intervention was associated with a greater risk of atrial fibrillation (relative risk, 2.36; 95% CI, 1.18 - 4.72) and a lower risk of renal replacement therapy in hypertensive patients (relative risk, 0.75; 95% CI, 0.57 - 1.0). Crossover trials suggest that achieving higher blood pressure targets by increasing vasopressor doses increases heart rate and cardiac index with no effect on serum lactate. Our findings underscore the paucity of clinical evidence to guide the administration of vasopressors in critically ill patients with septic shock. Further rigorous research is needed to establish an evidence base for vasopressor administration in this population. PMID:25895147

  16. 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

  17. Heavy charged particle radiobiology: using enhanced biological effectiveness and improved beam focusing to advance cancer therapy.

    PubMed

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

    2011-06-01

    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

  18. 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

  19. A modern literature review of carbon monoxide poisoning theories, therapies, and potential targets for therapy advancement.

    PubMed

    Roderique, Joseph D; Josef, Christopher S; Feldman, Michael J; Spiess, Bruce D

    2015-08-01

    The first descriptions of carbon monoxide (CO) and its toxic nature appeared in the literature over 100 years ago in separate publications by Drs. Douglas and Haldane. Both men ascribed the deleterious effects of this newly discovered gas to its strong interaction with hemoglobin. Since then the adverse sequelae of CO poisoning has been almost universally attributed to hypoxic injury secondary to CO occupation of oxygen binding sites on hemoglobin. Despite a mounting body of literature suggesting other mechanisms of injury, this pathophysiology and its associated oxygen centric therapies persists. This review attempts to elucidate the remarkably complex nature of CO as a gasotransmitter. While CO's affinity for hemoglobin remains undisputed, new research suggests that its role in nitric oxide release, reactive oxygen species formation, and its direct action on ion channels is much more significant. In the course of understanding the multifaceted character of this simple molecule it becomes apparent that current oxygen based therapies meant to displace CO from hemoglobin may be insufficient and possibly harmful. Approaching CO as a complex gasotransmitter will help guide understanding of the complex and poorly understood sequelae and illuminate potentials for new treatment modalities. PMID:25997893

  20. Pain and trauma in negative pressure wound therapy: a review.

    PubMed

    Upton, Dominic; Andrews, Abbye

    2015-02-01

    Negative pressure wound therapy (NPWT) is considered an effective wound treatment, but there are a number of issues that need to be addressed for improvements to be made. This review aimed to explore the literature relating to the pain and skin trauma that may be experienced during NPWT. A literature search was carried out using the following databases: Academic Search Complete, CINAHL, PsychINFO, MEDLINE and PsyARTICLES. A total of 30 articles were reviewed. Studies reported varying levels of pain in patients undergoing NPWT, with certain treatment factors affecting the level of pain, such as the NPWT system and the dressing/filler used. Similarly, although there is much less research exploring NPWT-related trauma, findings suggest that dressing and filler type may impact on whether trauma occurs. However, further research needs to consider the different stages of NPWT and how pain and trauma can be minimised during the whole procedure. As both pain and skin trauma impact on the patient's well-being and on wound healing, it is essential that research further explores the factors that may affect the experience of pain and trauma, so as to inform developments in wound care. PMID:23489350

  1. 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

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

    NASA Astrophysics Data System (ADS)

    Hofmann, K. M.; Schell, S.; Wilkens, J. J.

    2013-07-01

    Laser-accelerated particles can provide a promising opportunity for radiation therapy of cancer. Potential advantages arise from combining a compact, cost-efficient treatment unit with the physical advantages in dose delivery of charged particle beams. We consider different dose delivery schemes and the required devices to design a possible treatment unit. The secondary radiation produced in several beam line elements remains a challenge to be addressed.

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

    SciTech Connect

    Hofmann, K. M.; Schell, S.; Wilkens, J. J. [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München (Germany)] [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München (Germany)

    2013-07-26

    Laser-accelerated particles can provide a promising opportunity for radiation therapy of cancer. Potential advantages arise from combining a compact, cost-efficient treatment unit with the physical advantages in dose delivery of charged particle beams. We consider different dose delivery schemes and the required devices to design a possible treatment unit. The secondary radiation produced in several beam line elements remains a challenge to be addressed.

  4. Overview of PAMELA project : An approach to particle therapy using NS-FFAG

    Microsoft Academic Search

    Takeichiro Yokoi

    2009-01-01

    PAMELA(Particle Accelerator for Medical Application) aims to design a particle therapy facility using non-scaling FFAG(Fixed Field Alternating Gradient) accelerator. A newly proposed lattice design and new type of combined function magnet provide the accelerator flexible tuneablity of operating point and various operation mode. A remarkable features for a fixed field accelerator is its high repetition rate, about 1kHz and energy

  5. Supercritical Fluid Particle Design of DPI Formulations (Review).

    PubMed

    Sun, Yongda

    2015-01-01

    Pulmonary drug delivery (PDD) with dry powder inhaler (DPI) has rapidly developed for the treatment of local and systemic diseases, which targets the delivery of fine drug particles into the deep lung surface by combining technologies of fine drug particle formulation, small dose packaging and suitable inhaler, where by each contributes to the overall aerodynamic performance. The basic requirements of DPI formulation are an excellent aerodynamic performance, including particle size distribution within 1-5 ?m, suitable morphology and electrostatic charge, low surface energy, high deposition rate and long shelf life stability. The strategy of DPI formulation is shifting from carrier-based to carrier free, from single drug to drug combination, from microparticles to nanoparticles and from small molecules to biomacromolecules. Making such DPI formulation is a big challenge for conventional pharmaceutical techniques. Fortunately, an emerging technology of supercritical fluid particle design (SCF PD) provides a powerful platform for DPI formulation since it runs single step operation at near ambient temperature to minimize the potential damage of delicate active ingredients and to ensure the consistency of the DPI formulation. Combining with our research experiences in DPI formulation of budesonide and recombinant human insulin, this review focus on the most recent development of DPI formulation using SCF PD technology, which can well control and tune the particle size, morphology and surface properties through different design routes (nanoparticles or microparticles, polymorphic particles, composite particles and bio-drug particles), and hence enable prominent enhancement aerodynamic performance and pulmonary deposition of such inhaled dry powders. Also considered within this review is the progress of the industrialization of SCF PD processes for DPI formulation. PMID:25876911

  6. Connection of European particle therapy centers and generation of a common particle database system within the European ULICE-framework

    PubMed Central

    2012-01-01

    Background To establish a common database on particle therapy for the evaluation of clinical studies integrating a large variety of voluminous datasets, different documentation styles, and various information systems, especially in the field of radiation oncology. Methods We developed a web-based documentation system for transnational and multicenter clinical studies in particle therapy. 560 patients have been treated from November 2009 to September 2011. Protons, carbon ions or a combination of both, as well as a combination with photons were applied. To date, 12 studies have been initiated and more are in preparation. Results It is possible to immediately access all patient information and exchange, store, process, and visualize text data, any DICOM images and multimedia data. Accessing the system and submitting clinical data is possible for internal and external users. Integrated into the hospital environment, data is imported both manually and automatically. Security and privacy protection as well as data validation and verification are ensured. Studies can be designed to fit individual needs. Conclusions The described database provides a basis for documentation of large patient groups with specific and specialized questions to be answered. Having recently begun electronic documentation, it has become apparent that the benefits lie in the user-friendly and timely workflow for documentation. The ultimate goal is a simplification of research work, better study analyses quality and eventually, the improvement of treatment concepts by evaluating the effectiveness of particle therapy. PMID:22828013

  7. A review of family therapy as an effective intervention for anorexia nervosa in adolescents.

    PubMed

    Smith, Amanda; Cook-Cottone, Catherine

    2011-12-01

    This review examines family therapy as an effective intervention for Anorexia Nervosa (AN) in adolescents. An electronic and manual literature search was conducted. Studies pertaining to family therapy in the treatment of AN and specifically, the Maudsley Method/Family-Based Treatment were identified. A limited number of randomized control trials exist implicating family therapy. Of the existent studies, methodological limitations pertaining to small, homogeneous sample sizes are evident. Despite the limited number of studies, family therapy appears to illustrate probable efficacy. Additional research and funding are necessary to fully support family therapy in the treatment of AN in adolescents. PMID:22002673

  8. Systematic review of overactive bladder therapy in females

    PubMed Central

    Cardozo, Linda

    2011-01-01

    Although the prevalence of overactive bladder (OAB) is similar in both male and female populations, females have a greater tendency to seek medical advice regarding their symptoms. A review of the evidence of therapy among women shows that a variety of modalities has been shown to be effective for symptom improvement in women with OAB. Bladder retraining/re-education should be considered for all women with OAB. With respect to first-line pharmacotherapy with antimuscarinic agents, the development of extended release preparations, bladder selective M3 antagonists and alternative routes of delivery, have improved compliance and persistence. Other pharmacotherapeutic options with potential for providing benefit include antidepressants, vasopressin analogues, alpha-adrenoceptor antagonists and beta-adrenoceptor agonists. There are also a number of newer agents currently being investigated, including calcium channel blocking agents, potassium channel opening drugs, beta agonists and neurokinin receptor antagonists. Intravesical injections of botulinum toxin may be an alternative, while surgery can be considered for truly intractable cases. PMID:21989527

  9. 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

  10. 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

  11. 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

  12. Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises

    PubMed Central

    Song, Hyun Seok; Kim, Ji Soo

    2011-01-01

    Vestibular rehabilitation therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptation and substitution. The goals of VRT are 1) to enhance gaze stability, 2) to enhance postural stability, 3) to improve vertigo, and 4) to improve activities of daily living. VRT facilitates vestibular recovery mechanisms: vestibular adaptation, substitution by the other eye-movement systems, substitution by vision, somatosensory cues, other postural strategies, and habituation. The key exercises for VRT are head-eye movements with various body postures and activities, and maintaining balance with a reduced support base with various orientations of the head and trunk, while performing various upper-extremity tasks, repeating the movements provoking vertigo, and exposing patients gradually to various sensory and motor environments. VRT is indicated for any stable but poorly compensated vestibular lesion, regardless of the patient's age, the cause, and symptom duration and intensity. Vestibular suppressants, visual and somatosensory deprivation, immobilization, old age, concurrent central lesions, and long recovery from symptoms, but there is no difference in the final outcome. As long as exercises are performed several times every day, even brief periods of exercise are sufficient to facilitate vestibular recovery. Here the authors review the mechanisms and the key exercises for each of the VRT goals. PMID:22259614

  13. 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 and life review activity. This support system consists of an interactive tabletop display and interface system. On the reminiscence and life review activity, a therapist puts pictures on the table so

  14. Physical Therapy Interventions for Patients With Osteoarthritis of the Knee: An Overview of Systematic Reviews

    Microsoft Academic Search

    Gro Jamtvedt; Kristin Thuve Dahm; Anne Christie; Rikke H Moe; Espen Haavardsholm; Inger Holm; Kåre B Hagen

    Patients with osteoarthritis of the knee are commonly treated by physical therapists. Practice should be informed by updated evidence from systematic reviews. The purpose of this article is to summarize the evidence from systematic reviews on the effectiveness of physical therapy for patients with knee osteoarthritis. Systematic reviews published between 2000 and 2007 were identified by a comprehensive literature search.

  15. 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

  16. Insulin therapy and acute kidney injury in critically ill patients—a systematic review

    Microsoft Academic Search

    George Thomas; Maria C. Rojas; Scott K. Epstein; Ethan M. Balk; Orfeas Liangos; Bertrand L. Jaber

    2007-01-01

    Background. Intensive insulin therapy has been found to reduce mortality in some critically ill patients. We performed a systematic review and meta-analysis to ascertain the effect of intensive insulin therapy on the incidence of acute kidney injury (AKI) in adult critically ill patients. Methods. We searched MEDLINE, SCOPUS and the Cochrane Central Register of Controlled Trials for studies that compared

  17. Acceptance and Commitment Therapy for Psychological and Physiological Illnesses: A Systematic Review for Social Workers

    ERIC Educational Resources Information Center

    Montgomery, Katherine L.; Kim, Johnny S.; Franklin, Cynthia

    2011-01-01

    Social workers provide services to a variety of clients and are challenged with finding interventions that meet the multifaceted needs of diverse populations. Acceptance and commitment therapy (ACT) is becoming an increasingly popular therapy that offers flexibility and effectiveness in treating challenging cases. The purpose of this review is to…

  18. 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

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

    PubMed

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

    2014-05-10

    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. Concise review: stem cells as an emerging platform for antibody therapy of cancer.

    PubMed

    Frank, Richard T; Najbauer, Joseph; Aboody, Karen S

    2010-11-01

    Monoclonal antibodies are important tools for cancer therapy, however, three factors limit their effectiveness: toxicity, poor tumor penetration, and inability to cross the blood-brain barrier. This review discusses the emerging field of stem cell-mediated antibody delivery and how this approach may improve antibody therapy of cancer by overcoming these obstacles. PMID:21089119

  1. Concise Review: Stem Cells As an Emerging Platform for Antibody Therapy of Cancer

    PubMed Central

    Frank, Richard T; Najbauer, Joseph; Aboody, Karen S

    2010-01-01

    Monoclonal antibodies are important tools for cancer therapy, however, three factors limit their effectiveness: toxicity, poor tumor penetration, and inability to cross the blood-brain barrier. This review discusses the emerging field of stem cell-mediated antibody delivery and how this approach may improve antibody therapy of cancer by overcoming these obstacles. STEM CELLS 2010;28:2084–2087 PMID:21089119

  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. 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…

  4. 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

  5. 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.

  6. 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,

  7. A Critical Review of Alpha Radionuclide Therapy—How to Deal with Recoiling Daughters?

    PubMed Central

    de Kruijff, Robin M.; Wolterbeek, Hubert T.; Denkova, Antonia G.

    2015-01-01

    This review presents an overview of the successes and challenges currently faced in alpha radionuclide therapy. Alpha particles have an advantage in killing tumour cells as compared to beta or gamma radiation due to their short penetration depth and high linear energy transfer (LET). Touching briefly on the clinical successes of radionuclides emitting only one alpha particle, the main focus of this article lies on those alpha-emitting radionuclides with multiple alpha-emitting daughters in their decay chain. While having the advantage of longer half-lives, the recoiled daughters of radionuclides like 224Ra (radium), 223Ra, and 225Ac (actinium) can do significant damage to healthy tissue when not retained at the tumour site. Three different approaches to deal with this problem are discussed: encapsulation in a nano-carrier, fast uptake of the alpha emitting radionuclides in tumour cells, and local administration. Each approach has been shown to have its advantages and disadvantages, but when larger activities need to be used clinically, nano-carriers appear to be the most promising solution for reducing toxic effects, provided there is no accumulation in healthy tissue. PMID:26066613

  8. A Critical Review of Alpha Radionuclide Therapy-How to Deal with Recoiling Daughters?

    PubMed

    de Kruijff, Robin M; Wolterbeek, Hubert T; Denkova, Antonia G

    2015-01-01

    This review presents an overview of the successes and challenges currently faced in alpha radionuclide therapy. Alpha particles have an advantage in killing tumour cells as compared to beta or gamma radiation due to their short penetration depth and high linear energy transfer (LET). Touching briefly on the clinical successes of radionuclides emitting only one alpha particle, the main focus of this article lies on those alpha-emitting radionuclides with multiple alpha-emitting daughters in their decay chain. While having the advantage of longer half-lives, the recoiled daughters of radionuclides like 224Ra (radium), 223Ra, and 225Ac (actinium) can do significant damage to healthy tissue when not retained at the tumour site. Three different approaches to deal with this problem are discussed: encapsulation in a nano-carrier, fast uptake of the alpha emitting radionuclides in tumour cells, and local administration. Each approach has been shown to have its advantages and disadvantages, but when larger activities need to be used clinically, nano-carriers appear to be the most promising solution for reducing toxic effects, provided there is no accumulation in healthy tissue. PMID:26066613

  9. 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

  10. 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

  11. 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

  12. Analytical expressions for stopping-power ratios relevant for accurate dosimetry in particle therapy

    Microsoft Academic Search

    Armin Lühr; David C. Hansen; Oliver Jäkel; Nikolai Sobolevsky; Niels Bassler

    2010-01-01

    In particle therapy, knowledge of the stopping-power ratios (STPRs) of the\\u000aion beam for air and water is necessary for accurate ionization chamber\\u000adosimetry. Earlier work has investigated the STPRs for pristine carbon ion\\u000abeams, but here we expand the calculations to a range of ions (1 <= z <= 18) as\\u000awell as spread out Bragg peaks (SOBPs) and

  13. Magnets applied to acupuncture points as therapy – a literature review

    Microsoft Academic Search

    Agatha P Colbert; James Cleaver; Kimberly Ann Brown; Noelle Harling; Yuting Hwang; Heather C Schiffke; John Brons; Youping Qin

    2008-01-01

    Objectives To summarise the acu-magnet therapy literature and determine if the evidence justifies further investigation of acu-magnet therapy for specific clinical indications.Methods Using various search strategies, a professional librarian searched six electronic databases (PubMed, AMED, Science Direct College Edition, China Academic Journals, Acubriefs, and the in-house Journal Article Index maintained by the Oregon College of Oriental Medicine Library). English and

  14. Physiological, psychological and performance effects of massage therapy in sport: a review of the literature

    Microsoft Academic Search

    Brian J. Hemmings

    2001-01-01

    Objectives: Massage is widely used by the athletic population for a variety of purposes such as injury prevention, recovery from fatigue, relaxation, and to increase performance. This paper reviews the scientific literature on the use and effects of massage therapy in sport. Specifically, the review addresses physiological, psychological and performance effects. Method: A literature search was conducted using Medline, Psychlit

  15. A Systematic Review of Directly Applied Biologic Therapies for Acute Spinal Cord Injury

    PubMed Central

    Okon, Elena B.; Plunet, Ward; Baptiste, Darryl; Fouad, Karim; Hillyer, Jessica; Weaver, Lynne C.; Fehlings, Michael G.; Tetzlaff, Wolfram

    2011-01-01

    Abstract An increasing number of therapies for spinal cord injury (SCI) are emerging from the laboratory and seeking translation into human clinical trials. Many of these are administered as soon as possible after injury with the hope of attenuating secondary damage and maximizing the extent of spared neurologic tissue. In this article, we systematically reviewed the available preclinical research on such neuroprotective therapies that are administered in a non-invasive manner for acute SCI. Specifically, we reviewed treatments that have a relatively high potential for translation due to the fact that they are already used in human clinical applications or are available in a form that could be administered to humans. These included: erythropoietin, NSAIDs, anti-CD11d antibodies, minocycline, progesterone, estrogen, magnesium, riluzole, polyethylene glycol, atorvastatin, inosine, and pioglitazone. The literature was systematically reviewed to examine studies in which an in vivo animal model was utilized to assess the efficacy of the therapy in a traumatic spinal cord injury paradigm. Using these criteria, 122 studies were identified and reviewed in detail. Wide variations exist in the animal species, injury models, and experimental designs reported in the preclinical literature on the therapies reviewed. The review highlights the extent of investigation that has occurred in these specific therapies, and points out gaps in our knowledge that would be potentially valuable prior to human translation. PMID:20082560

  16. Family therapy in the Forbidden City: a review of Chinese journals from 1978 to 2006.

    PubMed

    Sim, Timothy; Hu, Chiyi

    2009-12-01

    This article provides a glimpse into the development of family therapy in China, by reviewing family therapy articles written in Chinese and published in journals in China that are not, therefore, readily accessible to the international community. A content analysis of journals published between 1978 and 2006 revealed 199 family therapy articles in 109 Chinese journals. Most of the studies were conducted by psychiatry or medical professionals, and were based on general systems theory or a systemic family therapy model. The articles focused on the promotion of family therapy theories and interventions in China, but did not specify the application of theory to specific clientele or symptoms. After the year 2000, a threefold increase in the number of family therapy publications was noted. These papers included the introduction of additional theories, but did not include critical assessment of the applicability of Western family therapy models to Chinese families. The researchers noted an absence of articles that identified Chinese approaches to family therapy, and a paucity of papers on gender, professional reflection, and the therapy process. The article concludes that there is room for improvement in the quality of family therapy publications in China, and that gains may be made by interdisciplinary collaboration among academics and practitioners. PMID:19930439

  17. Conceptual design of a nonscaling fixed field alternating gradient accelerator for protons and carbon ions for charged particle therapy

    NASA Astrophysics Data System (ADS)

    Peach, K. J.; Aslaninejad, M.; Barlow, R. J.; Beard, C. D.; Bliss, N.; Cobb, J. H.; Easton, M. J.; Edgecock, T. R.; Fenning, R.; Gardner, I. S. K.; Hill, M. A.; Owen, H. L.; Johnstone, C. J.; Jones, B.; Jones, T.; Kelliher, D. J.; Khan, A.; Machida, S.; McIntosh, P. A.; Pattalwar, S.; Pasternak, J.; Pozimski, J.; Prior, C. R.; Rochford, J.; Rogers, C. T.; Seviour, R.; Sheehy, S. L.; Smith, S. L.; Strachan, J.; Tygier, S.; Vojnovic, B.; Wilson, P.; Witte, H.; Yokoi, T.

    2013-03-01

    The conceptual design for a nonscaling fixed field alternating gradient accelerator suitable for charged particle therapy (the use of protons and other light ions to treat some forms of cancer) is described.

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

    SciTech Connect

    Levy, Richard P. [Department of Radiation Medicine, Loma Linda University Medical Center, Loma Linda, CA 92354 (United States); Blakely, Eleanor A. [Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Chu, William T. [Acceleraror and Fusion Research Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Coutrakon, George B. [Department of Physics, Northern Illinois University, DeKalb, IL 60115 (United States); Hug, Eugen B. [Center for Proton Radiation Therapy, Paul Scherrer Institut, 5232 Villigen (Switzerland); Kraft, Gerhard [Biophysics Research Group, Gesellschaft fuer Schwerionenforschung, 64291 Darmstadt (Germany); Tsujii, Hirohiko [Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba 263-8555 (Japan)

    2009-03-10

    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.

  19. 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.

  20. 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

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

    SciTech Connect

    Ying, C. K. [Advanced Medical and Dental Institute, AMDI, Universiti Sains Malaysia, Penang, Malaysia and School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu (Malaysia); Kamil, W. A. [Advanced Medical and Dental Institute, AMDI, Universiti Sains Malaysia, Penang, Malaysia and Radiology Department, Hospital USM, Kota Bharu (Malaysia); Shuaib, I. L. [Advanced Medical and Dental Institute, AMDI, Universiti Sains Malaysia, Penang (Malaysia); Matsufuji, Naruhiro [Research Centre of Charged Particle Therapy, National Institute of Radiological Sciences, NIRS, Chiba (Japan)

    2014-02-12

    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.

  2. 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.

  3. A systematic review of orofacial pain in patients receiving cancer therapy

    Microsoft Academic Search

    Joel B. Epstein; Catherine Hong; Richard M. Logan; Andrei Barasch; Sharon M. Gordon; Lorree Oberlee-Edwards; Deborah McGuire; Joel J. Napenas; Linda S. Elting; Fred K. L. Spijkervet; Michael T. Brennan

    2010-01-01

    Purpose  We present the findings of a structured systematic review of the literature assessing orofacial pain induced by malignant\\u000a disease and\\/or its therapy (excluding mucositis). This evaluation of the literature published after the 1989 NIH Development\\u000a Consensus conference on the oral complications of cancer therapies is an effort to assess the prevalence of pain, quality\\u000a of life and economic impact, and

  4. Spontaneous hemarthrosis following fibrinolytic therapy for acute myocardial infarction: a case report and literature review.

    PubMed

    Ramadan, Mahmoud M; Khan, Iqbal S; Mahdi, Ousama

    2014-01-01

    Background Despite the widespread use of fibrinolytic therapy and the numerous reports on its bleeding complications, spontaneous hemarthrosis following fibrinolytic therapy is quite rare. Case Report We describe in this report a patient with no previous history of articular disease who developed a spontaneous right knee bloody effusion following fibrinolytic therapy using rt-PA for acute ST-elevation myocardial infarction. Furthermore, we provide a review of all cases of spontaneous hemarthrosis documented so far in the literature. Conclusions Several pre-existing joint diseases may predispose to hemarthrosis following fibrinolytic therapy, even in patients who deny previous or current articular disorders. Therefore, hemorrhage should be considered in the differential diagnosis of mono-arthritis following fibrinolytic therapy for STEMI. PMID:25417208

  5. 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…

  6. 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

  7. 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

  8. The South African National Accelerator Centre: particle therapy and isotope production programmes

    NASA Astrophysics Data System (ADS)

    Jones, D. T. L.; Mills, S. J.

    1998-06-01

    The National Accelerator Centre (NAC) provides facilities for basic and applied research, radioisotope production and particle therapy. To date, 851 patients have been treated on the 66 MeV p+Be isocentric neutron therapy unit while 191 patients have been treated (mainly for intracranial conditions) on the 200 MeV horizontal proton beam facility. A variety of radioisotopes such as 67Ga, 81Rb/ 81Kr, 111In, 123I, and 201Tl are produced on a regular weekly basis, and more than 1000 consignments of radiopharmaceuticals prepared from these radioisotopes are supplied to more than 30 hospitals and private practices throughout South Africa each year. Some non-medical radioisotopes are also produced.

  9. 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

  10. 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.

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. Robot therapy: a new approach for mental healthcare of the elderly - a mini-review.

    PubMed

    Shibata, Takanori; Wada, Kazuyoshi

    2011-01-01

    Mental healthcare of elderly people is a common problem in advanced countries. Recently, high technology has developed robots for use not only in factories but also for our living environment. In particular, human-interactive robots for psychological enrichment, which provide services by interacting with humans while stimulating their minds, are rapidly spreading. Such robots not only simply entertain but also render assistance, guide, provide therapy, educate, enable communication, and so on. Robot therapy, which uses robots as a substitution for animals in animal-assisted therapy and activity, is a new application of robots and is attracting the attention of many researchers and psychologists. The seal robot named Paro was developed especially for robot therapy and was used at hospitals and facilities for elderly people in several countries. Recent research has revealed that robot therapy has the same effects on people as animal therapy. In addition, it is being recognized as a new method of mental healthcare for elderly people. In this mini review, we introduce the merits and demerits of animal therapy. Then we explain the human-interactive robot for psychological enrichment, the required functions for therapeutic robots, and the seal robot. Finally, we provide examples of robot therapy for elderly people, including dementia patients. PMID:20639620

  16. Physiological adjustments to stress measures following massage therapy: a review of the literature.

    PubMed

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

    2010-12-01

    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 were included in this review if (i) the massage therapy account consisted of manipulation of soft tissues and was conducted by a trained therapist, and (ii) a dependent measure to evaluate physiological stress was reported. Hormonal and physical parameters are reviewed. A total of 25 studies met all inclusion criteria. A majority of studies employed a 20-30 min massage administered twice-weekly over 5 weeks with evaluations conducted pre-post an individual session (single treatment) or following a series of sessions (multiple treatments). Single treatment reductions in salivary cortisol and heart rate were consistently noted. A sustained reduction for these measures was not supported in the literature, although the single-treatment effect was repeatable within a study. To date, the research data is insufficient to make definitive statements regarding the multiple treatment effect of massage therapy on urinary cortisol or catecholamines, but some evidence for a positive effect on diastolic blood pressure has been documented. While significant improvement has been demonstrated following massage therapy, the general research body on this topic lacks the necessary scientific rigor to provide a definitive understanding of the effect massage therapy has on many physiological variables associated with stress. PMID:18955340

  17. 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

  18. 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

  19. Nonpharmacological Therapies in Alzheimer’s Disease: A Systematic Review of Efficacy

    Microsoft Academic Search

    Javier Olazarán; Barry Reisberg; Linda Clare; Isabel Cruz; Jordi Peña-Casanova; Teodoro del Ser; Bob Woods; Cornelia Beck; Stefanie Auer; Claudia Lai; Aimee Spector; Sam Fazio; John Bond; Miia Kivipelto; Henry Brodaty; José Manuel Rojo; Helen Collins; Linda Teri; Mary Mittelman; Martin Orrell; Howard H. Feldman; Ruben Muñiz

    2010-01-01

    Introduction: Nonpharmacological therapies (NPTs) can improve the quality of life (QoL) of people with Alzheimer’s disease (AD) and their carers. The objective of this study was to evaluate the best evidence on the effects of NPTs in AD and related disorders (ADRD) by performing a systematic review and meta-analysis of the entire field. Methods: Existing reviews and major electronic databases

  20. Psychological therapies for people with intellectual disabilities: a systematic review and meta-analysis.

    PubMed

    Vereenooghe, Leen; Langdon, Peter E

    2013-11-01

    The aim of this study was to evaluate the efficacy of psychological therapies for people with intellectual disabilities (IDs) through a systematic review and meta-analysis of the current literature. A comprehensive literature search identified 143 intervention studies. Twenty-two trials were eligible for review, and 14 of these were subsequently included in the meta-analysis. Many studies did not include adequate information about their participants, especially the nature of their IDs; information about masked assessment, and therapy fidelity was also lacking. The meta-analysis yielded an overall moderate between-group effect size, g=.682, while group-based interventions had a moderate but smaller treatment effect than individual-based interventions. Cognitive-behaviour therapy (CBT) was efficacious for both anger and depression, while interventions aimed at improving interpersonal functioning were not effectual. When CBT was excluded, there was insufficient evidence regarding the efficacy of other psychological therapies, or psychological therapies intended to treat mental health problems in children and young people with IDs. Adults with IDs and concurrent mental health problems appear to benefit from psychological therapies. However, clinical trials need to make use of improved reporting standards and larger samples. PMID:24051363

  1. Review of the current targeted therapies for non-small-cell lung cancer.

    PubMed

    Nguyen, Kim-Son H; Neal, Joel W; Wakelee, Heather

    2014-10-10

    The last decade has witnessed the development of oncogene-directed targeted therapies that have significantly changed the treatment of non-small-cell lung cancer (NSCLC). In this paper we review the data demonstrating efficacy of gefitinib, erlotinib, and afatinib, which target the epidermal growth factor receptor (EGFR), and crizotinib which targets anaplastic lymphoma kinase (ALK). We discuss the challenge of acquired resistance to these small-molecular tyrosine kinase inhibitors and review promising agents which may overcome resistance, including the EGFR T790M-targeted agents CO-1686 and AZD9291, and the ALK-targeted agents ceritinib (LDK378), AP26113, alectinib (CH/RO5424802), and others. Emerging therapies directed against other driver oncogenes in NSCLC including ROS1, HER2, and BRAF are covered as well. The identification of specific molecular targets in a significant fraction of NSCLC has led to the personalized deployment of many effective targeted therapies, with more to come. PMID:25302162

  2. 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

  3. On Integrating Family Therapy: A Review of the Literature from 1988 to 1995.

    ERIC Educational Resources Information Center

    Watts, Stephen W.; Kempf, Walter G.; Cottone, R. Rocco

    1997-01-01

    This review of the literature summarizes works on integrating family therapy from 1988 to 1995. An epistemological lens is used to organize issues regarding integration strategy. Includes a discussion about the confusion caused by diverse epistemological assumptions in many integration attempts. Recommends joining theory, research, and practice.…

  4. 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

  5. The effects of orthodontic therapy on periodontal health A systematic review of controlled evidence

    Microsoft Academic Search

    Anne-Marie Bollen; Joana Cunha-Cruz; Daniel W. Bakko; Greg J. Huang; Philippe P. Hujoel

    Background. Orthodontic therapy has been sug- gested to lead to an improved periodontal status through mechanisms such as increased ease of plaque removal and reduced occlusal trauma. The objective of the authors' systematic review was to com- pare contemporary orthodontic treatment with no intervention, by means of evaluating periodontal outcomes measured after end of treatment. Methods. The authors completed electronic

  6. 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…

  7. Antibiotic Therapy in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

    Microsoft Academic Search

    Khurram J Khan; Thomas A Ullman; Alexander C Ford; Maria T Abreu; A Abadir; John K Marshall; Nicholas J Talley; Paul Moayyedi

    2011-01-01

    The etiology of inflammatory bowel disease (IBD) is unknown but may relate to an unidentified bacterial pathogen or an immunological reaction to gut microbiota. Antibiotics have therefore been proposed as a therapy for Crohn's disease (CD) and ulcerative colitis (UC) to induce remission in active disease to prevent relapse. Current data are conflicting and we therefore conducted a systematic review

  8. Palliative Sedation Therapy in the Last Weeks of Life: A Literature Review and Recommendations for Standards

    Microsoft Academic Search

    Alexander De Graeff; Mervyn Dean

    2007-01-01

    Purpose: Palliative sedation therapy (PST) is a controversial issue. There is a need for inter- nationally accepted definitions and standards. Methods: A systematic review of the literature was performed by an international panel of 29 palliative care experts. Draft papers were written on various topics concerning PST. This paper is a summary of the individual papers, written after two meetings

  9. 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

  10. Systematic review and meta-analysis of antibiotic therapy for bone and joint infections

    Microsoft Academic Search

    Dirk Stengel; Kai Bauwens; Jalid Sehouli; Axel Ekkernkamp; Franz Porzsolt

    2001-01-01

    175 We set out to evaluate the clinical efficacy of individual antibiotic agents for bone and joint infections in adults. Published and unpublished controlled trials reported between 1966 and 2000 were reviewed to determine if they involved random or quasi-random allocation to systemically administered antimicrobials or local antibiotic therapy for osteomyelitis and septic arthritis. Quiescence of infection after 1 year

  11. A review of current and future medical therapies for cerebral vasospasm following aneurysmal subarachnoid hemorrhage.

    PubMed

    Mocco, J; Zacharia, Brad E; Komotar, Ricardo J; Connolly, E Sander

    2006-01-01

    In an effort to help clarify the current state of medical therapy for cerebral vasospasm, the authors reviewed the relevant literature on the established medical therapies used for cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH), and they discuss burgeoning areas of investigation. Despite advances in the treatment of aneurysmal SAH, cerebral vasospasm remains a common complication and has been correlated with a 1.5- to threefold increase in death during the first 2 weeks after hemorrhage. A number of medical, pharmacological, and surgical therapies are currently in use or being investigated in an attempt to reverse cerebral vasospasm, but only a few have proven to be useful. Although much has been elucidated regarding its pathophysiology, the treatment of cerebral vasospasm remains a dilemma. Although a poor understanding of SAH-induced cerebral vasospasm pathophysiology has, to date, hampered the development of therapeutic interventions, current research efforts promise the eventual production of new medical therapies. PMID:17029348

  12. Stem cell therapy in autoimmune rheumatic diseases: a comprehensive review.

    PubMed

    Liu, Bin; Shu, ShangAn; Kenny, Thomas P; Chang, Christopher; Leung, Patrick S C

    2014-10-01

    The clinical management of autoimmune rheumatic diseases (ARD) has undergone significant changes in the last few decades, leading to remarkable improvements in clinical outcomes of many patients with mild to moderate ARD. On the other hand, severe refractory ARD patients often have high morbidity and mortality. Extensive basic research and clinical evidence has opened the door to new encouraging perspectives, such as the establishment of a role of stem cell transplantation (SCT) in the strategic management of ARD. Given the great heterogeneity of ARD, it is difficult to assign an optimal SCT regimen to all ARD patients. SCT remains a challenging mode of therapy in ARD patients from the standpoints of both efficacy and safety. As the clinical data of SCT in ARD increases and as we improve our understanding of stem cell biology and the downstream effects on the immune system, the future is promising for the development of optimal personalized SCT regimens in ARD. PMID:25146442

  13. Photodynamic therapy in Barrett's esophagus: review of current results

    NASA Astrophysics Data System (ADS)

    Panjehpour, Masoud; Overholt, Bergein F.

    1996-04-01

    Photodynamic therapy has been established as an alternative treatment for patients with Barrett's esophagus with dysplasia or early superficial cancer. Twenty-three patients have been treated and followed for 6 - 54 months. Twenty-one patients had high grade dysplasia and 2 had low grade dysplasia. Ten patients had early cancer (Tis-T1) and 1 had T2 cancer. All patients were maintained on omeprazole after treatment. Three separate PDT treatments were required in 2 patients, 2 in 5 patients and 1 in 16. Dysplasia and carcinoma were eliminated in all. Seventy-five to eighty percent of Barrette's mucosa was replaced by squamous epithelium. One patient developed a new carcinoma in an area of dysplasia treated 3 months earlier and was retreated successfully. Two patients developed new areas of dysplasia in untreated segments of the Barrett's esophagus, requiring a separate treatment. Twelve patients developed strictures, all responding well to dilatation.

  14. Dosimetric Considerations in Radioimmunotherapy and Systemic Radionuclide Therapies: A Review

    PubMed Central

    Loke, Kelvin S. H.; Padhy, Ajit K.; Ng, David C. E.; Goh, Anthony S.W.; Divgi, Chaitanya

    2011-01-01

    Radiopharmaceutical therapy, once touted as the “magic bullet” in radiation oncology, is increasingly being used in the treatment of a variety of malignancies; albeit in later disease stages. With ever-increasing public and medical awareness of radiation effects, radiation dosimetry is becoming more important. Dosimetry allows administration of the maximum tolerated radiation dose to the tumor/organ to be treated but limiting radiation to critical organs. Traditional tumor dosimetry involved acquiring pretherapy planar scans and plasma estimates with a diagnostic dose of intended radiopharmaceuticals. New advancements in single photon emission computed tomography and positron emission tomography systems allow semi-quantitative measurements of radiation dosimetry thus allowing treatments tailored to each individual patient. PMID:22144871

  15. A review of skin ageing and its medical therapy.

    PubMed

    Gilchrest, B A

    1996-12-01

    Intrinsic (chronological) skin ageing is characterized by atrophy of the skin with loss of elasticity and slowed metabolic activity. The superposition of environmental damage, particularly exposure to ultraviolet radiation (photodamage), on the intrinsic ageing process results, at least initially, in a hypertrophic repair response, with a thickened epidermis and increased melanogenesis. Even more striking changes occur in the dermis: massive elastosis (deposition of abnormal elastic fibres), collagen degeneration, and twisted, dilated microvasculature. Regular use of a sunscreen alone appears to allow some repair as well as protection from further photodamage. Topical tretinoin has been shown to partially reverse the clinical and histological changes induced by the combination of sunlight exposure and chronological ageing. A formulation of tretinoin in an emollient cream (Retinova, Renova), developed specifically for the treatment of photodamaged skin, has been extensively investigated in multicentre, double-blind trials and has been shown to produce significant improvement within 4-6 months of daily use, compared with vehicle alone, as part of a regimen including sun protection and moisturizer use. Histological changes in the epidermis and dermis noted after 12 months suggest tretinoin repairs photodamage by reconstitution of the rete pegs, repair of keratinocyte ultrastructural damage, more even distribution of melanocytes and melanin pigment, deposition of new papillary dermal collagen, and improvements in vasculature. Alpha-hydroxy acids (AHAs) have also been widely used for therapy of photodamaged skin, and these compounds have been reported to normalize hyperkeratinization and increase viable epidermal thickness and dermal glycosaminoglycans content. The single randomized controlled study now available appears to substantiate AHA efficacy and safety. In summary, recent work has substantially elucidated the ageing processes that affect the skin and has demonstrated that many of the unwanted changes can be improved by topical therapy. PMID:8977705

  16. 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

  17. Review of current therapies for secondary hypertrophic pulmonary osteoarthropathy

    Microsoft Academic Search

    Sheila Nguyen; Mehrnaz Hojjati

    2011-01-01

    Hypertrophic osteoarthropathy (HOA) is a disabling condition that may occur secondarily to primary lung cancer. It is characterized\\u000a by digital clubbing, arthralgia\\/arthritis, and periostosis of the tubular bones. The pain associated with HOA can be disabling\\u000a and often refractory to conventional analgesics. We performed a comprehensive review of the literature using the PubMed database\\u000a on treatment modalities available for HOA.

  18. Physical therapies for Achilles tendinopathy: systematic review and meta-analysis

    PubMed Central

    2012-01-01

    Background Achilles tendinopathy (AT) is a common condition, causing considerable morbidity in athletes and non-athletes alike. Conservative or physical therapies are accepted as first-line management of AT; however, despite a growing volume of research, there remains a lack of high quality studies evaluating their efficacy. Previous systematic reviews provide preliminary evidence for non-surgical interventions for AT, but lack key quality components as outlined in the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Statement. The aim of this study was to conduct a systematic review and meta-analysis (where possible) of the evidence for physical therapies for AT management. Methods A comprehensive strategy was used to search 11 electronic databases from inception to September 2011. Search terms included Achilles, tendinopathy, pain, physical therapies, electrotherapy and exercise (English language full-text publications, human studies). Reference lists of eligible papers were hand-searched. Randomised controlled trials (RCTs) were included if they evaluated at least one non-pharmacological, non-surgical intervention for AT using at least one outcome of pain and/or function. Two independent reviewers screened 2852 search results, identifying 23 suitable studies, and assessed methodological quality and risk of bias using a modified PEDro scale. Effect size calculation and meta-analyses were based on fixed and random effects models respectively. Results Methodological quality ranged from 2 to 12 (/14). Four studies were excluded due to high risk of bias, leaving 19 studies, the majority of which evaluated midportion AT. Effect sizes from individual RCTs support the use of eccentric exercise. Meta-analyses identified significant effects favouring the addition of laser therapy to eccentric exercise at 12?weeks (pain VAS: standardised mean difference ?0.59, 95% confidence interval ?1.11 to ?0.07), as well as no differences in effect between eccentric exercise and shock wave therapy at 16?weeks (VISA-A:–0.55,–2.21 to 1.11). Pooled data did not support the addition of night splints to eccentric exercise at 12?weeks (VISA-A:–0.35,–1.44 to 0.74). Limited evidence from an individual RCT suggests microcurrent therapy to be an effective intervention. Conclusions Practitioners can consider eccentric exercise as an initial intervention for AT, with the addition of laser therapy as appropriate. Shock wave therapy may represent an effective alternative. High-quality RCTs following CONSORT guidelines are required to further evaluate the efficacy of physical therapies and determine optimal clinical pathways for AT. PMID:22747701

  19. 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.

  20. Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review.

    PubMed

    Muller, Monique; Tsui, Deborah; Schnurr, Ronda; Biddulph-Deisroth, Lori; Hard, Julie; MacDermid, Joy C

    2004-01-01

    The purpose of this study was to determine the effectiveness of hand therapy interventions for carpal tunnel syndrome (CTS) based on the best available evidence. A qualitative systematic review was conducted. A literature search using 40 key terms was conducted from the earliest available date to January 2003 using seven databases. Articles were randomly assigned to two of five reviewers and evaluated according to predetermined criteria for inclusion at each of the title, abstract, and article levels. Included studies were independently scored by two reviewers using a structured effectiveness quality evaluation scale and also graded according to Sackett's Levels of Evidence. There were 2027 articles identified from the literature search, of which 345 met the inclusion criteria. Twenty-four studies were used to formulate 30 recommendations. Current evidence demonstrates a significant benefit (grade B recommendations) from splinting, ultrasound, nerve gliding exercises, carpal bone mobilization, magnetic therapy, and yoga for people with CTS. PMID:15162107

  1. PHYSICAL REVIEW E 85, 026608 (2012) Dipole interaction of the Quincke rotating particles

    E-print Network

    Elperin, Tov

    2012-01-01

    PHYSICAL REVIEW E 85, 026608 (2012) Dipole interaction of the Quincke rotating particles Yu are the importance of fluid-particle suspensions subjected to an external electric field in various fields of physics 25 November 2011; published 27 February 2012) We study the behavior of particles having a finite

  2. PHYSICAL REVIEW A 87, 052104 (2013) Past of a quantum particle

    E-print Network

    Vaidman, Lev

    2013-01-01

    trajectory with a nonvanishing quantum wave of the particle between its emission and detection points, it seems "safe" to associate the past of the particle with this trajectory. A method for analyzing the pastPHYSICAL REVIEW A 87, 052104 (2013) Past of a quantum particle L. Vaidman Raymond and Beverly

  3. Evidence-based review: fixed-combination therapy and topical retinoids in the treatment of acne.

    PubMed

    Webster, Guy F

    2011-06-01

    Topical fixed-combination products and topical retinoid monotherapy are established first-line treatments for mild-to-moderate acne vulgaris, yet adequate comparative data are lacking. The following evidence-based review addresses the question: "In patients with mild-to-moderate acne, are topical fixed-combination products or topical retinoids a more efficacious choice in reducing noninflammatory, inflammatory and total lesions after 12 weeks of treatment?" To identify relevant studies, a PubMed search was performed using "acne" and search terms for adapalene, tretinoin, tazarotene, benzoyl peroxide, clindamycin, or erythromycin. Forty-two studies from January 1991 to November 2009 were included. The studies were evaluated using the Strength of Recommendation Taxonomy, and all but seven received the highest level of evidence grade. To evaluate efficacy, a side-by-side comparison was made using reduction in acne lesion counts at week 12 for study groups treated with fixed-combination therapy or retinoid monotherapy. Twenty-nine studies containing relevant efficacy data for fixed-combination therapy and retinoid monotherapy are summarized here. Nine studies compared fixed-combination therapy with retinoid monotherapy; in eight of these studies, fixed-combination therapy was significantly more efficacious in reducing acne lesion counts. This evidence-based review analyzes clinical evidence to date for these therapies to provide guidance in determining appropriate treatment for patients with mild-to-moderate acne. PMID:21637904

  4. Phage display as a novel promising antivenom therapy: a review.

    PubMed

    Roncolato, Eduardo Crosara; Campos, Lucas Benício; Pessenda, Gabriela; Costa e Silva, Luciano; Furtado, Gilvan Pessoa; Barbosa, José Elpidio

    2015-01-01

    In this work, we present recent advances in the use of phage display technology for the preparation of antivenoms for animal toxin neutralization. Even though classical antivenoms have been used since the early 20th century, envenomation remains a global public health problem. Recently, the phage display technique has been used in an attempt to circumvent some of the difficulties associated with traditional preparations of antivenom. Here, we review studies that developed antibody fragments with potential inhibitory effects against animal toxins and discuss the most current technical issues and perspectives regarding phage display technology in this field. PMID:25447775

  5. Review article: Nutritional therapy in alcoholic liver disease.

    PubMed

    Stickel, F; Hoehn, B; Schuppan, D; Seitz, H K

    2003-08-15

    Chronic alcohol consumption may lead to primary and secondary malnutrition. In particular, protein energy malnutrition not only aggravates alcoholic liver disease but also correlates with impaired liver function and increased mortality. Therefore, in these patients, adequate nutritional support should be implemented in order to improve their prognosis. Clinical trials addressing this issue have shown that nutritional therapy either enterally or parenterally improves various aspects of malnutrition, and there is increasing evidence that it may also improve survival. Therefore, malnourished alcoholics should be administered a diet rich in carbohydrate- and protein-derived calories preferentially via the oral or enteral route. Micronutrient deficiencies typically encountered in alcoholics, such as for thiamine and folate, require specific supplementation. Patients with hepatic encephalopathy may be treated with branched-chain amino acids in order to achieve a positive nitrogen balance. Fatty liver represents the early stage of alcoholic liver disease, which is usually reversible with abstinence. Metadoxine appears to improve fatty liver but confirmatory studies are necessary. S-adenosyl-L-methionine may be helpful for patients with severe alcoholic liver damage, since various mechanisms of alcohol-related hepatotoxicity are counteracted with this essential methyl group donor, while a recent large trial showed that the use of polyenylphosphatidylcholine is of limited efficacy. PMID:12940921

  6. Effectiveness of manual physical therapy in the treatment of cervical radiculopathy: a systematic review

    PubMed Central

    Boyles, Robert; Toy, Patrick; Mellon, James; Hayes, Margaret; Hammer, Bradley

    2011-01-01

    Study design Systematic review of randomized clinical trials. Objective Review of current literature regarding the effectiveness of manual therapy in the treatment of cervical radiculopathy. Background Cervical radiculopathy (CR) is a clinical condition frequently encountered in the physical therapy clinic. Cervical radiculopathy is a result of space occupying lesions in the cervical spine: either cervical disc herniations, spondylosis, or osteophytosis. These affect the pain generators of bony and ligamentous tissues, producing radicular symptoms (i.e. pain, numbness, weakness, paresthesia) observed in the upper extremity of patients with cervical nerve root pathology. Cervical radiculopathy has a reported annual incidence of 83·2 per 100?000 and an increased prevalence in the fifth decade of life among the general population. Results Medline and CINAHL via EBSCO, Cochrane Library, and Google Scholar were used to retrieve the randomized clinical trial studies for this review between the years of 1995 and February of 2011. Four studies met inclusion criteria and were considered to be high quality (PEDro scores of ?5). Manual therapy techniques included muscle energy techniques, non-thrust/thrust manipulation/mobilization of the cervical and/or thoracic spine, soft-tissue mobilization, and neural mobilization. In each study, manual therapy was either a stand-alone intervention or part of a multimodal approach which included therapeutic exercise and often some form of cervical traction. Although no clear cause and effect relationship can be established between improvement in radicular symptoms and manual therapy, results are generally promising. Conclusion Although a definitive treatment progression for treating CR has not been developed a general consensus exists within the literature that using manual therapy techniques in conjunction with therapeutic exercise is effective in regard to increasing function, as well as AROM, while decreasing levels of pain and disability. High quality RCTs featuring control groups are necessary to establish clear and effective protocols in the treatment of CR. PMID:22851876

  7. 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

  8. 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

  9. Optimization of radiation therapy techniques for prostate cancer with prostate-rectum spacers: a systematic review.

    PubMed

    Mok, Gary; Benz, Eileen; Vallee, Jean-Paul; Miralbell, Raymond; Zilli, Thomas

    2014-10-01

    Dose-escalated radiation therapy for localized prostate cancer improves disease control but is also associated with worse rectal toxicity. A spacer placed between the prostate and rectum can be used to displace the anterior rectal wall outside of the high-dose radiation regions and potentially minimize radiation-induced rectal toxicity. This systematic review focuses on the published data regarding the different types of commercially available prostate-rectum spacers. Dosimetric results and preliminary clinical data using prostate-rectum spacers in patients with localized prostate cancer treated by curative radiation therapy are compared and discussed. PMID:25304788

  10. 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

  11. Systematic Review: Impact of Interferon-based Therapy on HCV-related Hepatocellular Carcinoma

    PubMed Central

    Hsu, Ching-Sheng; Chao, You-Chen; Lin, Hans Hsienhong; Chen, Ding-Shinn; Kao, Jia-Horng

    2015-01-01

    Hepatitis C virus (HCV) is the leading cause of hepatocellular carcinoma (HCC), and several antiviral agents are available for the treatment of chronic HCV infection. However, the impact of antiviral therapy on the long-term outcomes of HCV-related HCC patients remains inconclusive. We aimed to examine the impact of antiviral therapy on the long-term outcomes of HCV-related HCC patients. We conducted a systematic review using PRISMA guidelines to identify trials and English-language literature from PubMed, Ovid MEDLINE, Scopus and the Cochrane Library database till August 2014. Randomized trials of antiviral treatments examining the effects of antiviral therapy on CHC patients and HCV-related HCC patients were screened and selected. We identified 6 trials evaluated the effectiveness of interferon (IFN)-alfa treatment, 3 studies examined pegylated interferon-alfa treatment, and 2 studies examined IFN-beta treatment. IFN-based therapy may decrease HCC incidence in HCV cirrhotic patients after a >5-year follow-up, improve liver reserve, decrease HCC recurrence rate, and increase survival rate in HCV-related HCC patients after curative HCC therapy. In conclusion, IFN-based therapy is beneficial and may be recommended in the management of HCV-related HCC patients who are IFN eligible. PMID:25963067

  12. Dermatomyositis as a complication of interferon-? therapy: a case report and review of the literature.

    PubMed

    Shiba, Hideyuki; Takeuchi, Tohru; Isoda, Kentaro; Kokunai, Yasuhito; Wada, Yumiko; Makino, Shigeki; Hanafusa, Toshiaki

    2014-09-01

    Autoimmune disorder is one of the important side effects of interferon-? therapy. Some polymyositis cases as complication of interferon-? therapy were reported, but dermatomyositis were rarely. We report a case of dermatomyositis as a complication of interferon-? therapy for hepatitis C. A 52-year-old Japanese man was treated by combination therapy with pegylated interferon-?-2b and ribavirin for hepatitis C. Three months after the initiation of therapy, he showed erythema in the posterior cervical to dorsal and anterior cervical to thoracic regions, weight loss, general malaise, muscle pain, and severe increase in levels of muscle enzymes. We made a diagnosis of dermatomyositis according to these clinical features, proximal muscle-predominant myogenic change on electromyography, and infiltration of monocytes and CD4+-dominant lymphocytes on skin biopsy, although myositis-associated antibodies were absent. He was successfully treated with intravenous immunoglobulin and tacrolimus in addition to glucocorticoid. This is a very rare case of dermatomyositis associated with interferon-? therapy. We reviewed several similar published cases and the association of dermatomyositis and type I interferon. PMID:24638953

  13. Extracorporeal shockwave therapy: A systematic review of its use in fracture management

    PubMed Central

    Petrisor, BA; Lisson, Selene; Sprague, Sheila

    2009-01-01

    Extracorporeal shockwave therapy is increasingly used as an adjuvant therapy in the management of nonunions, delayed unions and more recently fresh fractures. This is in an effort to increase union rates or obtain unions when fractures have proven recalcitrant to healing. In this report we have systematically reviewed the English language literature to attempt to determine the potential clinical efficacy of extracorporeal shockwave therapy in fracture management. Of 32 potentially eligible studies identified, 10 were included that assessed the extracorporeal shockwave therapy use for healing nonunions or delayed unions, and one trial was included that assessed its use for acute high-energy fractures. From the included, studies' overall union rates were in favor of extracorporeal shockwave therapy (72% union rate overall for nonunions or delayed unions, and a 46% relative risk reduction in nonunions when it is used for acute high-energy fractures). However, the methodologic quality of included studies was weak and any clinical inferences made from these data should be interpreted with caution. Further research in this area in the form of a large-scale randomized trial is necessary to better answer the question of the effectiveness of extracorporeal shockwave therapy on union rates for both nonunions and acute fractures. PMID:19838365

  14. Systematic Review: Impact of Interferon-based Therapy on HCV-related Hepatocellular Carcinoma.

    PubMed

    Hsu, Ching-Sheng; Chao, You-Chen; Lin, Hans Hsienhong; Chen, Ding-Shinn; Kao, Jia-Horng

    2015-01-01

    Hepatitis C virus (HCV) is the leading cause of hepatocellular carcinoma (HCC), and several antiviral agents are available for the treatment of chronic HCV infection. However, the impact of antiviral therapy on the long-term outcomes of HCV-related HCC patients remains inconclusive. We aimed to examine the impact of antiviral therapy on the long-term outcomes of HCV-related HCC patients. We conducted a systematic review using PRISMA guidelines to identify trials and English-language literature from PubMed, Ovid MEDLINE, Scopus and the Cochrane Library database till August 2014. Randomized trials of antiviral treatments examining the effects of antiviral therapy on CHC patients and HCV-related HCC patients were screened and selected. We identified 6 trials evaluated the effectiveness of interferon (IFN)-alfa treatment, 3 studies examined pegylated interferon-alfa treatment, and 2 studies examined IFN-beta treatment. IFN-based therapy may decrease HCC incidence in HCV cirrhotic patients after a >5-year follow-up, improve liver reserve, decrease HCC recurrence rate, and increase survival rate in HCV-related HCC patients after curative HCC therapy. In conclusion, IFN-based therapy is beneficial and may be recommended in the management of HCV-related HCC patients who are IFN eligible. PMID:25963067

  15. 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

    2015-07-01

    Connective-tissue disorders, which include lupus erythematosus, morphoea/scleroderma and dermatomyositis, are characterized by cutaneous manifestations that are sometimes resistant to conventional therapy. Light treatments, which include phototherapy, photodynamic therapy (PDT) and photopheresis, are routinely utilized in the treatment of dermatological 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, PDT and photopheresis in the treatment of lupus erythematosus, morphoea/scleroderma and dermatomyositis. A MEDLINE search was conducted to find articles that discuss treatment of connective-tissue diseases with light therapies and more than 30 publications that discuss light therapy for these diseases were identified. These range 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 includes phototherapy, PDT 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, morphoea/scleroderma and dermatomyositis. PMID:25400115

  16. Radiobiology with heavy charged particles: a historical review.

    PubMed

    Skarsgard, L D

    1998-07-01

    Radiobiological studies using heavy charged particles followed closely the development of accelerators to produce beams of ever-increasing energy, driven primarily by the aspirations of physicists and chemists interested in the structure of matter. An impressive share of this development took place at Berkeley, beginning with the invention of the cyclotron by Ernest Lawrence in 1930. There followed a series of cyclotrons, synchrotrons and linear accelerators, culminating in the BEVALAC, which provided the first source of very heavy ions (helium to argon) to be used clinically, beginning in 1975. Other early entrants (1950's-1960's) in the clinical use of heavy ion beams (protons only) included Uppsala, Harvard/MGH and several facilities in the USSR. During the 1970's negative pi-meson (pion) beams for clinical use were developed in the US (LAMPF), Switzerland (SIN/PSI) and Canada (TRIUMF). Although the first accelerator built primarily for medical use, the Crocker Medical Cyclotron, was completed at Berkeley in 1939 (it was used primarily to produce neutron beams) it was not until 1990 that the next clearly dedicated medical heavy ion facility went into operation: the 3-gantry proton synchrotron at Loma Linda. There are several reasons for this long hiatus: the long time required to complete clinical trials; the need to develop more economic and flexible accelerators and beam handling systems; the early discouraging clinical results obtained with neutron beams at Berkeley in the 1940's, before the dose response differences for early and late effects were fully understood. During the last decade or so there has been a rapid increase in the number of proton beam facilities; heavier ion beams are so far available only at HIMAC in Japan and GSI in Germany. Earlier studies with radioactive alpha-particle sources and plant cells had already shown, by the early 1930's that high LET radiations were biologically more effective than X-rays in producing damage in eukaryotes. The increased penetration of high energy particles from accelerators made it possible to carry out in vivo radiobiological studies in animals, and the publication by Puck of the first radiation survival response for cultured mammalian cells in 1956, provided another valuable tool for radiobiological studies. One of the earliest systematic studies of the dependence of RBE (relative biological effectiveness) and OER (oxygen enhancement ratio) on LET (linear energy transfer) was that by Barendsen in the early 1960's; he irradiated cultured human kidney cells with deuterium and alpha-particles, and showed that RBE reached a maximum at an LET of 100-200 keV/micrometer, the same LET at which the OER decreased to approximately 1.0. More recent studies (Belli, Folkard, etc.) show that the RBE 'peaks' at a LET which is particle-dependent (for protons, RBE maximum is at approximately 30 keV/micrometer), indicating that LET alone does not adequately define the microscopic energy deposition and its influence on biological effect. One of the complications with heavy ion and pion beams is the increase in RBE with depth in the stopping region. Cultured cell techniques were developed to accurately map these RBE changes, which were investigated at each of the heavy ion and pion facilities, allowing physical dose profiles to be shaped to compensate for the change in biological effectiveness. With the heavier ions, RBE is also dependent on dose and on the dose fractionation scheme used. In vivo systems are the most suitable for such measurements and a variety of normal tissue and tumour end-points has been employed for such studies. A review of the published RBE values for proton beams, 1975-1997, shows very good consistency between the various centres, with average in vivo and average in vitro values falling in the range 1.11-1.18. In this article we have, due to space limitations, only been able to review a representative fraction of the extensive literature on heavy ion radiobiology. We have arbitrarily limited our discussion to mammalian systems, except for a few very early e

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

    SciTech Connect

    Ebina, Futaro; Umezawa, Masumi; Hiramoto, Kazuo [Hitachi Research Laboratory, Hitachi, Ltd. 2-1, Omika-cho 7-chome, Hitachi-shi, Ibaraki-ken, 319-1221 (Japan)

    2013-04-19

    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.

  18. 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

  19. 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

  20. Proton therapy in chordoma of the base of the skull: a systematic review

    Microsoft Academic Search

    Maurizio Amichetti; Marco Cianchetti; Dante Amelio; Riccardo Maurizi Enrici; Giuseppe Minniti

    2009-01-01

    Chordoma is a rare, slow-growing, locally aggressive, primary bone tumor that arises from the skull base region in approximately\\u000a 25–35% of cases. The therapeutic approach to chordoma has traditionally been surgery, followed by radiation therapy. The advent\\u000a of charged particle radiotherapy has let us consider protons as the postoperative treatment of choice, but no controlled studies\\u000a have yet confirmed the

  1. Occupational therapy interventions for work-related injuries and conditions of the forearm, wrist, and hand: a systematic review.

    PubMed

    Amini, Debbie

    2011-01-01

    A systematic review of the literature related to effective occupational therapy interventions in rehabilitation of individuals with work-related forearm, wrist, and hand injuries and illnesses was conducted as part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association. This review provides a comprehensive overview and analysis of 36 studies that addressed many of the interventions commonly used in hand rehabilitation. Findings reveal that the use of occupation-based activities has reasonable yet limited evidence to support its effectiveness. This review supports the premise that many client factors can be positively affected through the use of several commonly used occupational therapy-related modalities and methods. The implications for occupational therapy practice, research, and education and limitations of reviewed studies are also discussed. PMID:21309369

  2. Radiation biophysical aspects of charged particles: From the nanoscale to therapy

    NASA Astrophysics Data System (ADS)

    Scifoni, Emanuele

    2015-04-01

    Charged particle applications for radiotherapy are motivated by their specific advantages in terms of dose delivery and biological effect. These advantages have to a large extent originated from the peculiarities of ion beam energy deposition patterns in the medium on a microscopic, down to a nanoscopic scale. A large amount of research was conducted in this direction, especially in the last two decades, profiting also from the parallel investigations going on in radiation protection for space exploration. The main biophysical aspects of charged particles, which are relevant to hadrontherapy are shortly reviewed in the present contribution, namely focusing on relative biological effectiveness (RBE), oxygen enhancement ratio (OER) and combination with radiosensitizers. A summary of present major research direction on both microscopic and macroscopic assessment of the specific mechanism of radiation damage will be given, as well as several open challenges for a better understanding of the whole process, which still limit the full exploitation of ion beams for radiotherapy.

  3. 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

  4. 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

  5. Magnetic resonance-guided laser induced thermal therapy for glioblastoma multiforme: a review.

    PubMed

    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

  6. Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Li, Yan-hui; Wang, Feng-yun; Feng, Chun-qing; Yang, Xia-feng; Sun, Yi-hua

    2014-01-01

    Background Although some studies evaluated the effectiveness of massage therapy for fibromyalgia (FM), the role of massage therapy in the management of FM remained controversial. Objective The purpose of this systematic review is to evaluate the evidence of massage therapy for patients with FM. Methods Electronic databases (up to June 2013) were searched to identify relevant studies. The main outcome measures were pain, anxiety, depression, and sleep disturbance. Two reviewers independently abstracted data and appraised risk of bias. The risk of bias of eligible studies was assessed based on Cochrane tools. Standardised mean difference (SMD) and 95% confidence intervals (CI) were calculated by more conservative random-effects model. And heterogeneity was assessed based on the I2 statistic. Results Nine randomized controlled trials involving 404 patients met the inclusion criteria. The meta-analyses showed that massage therapy with duration ?5 weeks significantly improved pain (SMD, 0.62; 95% CI 0.05 to 1.20; p?=?0.03), anxiety (SMD, 0.44; 95% CI 0.09 to 0.78; p?=?0.01), and depression (SMD, 0.49; 95% CI 0.15 to 0.84; p?=?0.005) in patients with FM, but not on sleep disturbance (SMD, 0.19; 95% CI ?0.38 to 0.75; p?=?0.52). Conclusion Massage therapy with duration ?5 weeks had beneficial immediate effects on improving pain, anxiety, and depression in patients with FM. Massage therapy should be one of the viable complementary and alternative treatments for FM. However, given fewer eligible studies in subgroup meta-analyses and no evidence on follow-up effects, large-scale randomized controlled trials with long follow-up are warrant to confirm the current findings. PMID:24586677

  7. A review of "music and movement" therapies for children with autism: embodied interventions for multisystem development.

    PubMed

    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

  8. 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

  9. REPETITIVE TASK PRACTICE: A CRITICAL REVIEW OF CONSTRAINT-INDUCED MOVEMENT THERAPY IN STROKE

    PubMed Central

    Wolf, Steven L.; Blanton, Sarah; Baer, Heather; Breshears, Jenifer; Butler, Andrew J.

    2013-01-01

    BACKGROUND Constraint-induced (CI) movement therapy (also called forced use by some investigators and clinicians) has gained increasing popularity as a treatment mode for restoring function in the upper extremities of patients with stroke. The purpose of this article is to review the concept of constraint-induced movement therapy and provide a critical analysis of the existing data. REVIEW SUMMARY The evidence to date offers encouragement for the application of this procedure for patients who have some movement recovery out of synergy. Success may be contingent on patient cooperation and intense repetitive use with applications of retraining through practice and shaping. The extent to which each of the latter elements influences the magnitude of recovery is still unclear. However, task novelty and challenge seem important to recovery of function. There are several methods used to map cortical changes after stroke. At this time, transcranial magnetic stimulation is the primary vehicle used to assess motor cortical reorganization after CI therapy in humans. CONCLUSIONS Accumulating data indicate that the size of a cortical area representative of a muscle does expand and its center of gravity does change with CI therapy. PMID:12801434

  10. Production of [(211)At]-astatinated radiopharmaceuticals and applications in targeted ?-particle therapy.

    PubMed

    Guérard, François; Gestin, Jean-François; Brechbiel, Martin W

    2013-02-01

    (211)At is a promising radionuclide for ?-particle therapy of cancers. Its physical characteristics make this radionuclide particularly interesting to consider when bound to cancer-targeting biomolecules for the treatment of microscopic tumors. (211)At is produced by cyclotron irradiation of (209)Bi with ?-particles accelerated at ~28 MeV and can be obtained in high radionuclidic purity after isolation from the target. Its chemistry resembles iodine, but there is also a tendency to behave as a metalloid. However, the chemical behavior of astatine has not yet been clearly established, primarily due to the lack of any stable isotopes of this element, which precludes the use of conventional analytical techniques for its characterization. There are also only a limited number of research centers that have been able to produce this element in sufficient amounts to carry out extensive investigations. Despite these difficulties, chemical reactions typically used with iodine can be performed, and a number of biomolecules of interest have been labeled with (211)At. However, most of these compounds exhibit unacceptable instability in vivo due to the weakness of the astatine-biomolecule bond. Nonetheless, several compounds have shown high potential for the treatment of cancers in vitro and in several animal models, thus providing a promising basis that has allowed initiation of the first two clinical studies. PMID:23075373

  11. Efficacy of Immunosuppressive Therapy for Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

    Microsoft Academic Search

    Khurram J Khan; Marla C Dubinsky; Alexander C Ford; Thomas A Ullman; Nicholas J Talley; Paul Moayyedi

    2011-01-01

    OBJECTIVES:There remains controversy regarding the efficacy of thiopurine analogs (azathioprine (AZA) and 6-mercaptopurine (6-MP)), methotrexate (MTX), and cyclosporine for the treatment of inflammatory bowel disease (IBD). We performed an updated systematic review of the literature to clarify the efficacy of immunosuppressive therapy at inducing remission and preventing relapse in ulcerative colitis (UC) and Crohn's disease (CD).METHODS:Only parallel group randomized controlled

  12. Efficacy of Biological Therapies in Inflammatory Bowel Disease: Systematic Review and Meta-Analysis

    Microsoft Academic Search

    Alexander C Ford; William J Sandborn; Khurram J Khan; Stephen B Hanauer; Nicholas J Talley; Paul Moayyedi

    2011-01-01

    OBJECTIVES:Crohn's disease (CD) and ulcerative colitis (UC) are inflammatory disorders of the gastrointestinal tract of unknown etiology. Evidence for treatment of the condition with biological therapies exists, but no systematic review and meta-analysis has examined this issue in its entirety.METHODS:MEDLINE, EMBASE, and the Cochrane central register of controlled trials were searched (through to December 2010). Trials recruiting adults with active

  13. Clinical review: Patency of the circuit in continuous renal replacement therapy

    Microsoft Academic Search

    Michael Joannidis; Heleen M Oudemans-van Straaten

    2007-01-01

    Premature circuit clotting is a major problem in daily practice of continuous renal replacement therapy (CRRT), increasing\\u000a blood loss, workload, and costs. Early clotting is related to bioincompatibility, critical illness, vascular access, CRRT\\u000a circuit, and modality. This review discusses non-anticoagulant and anticoagulant measures to prevent circuit failure. These\\u000a measures include optimization of the catheter (inner diameter, pattern of flow, and

  14. 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

  15. Can cognitive-behavioral therapy increase self-esteem among depressed adolescents? A systematic review

    Microsoft Academic Search

    Tatiana L. Taylor; Paul Montgomery

    2007-01-01

    This systematic review evaluates the efficacy of cognitive-behavioral therapy (CBT) in improving self-esteem among depressed adolescents aged 13–18 years. A search identified 265 references, 33 articles were acquired, of which two papers met the inclusion criteria. Two excluded studies are also discussed. A total of 82 participants from two trials were included in the meta-analysis. The data suggest CBT may be

  16. Intralesional corticosteroid therapy in proliferating head and neck hemangiomas: A review of 155 cases

    Microsoft Academic Search

    M. T. Chen; E. K. Yeong; S. Y Horng

    2000-01-01

    Purpose: The purpose of this paper is to review the effect of intralesional corticosteroid therapy in the treatment of 155 head and neck hemangiomas.Methods: In the past 10 years, we have treated 155 proliferating head and neck hemangiomas with intralesional corticosteroid injections. Three to 6 injections of triamcinolone acetonide (10 mg\\/mL) in monthly intervals were given. Using slides and chart

  17. 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.

  18. Spontaneous Hemarthrosis Following Fibrinolytic Therapy for Acute Myocardial Infarction: A Case Report and Literature Review

    PubMed Central

    Ramadan, Mahmoud M.; Khan, Iqbal S.; Mahdi, Ousama

    2014-01-01

    Patient: Male, 48 Final Diagnosis: Spontaneous hemarthrosis of right knee Symptoms: A rapidly growing knee swelling was “witnessed” associated with severe tenderness, hotness and profound agony but without color change Medication: — Clinical Procedure: Suprapatellar arthrocentesis of the right knee joint Specialty: Cardiology Objective: Unusual clinical course Background: Despite the widespread use of fibrinolytic therapy and the numerous reports on its bleeding complications, spontaneous hemarthrosis following fibrinolytic therapy is quite rare. Case Report: We describe in this report a patient with no previous history of articular disease who developed a spontaneous right knee bloody effusion following fibrinolytic therapy using rt-PA for acute ST-elevation myocardial infarction. Furthermore, we provide a review of all cases of spontaneous hemarthrosis documented so far in the literature. Conclusions: Several pre-existing joint diseases may predispose to hemarthrosis following fibrinolytic therapy, even in patients who deny previous or current articular disorders. Therefore, hemorrhage should be considered in the differential diagnosis of mono-arthritis following fibrinolytic therapy for STEMI. PMID:25417208

  19. 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

  20. 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

  1. Treatment of Upper Tract Urothelial Carcinoma: A Review of Surgical and Adjuvant Therapy

    PubMed Central

    Latchamsetty, Kalyan C; Porter, Christopher R

    2006-01-01

    Upper tract urothelial carcinoma is a disease entity that has not been as extensively studied and reviewed as carcinoma of the bladder. Recent advances in technology and adjuvant therapy have changed the treatment armamentarium of oncologists and urologists. A literature review was conducted that focused on newer surgical techniques, including laparoscopy and endoscopic management of upper tract disease. Adjuvant therapy including immunotherapy, chemotherapy, and radiation is also reviewed. Nephroureterectomy with removal of a bladder cuff still remains the gold standard of treatment. However, laparoscopic nephroureterectomy is quickly becoming popular, with equivalent recurrence rates. Because of the relatively recent introduction of laparoscopy into the urologic field, long-term data with respect to recurrence rates and survival rates are not yet available. Immunotherapy has also shown promise, but with higher recurrence rates than surgery. Chemotherapy and radiation also show some improvement in recurrence rates, but there have been no randomized, prospective trials. Endoscopic management is acceptable in patients with severe medical comorbidities or solitary kidneys but requires rigorous and close follow-up. Adjuvant therapy with either chemotherapy or radiation is still debated but does offer some improvement in disease-specific survival. Randomized, prospective, placebo-controlled studies are required but are difficult to perform because of the relatively low incidence and prevalence of this disease. PMID:17021628

  2. 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)

  3. Review of the facile (F/sub N/) method in particle transport theory

    SciTech Connect

    Garcia, R.D.M.

    1985-10-01

    The facile (F/sub N/) method for solving particle transport problems is reviewed. The fundamentals of the method are summarized, recent developments are discussed and several applications of the method are described in detail.

  4. 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

  5. The role of radiation therapy in the management of craniopharyngioma: a 25-year experience and review of the literature

    Microsoft Academic Search

    Jean-Louis Habrand; Oliver Ganry; Dominique Couanet; Va?erie Rouxel; Christine Levy-Piedbois; Alain Pierre-Kahn; Chantal Kalifa

    1999-01-01

    Purpose: To review the outcome and quality of life at 5 years and more of 37 children treated with radiation therapy combined or not with surgical resection for a craniopharyngioma in a single institution.Methods and Materials: From January 1969 through December 1992, 37 children received external therapy at the Institut Gustave Roussy (Villejuif, France). Age ranged between 1 and 15

  6. Meditative Therapies for Reducing Anxiety: A Systematic Review and Meta-analysis of Randomized Controlled Trials*

    PubMed Central

    Chen, Kevin W; Berger, Christine C.; Manheimer, Eric; Forde, Darlene; Magidson, Jessica; Dachman, Laya; Lejuez, C. W.

    2013-01-01

    BACKGROUND Anxiety disorders are among the most common psychiatric disorders; meditative therapies are frequently sought by patients with anxiety as a complementary therapy. Although multiple reviews exist on the general health benefits of meditation, no review has been focused on the efficacy of meditation for anxiety specifically. METHODS Major medical databases were searched thoroughly with keywords related to various types of meditation AND anxiety. Over 1000 abstracts were screened, and 200+ full articles were reviewed. Only RCTs were included. The Boutron (2005) checklist to evaluate a report of a non-pharmaceutical trial (CLEAR-NPT) was used to assess study quality; 90% authors were contacted for additional information. Review Manager 5 was used for meta-analysis. RESULTS A total of 36 RCTs were included in the meta-analysis (2,466 observations). Most RCTs were conducted among patients with anxiety as a secondary concern. The study quality ranged from 0.3 to 1.0 on the 0.0–1.0 scale (mean = 0.72). Standardized mean difference (SMD) was ?0.52 in comparison with waiting-list control (p < .001; 25 RCTs), ?0.59 in comparison with attention control (p < .001; 7 RCTs), and ?0.27 in comparison with alternative treatments (p < 0.01; 10 RCTs). 25 studies reported statistically superior outcomes in the meditation group compared to control. No adverse effects were reported. CONCLUSIONS This review demonstrates some efficacy of meditative therapies in reducing anxiety symptoms, which has important clinical implications for applying meditative techniques in treating anxiety. However, most studies measured only improvement in anxiety symptoms, but not anxiety disorders as clinically diagnosed. PMID:22700446

  7. 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. PMID:25848344

  8. A Systematic Review of the Combined Use of Electroconvulsive Therapy and Psychotherapy for Depression

    PubMed Central

    McClintock, Shawn M.; Brandon, Anna R.; Husain, Mustafa M.; Jarrett, Robin B.

    2011-01-01

    Objective Electroconvulsive therapy (ECT) is one of the most effective treatments for severe Major Depressive Disorder (MDD). However, after acute phase treatment and initial remission, relapse rates are significant. Strategies to prolong remission include continuation phase ECT, pharmacotherapy, psychotherapy, or their combinations. This systematic review synthesizes extant data regarding the combined use of psychotherapy with ECT for the treatment of patients with severe MDD and offers the hypothesis that augmenting ECT with depression-specific psychotherapy represents a promising strategy for future investigation. Methods The authors performed two independent searches in PsychInfo (1806 – 2009) and MEDLINE (1948 – 2009) using combinations of the following search terms: Electroconvulsive Therapy (including ECT, ECT therapy, electroshock therapy, EST, shock therapy) and Psychotherapy (including cognitive behavioral, interpersonal, group, psychodynamic, psychoanalytic, individual, eclectic, and supportive). We included in this review a total of six articles (English language) that mentioned ECT and psychotherapy in the abstract, and provided a case report, series, or clinical trial. We examined the articles for data related to ECT and psychotherapy treatment characteristics, cohort characteristics, and therapeutic outcome. Results Although research over the past seven decades documenting the combined use of ECT and psychotherapy is limited, the available evidence suggests that testing this combination has promise and may confer additional, positive functional outcomes. Conclusions Significant methodological variability in ECT and psychotherapy procedures, heterogeneous patient cohorts, and inconsistent outcome measures prevent strong conclusions; however, existing research supports the need for future investigations of combined ECT and psychotherapy in well-designed, controlled clinical studies. Depression-specific psychotherapy approaches may need special adaptations in view of the cognitive effects following ECT. PMID:21206376

  9. 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.

  10. 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

  11. PHYSICAL REVIEW A 89, 024102 (2014) Tracing the past of a quantum particle

    E-print Network

    Vaidman, Lev

    2014-01-01

    PHYSICAL REVIEW A 89, 024102 (2014) Tracing the past of a quantum particle L. Vaidman Raymond and Beverly Sackler School of Physics and Astronomy, Tel-Aviv University, Tel-Aviv 69978, Israel (Received 29 December 2013; published 13 February 2014) The question "Where was a quantum particle between pre

  12. 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 Department of Applied Mathematics, 8'eizmann Institute, Eehovot, Israel AND I. KzLsoNt IVright nuclear manuscript received 6 December 1968) The single-particle aspects of nuclear fission theories are investigated

  13. 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.

  14. PHYSICAL REVIEW E 85, 061305 (2012) Constraints and vibrations in static packings of ellipsoidal particles

    E-print Network

    O'Hern, Corey S.

    2012-01-01

    packings of ellipsoidal particles. At jamming onset, the harmonic response of static packingsPHYSICAL REVIEW E 85, 061305 (2012) Constraints and vibrations in static packings of ellipsoidal packings of frictionless ellipsoidal particles in two and three dimensions over a range of aspect ratio

  15. 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.

  16. Lenalidomide in multiple myeloma: an evidence-based review of its role in therapy

    PubMed Central

    Richardson, Paul; Mitsiades, Constantine; Laubach, Jacob; Schlossman, Robert; Ghobrial, Irene; Hideshima, Teru; Munshi, Nikhil; Anderson, Kenneth

    2010-01-01

    Introduction: Multiple myeloma (MM) is a relatively common and incurable hematological malignancy. Currently, there is no single standard therapy, with choice of treatment dependent on individual patient factors. Lenalidomide is an immunomodulatory drug with potent antitumor, antiangiogenic, immunomodulatory, and proapoptotic activity in MM. Aims: To evaluate the evidence for the use of lenalidomide in its current indication in relapsed or refractory MM, and additionally its investigational use for the treatment of newly diagnosed MM. Evidence review: In patients with relapsed and refractory MM, adding lenalidomide to high-dose dexamethasone significantly improves response rates and time-to-progression, relative to high-dose dexamethasone alone. This translates into a significant extension of overall survival (with a median extension of 9.1 months in a pivotal phase III study). Outcome is independent of patient age, number of previous therapies, type of previous therapy (including thalidomide or autologous stem cell transplantation), renal impairment, and ?2-microglobulin level. Evidence suggests that combining lenalidomide with low-dose dexamethasone improves outcomes in patients with newly diagnosed disease and is superior to lenalidomide combined with high-dose dexamethasone. Myelosuppression is the predominant toxicity observed, although some studies have shown high incidences of venous thromboembolism in the absence of prophylactic antithrombotic anticoagulation therapy. There is currently only limited evidence regarding the health economics of lenalidomide. Role in therapy: The encouraging results obtained with lenalidomide alone and in combination with dexamethasone in patients with relapsed or refractory MM have led to its adoption as a recommended therapy in patients who have received at least one prior treatment. Emerging evidence supports the ongoing investigation of lenalidomide in combination with low-dose dexamethasone, and in other combinations including bortezomib, for use both in relapsed, refractory, and newly diagnosed MM. PMID:20694078

  17. Black holes as particle accelerators: a brief review

    NASA Astrophysics Data System (ADS)

    Harada, Tomohiro; Kimura, Masashi

    2014-12-01

    Rapidly rotating Kerr black holes can accelerate particles to arbitrarily high energy if the angular momentum of the particle is fine-tuned to some critical value. This phenomenon is robust as it is founded on the basic properties of geodesic orbits around a near-extremal Kerr black hole. On the other hand, the maximum energy of the acceleration is subjected to several physical effects. There is convincing evidence that the particle acceleration to arbitrarily high energy is one of the universal properties of general near-extremal black holes. We also discuss gravitational particle acceleration in a more general context. This article is intended to provide a pedagogical introduction to and a brief overview of this topic for non-specialists.

  18. Black holes as particle accelerators: a brief review

    E-print Network

    Tomohiro Harada; Masashi Kimura

    2014-11-18

    Rapidly rotating Kerr black holes can accelerate particles to arbitrarily high energy if the angular momentum of the particle is fine-tuned to some critical value. This phenomenon is robust as it is founded on the basic properties of geodesic orbits around a near-extremal Kerr black hole. On the other hand, the maximum energy of the acceleration is subjected to several physical effects. There is convincing evidence that the particle acceleration to arbitrarily high energy is one of the universal properties of general near-extremal black holes. We also discuss gravitational particle acceleration in more general context. This article is intended to provide a pedagogical introduction to and a brief overview of this topic for non-specialists.

  19. 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

  20. 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.

  1. A systematic review of the neurocognitive effects of magnetic seizure therapy.

    PubMed

    McClintock, Shawn M; Tirmizi, Owais; Chansard, Matthieu; Husain, Mustafa M

    2011-10-01

    Magnetic seizure therapy (MST) is a novel neurotherapeutic intervention in development for the treatment of major affective disorders. Like other neurotherapeutic strategies such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS), a primary interest will be to monitor the associated neurocognitive effects. Thus, the purpose of this systematic review was to synthesize the available data on the neurocognitive effects of MST. The authors performed two independent literature searches with the following terms terms: MST, magnetic, magnetic seizure therapy, depression, neurocognition, cognitive, preclinical. We included in this review a total of eleven articles that mentioned MST and neurocognition in the abstract. The articles were divided into three methodological domains that included virtual computer simulations, preclinical studies, and clinical investigations. Collectively, the available evidence suggests MST has little to no adverse cognitive effects. Specifically, virtual computer simulations found the magnetic field was localized to grey matter, and preclinical studies found no neurocortical or neurocognitive sequelae. Clinical investigations found MST to be associated with rapid reorientation and intact anterograde and retrograde memory. Future investigations using translational methods are warranted to confirm these findings and to further determine the effects of MST on neurocognitive functions. PMID:22200131

  2. 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

  3. Nanoparticle-mediated photothermal therapy: A comparative study of heating for different particle types

    PubMed Central

    Pattani, Varun P.

    2012-01-01

    Introduction Near infrared absorbing plasmonic nanoparticles enhance photothermal therapy of tumors. In this procedure, systemically delivered gold nanoparticles preferentially accumulate at the tumor site and when irradiated using laser light, produce localized heat sufficient to damage tumor cells. Gold nanoshells and nanorods have been widely studied for this purpose, and while both exhibit strong NIR absorption, their overall absorption and scattering properties differ widely due to their geometry. In this paper, we compared the photothermal response of both nanoparticle types including the heat generation and photothermal efficiency. Methods Tissue simulating phantoms, with varying concentrations of gold nanoparticles, were irradiated with a near-infrared diode laser while concurrently monitoring the surface temperature with an infrared camera. We calculated nanoshell and nanorod optical properties using the Mie solution and the discrete dipole approximation, respectively. In addition, we measured the heat generation of nanoshells and nanorods at the same optical density to determine the photothermal transduction efficiency for both nanoparticle types. Results We found that the gold nanoshells produced more heat than gold nanorods at equivalent number densities (# of nanoparticles/mL), whereas the nanorods generated more heat than nanoshells at equivalent extinction values at the irradiance wavelength. To reach an equivalent heat generation, we found that it was necessary to have ~36x more nanorods than nanoshells. However, the gold nanorods were found to have two times the photothermal transduction efficiency than the gold nanoshells. Conclusion For the NPs tested, the nanoshells generated more heat, per nanoparticle, than nanorods, primarily due to their overall larger geometric cross section. Conversely, we found that the gold nanorods had a higher photothermal efficiency than the gold nanoshells. In conclusion, the ideal choice of plasmonic nanoparticle requires not only per particle efficiency, but also the in vivo particle targeting ability under study. PMID:22933382

  4. 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

  5. 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

  6. Calcium and Vitamin D Supplementation During Androgen Deprivation Therapy for Prostate Cancer: A Critical Review

    PubMed Central

    Datta, Mridul

    2012-01-01

    Background. Loss of bone mineral density is an unintended consequence of androgen deprivation therapy in men with prostate cancer. Supplementation with calcium and/or vitamin D in these men seems logical and is advocated by many lay and professional groups. Methods. We reviewed guidelines for calcium and vitamin D supplementation and the results of clinical trials of calcium and vitamin D supplementation on bone mineral density in men with prostate cancer undergoing androgen deprivation therapy. Results. Whether supplementation of men undergoing androgen deprivation therapy with calcium and/or vitamin D results in higher bone mineral density than no supplementation has not been tested. The results of 12 clinical trials show that, at the doses commonly recommended, 500–1,000 mg calcium and 200–500 IU vitamin D per day, men undergoing androgen deprivation lose bone mineral density. Conclusion. The doses of calcium and vitamin D that have been tested are inadequate to prevent loss of bone mineral density in men undergoing androgen deprivation therapy. In light of evidence that high levels of dietary calcium and calcium supplement use are associated with higher risks for cardiovascular disease and advanced prostate cancer, intervention studies should evaluate the safety as well as the efficacy of calcium and vitamin D supplementation in these men. PMID:22836449

  7. Total skin electron beam (TSEB) therapy in pediatric patients: A review of the literature

    PubMed Central

    Skórska, Ma?gorzata.

    2013-01-01

    Aim A literature review was undertaken to identify current TSEB therapy in pediatric patients. Background Total skin electron beam (TSEB) therapy is a method of irradiation with low energy electron beam dedicated to patients who have superficial skin lesions all over their body. Such skin malignancies are sparse among adults and even more uncommon with pediatric population. Materials and methods In this study, all reported case reports were summed up with a special emphasis on techniques used, doses prescribed and special shielding of critical organs. Moreover, potential problems that were encountered during TSEB irradiation of very young patients were depicted. Results The literature has described only seven case reports of children undergoing TSEB therapy. Most of them were infants; however, two adolescents were also treated. For all infants, general anesthesia was provided to allow safe and accurate TSEB irradiation. The prescribed dose varied from 16 Gy to 28 Gy depending on the irradiation schedule and patient condition. Usually, boost fields were applied to the scalp and perineum. Typical shields for fingernails, toenails and lenses were usually used. Conclusion This paper revealed that TSEB therapy may be considered as a palliative treatment for pediatric patients with leukemia cutis. However, its role is still unclear and should be further investigated. PMID:24936329

  8. Biological dose estimation for charged-particle therapy using an improved PHITS code coupled with a microdosimetric kinetic model.

    PubMed

    Sato, Tatsuhiko; Kase, Yuki; Watanabe, Ritsuko; Niita, Koji; Sihver, Lembit

    2009-01-01

    Microdosimetric quantities such as lineal energy, y, are better indexes for expressing the RBE of HZE particles in comparison to LET. However, the use of microdosimetric quantities in computational dosimetry is severely limited because of the difficulty in calculating their probability densities in macroscopic matter. We therefore improved the particle transport simulation code PHITS, providing it with the capability of estimating the microdosimetric probability densities in a macroscopic framework by incorporating a mathematical function that can instantaneously calculate the probability densities around the trajectory of HZE particles with a precision equivalent to that of a microscopic track-structure simulation. A new method for estimating biological dose, the product of physical dose and RBE, from charged-particle therapy was established using the improved PHITS coupled with a microdosimetric kinetic model. The accuracy of the biological dose estimated by this method was tested by comparing the calculated physical doses and RBE values with the corresponding data measured in a slab phantom irradiated with several kinds of HZE particles. The simulation technique established in this study will help to optimize the treatment planning of charged-particle therapy, thereby maximizing the therapeutic effect on tumors while minimizing unintended harmful effects on surrounding normal tissues. PMID:19138056

  9. Particle bombardment effects on thin-film deposition: A review

    SciTech Connect

    Mattox, D.M.

    1989-05-01

    In many atomistic film deposition processes, concurrent energetic particle bombardment (ions, atoms, molecules, atom clusters) may occur inadvertently and uncontrollably or bombardment may be used to deliberately modify film properties. These energetic particles can arise from (i) the acceleration of charged particles, (ii) high-energy neutrals from reflection from bombarded surfaces, or (iii) charge exchange processes. Particle bombardment effects that can affect film formation and growth include (a) modifying the substrate surface (cleaning, defect formation), (b) momentum transfer processes in the surface region (sputtering, desorption, recoil implantation, defect formation), (c) addition of heat to the surface region, and (d) formation of secondary elelctrons that can affect chemical reactions. These in turn affect film properties such as adhesion, residual film stress, film morphology, density, grain size and orientation, surface coverage, pinhole density, and surface area. The understanding of these effects and how to use them advantageously is important to those utilizing processes where concurrent energetic particle bombardment is occurring or can be made to occur.

  10. Chromatic energy filter and characterization of laser-accelerated proton beams for particle therapy

    NASA Astrophysics Data System (ADS)

    Hofmann, Ingo; Meyer-ter-Vehn, Jürgen; Yan, Xueqing; Al-Omari, Husam

    2012-07-01

    The application of laser accelerated protons or ions for particle therapy has to cope with relatively large energy and angular spreads as well as possibly significant random fluctuations. We suggest a method for combined focusing and energy selection, which is an effective alternative to the commonly considered dispersive energy selection by magnetic dipoles. Our method is based on the chromatic effect of a magnetic solenoid (or any other energy dependent focusing device) in combination with an aperture to select a certain energy width defined by the aperture radius. It is applied to an initial 6D phase space distribution of protons following the simulation output from a Radiation Pressure Acceleration model. Analytical formula for the selection aperture and chromatic emittance are confirmed by simulation results using the TRACEWIN code. The energy selection is supported by properly placed scattering targets to remove the imprint of the chromatic effect on the beam and to enable well-controlled and shot-to-shot reproducible energy and transverse density profiles.

  11. review The American Society of Gene & Cell Therapy Molecular Therapy vol. 17 no. 10, 16771682 oct. 2009 1677

    E-print Network

    Cai, Long

    follow- ing treatment with surgery, chemotherapy, radiation therapy, and some of the newer targetedreview© The American Society of Gene & Cell Therapy Molecular Therapy vol. 17 no. 10, 1677­1682 oct and improved survival for many patients with cancer. Unfortunately, even for patients who achieve remission

  12. 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

  13. Vertebral compression fractures: a review of current management and multimodal therapy

    PubMed Central

    Wong, Cyrus C; McGirt, Matthew J

    2013-01-01

    Vertebral compression fractures are a prevalent disease affecting osteoporotic patients. When symptomatic, they cause significant pain and loss of function and have a high public health impact. In this paper we outline the diagnosis and management of these patients, with evidence-based review of treatment outcomes for the various therapeutic options. Diagnosis involves a clinical history focusing on the nature of the patient’s pain as well as various imaging studies. Management is multimodal in nature and starts with conservative therapy consisting of analgesic medication, medication for osteoporosis, physical therapy, and bracing. Patients who are refractory to conservative management may be candidates for vertebral augmentation through either vertebroplasty or kyphoplasty. PMID:23818797

  14. 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.

  15. A review of transport theory. [particle acceleration in astrophysical plasmas

    NASA Technical Reports Server (NTRS)

    Jones, Frank C.

    1992-01-01

    Ways in which energy change terms arise in the transport equation and how the various terms relate to the modes of energy exchange between the particles and plasma are shown. It is argued that the transport equation cannot be used to describe the initial acceleration of thermal particles by plasma shocks or relativistic shocks where the energetic particle speeds are never much greater than the flow speeds. In most other situations, it describes almost any acceleration process that can be caused by a moving plasma. It describes shock acceleration for both parallel shocks and oblique ones, and stochastic acceleration by the turbulent motion of the scatterers as well as by their motion across the magnetic field.

  16. Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review

    PubMed Central

    Romano, Michele; Negrini, Stefano

    2008-01-01

    Background The treatment of adolescent idiopathic scoliosis is contingent upon many variables. Simple observation is enough for less serious curvatures, but for very serious cases surgical intervention could be proposed. Between these there is a wide range of different treatments. Manual therapy is commonly used: the aim of this paper is to verify the data existing in the literature on the efficacy of this approach. Methods A systematic review of the scientific literature published internationally has been performed. We have included in the term manual therapy all the manipulative and generally passive techniques performed by an external operator. In a more specific meaning, osteopathic, chiropractic and massage techniques have been considered as manipulative therapeutic methods. We performed our systematic research in Medline, Embase, Cinhal, Cochrane Library, Pedro with the following terms: idiopathic scoliosis combined with chiropractic; manipulation; mobilization; manual therapy; massage; osteopathy; and therapeutic manipulation. The criteria for inclusion were as follows: Any kind of research; diagnosis of adolescent idiopathic scoliosis; patients treated exclusively by one of the procedures established as a standard for this review (chiropractic manipulation, osteopathic techniques, massage); and outcome in Cobb degrees. Results We founded 145 texts, but only three papers were relevant to our study. However, no one of the three satisfied all the required inclusion criteria because they were characterized by a combination of manual techniques and other therapeutic approaches. Conclusion The lack of any kind of serious scientific data does not allow us to draw any conclusion on the efficacy of manual therapy as an efficacious technique for the treatment of Adolescent idiopathic scoliosis. PMID:18211702

  17. Game-based digital interventions for depression therapy: a systematic review and meta-analysis.

    PubMed

    Li, Jinhui; Theng, Yin-Leng; Foo, Schubert

    2014-08-01

    The aim of this study was to review the existing literature on game-based digital interventions for depression systematically and examine their effectiveness through a meta-analysis of randomized controlled trials (RCTs). Database searching was conducted using specific search terms and inclusion criteria. A standard meta-analysis was also conducted of available RCT studies with a random effects model. The standard mean difference (Cohen's d) was used to calculate the effect size of each study. Nineteen studies were included in the review, and 10 RCTs (eight studies) were included in the meta-analysis. Four types of game interventions-psycho-education and training, virtual reality exposure therapy, exercising, and entertainment-were identified, with various types of support delivered and populations targeted. The meta-analysis revealed a moderate effect size of the game interventions for depression therapy at posttreatment (d=-0.47 [95% CI -0.69 to -0.24]). A subgroup analysis showed that interventions based on psycho-education and training had a smaller effect than those based on the other forms, and that self-help interventions yielded better outcomes than supported interventions. A higher effect was achieved when a waiting list was used as the control. The review and meta-analysis support the effectiveness of game-based digital interventions for depression. More large-scale, high-quality RCT studies with sufficient long-term data for treatment evaluation are needed. PMID:24810933

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

    PubMed

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

    2013-07-01

    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

  19. Comparative effectiveness of Mitraclip plus medical therapy versus medical therapy alone in high-risk surgical patients: a comprehensive review.

    PubMed

    Gonzalez, Fernando Matias; Finch, Aureliano Paolo; Armeni, Patrizio; Boscolo, Paola Roberta; Tarricone, Rosanna

    2015-07-01

    In recent years, Mitraclip has become available as a treatment option for mitral regurgitation in high-risk surgical patients. Focusing on the incremental effectiveness of Mitraclip versus the current standard of care, this article provides a comparative review of the evidence on Mitraclip and standard medical therapy (MT) in high-risk mitral regurgitation patients. Evidence was retrieved from seven major databases. Results suggest that Mitraclip presents a high safety profile and a good middle-term effectiveness performance. Evidence on long-term effectiveness is limited both for Mitraclip and MT. Few studies allow a comparison with MT and comparative results on different endpoints are mixed. Therefore, the available evidence does not conclusively inform whether or under which circumstances Mitraclip should be preferred over MT in the treatment of high-risk patients. Head-to-head real-world studies would be needed, as they would provide great and timely insights to support policy decisions when medical devices are at stake. PMID:26051009

  20. Adjuvant Chemoradiation Therapy in Gastric Cancer: Critically Reviewing the Past and Visualizing the Next Step Forward

    PubMed Central

    Papadimitriou, Konstantinos; Antoniou, Georgios; Bronte, Giuseppe; Vassiliou, Vassilios; Papamichael, Demetris; Peeters, Marc; Kountourakis, Panteleimon

    2015-01-01

    Gastric cancer remains one of the most common malignancies worldwide. Despite the significant advances in surgical treatment and multimodality strategies, prognosis has modestly improved over the last two decades. Locoregional relapse remains one of the main issues and the combined chemoradiation treatment seems to be one of the preferred approaches. However, more than ten years after the hallmark INT-0116 trial, minimal progress has been made both in terms of effectiveness and toxicity. Moreover, new regimens added to combined therapy failed to prove favourable results. Herein, we attempt a thorough literature review comparing pros and cons of all relative studies and potential bias, targeting well-designed future approaches.

  1. Neural tube defects: review of experimental evidence on stem cell therapy and newer treatment options.

    PubMed

    Dhaulakhandi, Dhara B; Rohilla, Seema; Rattan, Kamal Nain

    2010-01-01

    The failure of closure of the neural tube during development leads to malformations called neural tube defects (NTDs). The most common neural malformations in humans include anencephaly, encephalocele, exencephaly, craniorachischisis spina bifida with or without myelomeningocele, lipomyeloschisis, lipomyelomeningocele, meningocele and myelocystocele. Current preventive strategies are mainly based on pharmacologic/folic acid supplementation. However, stem cell-based and other combination approaches may emerge as potential treatment options for NTDs. This review provides an account of experimental evidence on stem cell therapy and newer treatment options for NTDs which have become available in recent years. PMID:20689263

  2. Low intensity laser therapy in wound healing — a review with special respect to diabetic angiopathies

    Microsoft Academic Search

    A. Schindl; M. Schindl; Heidemarie Pernerstorfer-Schön; Liesbeth Schindl

    2001-01-01

    Summary  \\u000a Background: Low intensity laser radiation is characterized by its ability to induce athermic, non-destructive photobiological processes.\\u000a Albeit in use for about thirty years, this phototherapy is still not an established therapeutic modality in wound healing.\\u000a \\u000a \\u000a Methods: We have reviewed the literature addressing both in vitro and in vivo effects of low intensity laser therapy on constituents\\u000a of the wound

  3. 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

  4. 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.

  5. 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

  6. Review of photodynamic therapy in actinic keratosis and basal cell carcinoma

    PubMed Central

    Ericson, Marica B; Wennberg, Ann-Marie; Larkö, Olle

    2008-01-01

    The number of non-melanoma skin cancers is increasing worldwide, and so also the demand for effective treatment modalities. Topical photodynamic therapy (PDT) using aminolaevulinic acid or its methyl ester has recently become good treatment options for actinic keratosis and basal cell carcinoma; especielly when treating large areas and areas with field cancerization. The cure rates are usually good, and the cosmetic outcomes excellent. The only major side effect reported is the pain experienced by the patients during treatment. This review covers the fundamental aspects of topical PDT and its application for treatment of actinic keratosis and basal cell carcinoma. Both potentials and limitations will be reviewed, as well as some recent development within the field. PMID:18728698

  7. Bench-to-bedside review: Immunoglobulin therapy for sepsis - biological plausibility from a critical care perspective

    PubMed Central

    2012-01-01

    Sepsis represents a dysregulated host response to infection, the extent of which determines the severity of organ dysfunction and subsequent outcome. All trialled immunomodulatory strategies to date have resulted in either outright failure or inconsistent degrees of success. Intravenous immunoglobulin (IVIg) therapy falls into the latter category with opinion still divided as to its utility. This article provides a narrative review of the biological rationale for using IVIg in sepsis. A literature search was conducted using the PubMed database (1966 to February 2011). The strategy included the following text terms and combinations of these: IVIg, intravenous immune globulin, intravenous immunoglobulin, immunoglobulin, immunoglobulin therapy, pentaglobin, sepsis, inflammation, immune modulation, apoptosis. Preclinical and extrapolated clinical data of IVIg therapy in sepsis suggests improved bacterial clearance, inhibitory effects upon upstream mediators of the host response (for example, the nuclear factor kappa B (NF-?B) transcription factor), scavenging of downstream inflammatory mediators (for example, cytokines), direct anti-inflammatory effects mediated via Fc? receptors, and a potential ability to attenuate lymphocyte apoptosis and thus sepsis-related immunosuppression. Characterizing the trajectory of change in immunoglobulin levels during sepsis, understanding mechanisms contributing to these changes, and undertaking IVIg dose-finding studies should be performed prior to further large-scale interventional trials to enhance the likelihood of a successful outcome. PMID:22424150

  8. Magnetic Seizure Therapy for Unipolar and Bipolar Depression: A Systematic Review

    PubMed Central

    Cretaz, Eric; Brunoni, André R.

    2015-01-01

    Objective. Magnetic seizure therapy (MST) is a novel, experimental therapeutic intervention, which combines therapeutic aspects of electroconvulsive therapy (ECT) and transcranial magnetic stimulation, in order to achieve the efficacy of the former with the safety of the latter. MST might prove to be a valuable tool in the treatment of mood disorders, such as major depressive disorder (MDD) and bipolar disorder. Our aim is to review current literature on MST. Methods. OVID and MEDLINE databases were used to systematically search for clinical studies on MST. The terms “magnetic seizure therapy,” “depression,” and “bipolar” were employed. Results. Out of 74 studies, 8 met eligibility criteria. There was considerable variability in the methods employed and samples sizes were small, limiting the generalization of the results. All studies focused on depressive episodes, but few included patients with bipolar disorder. The studies found reported significant antidepressant effects, with remission rates ranging from 30% to 40%. No significant cognitive side effects related to MST were found, with a better cognitive profile when compared to ECT. Conclusion. MST was effective in reducing depressive symptoms in mood disorders, with generally less side effects than ECT. No study focused on comparing MST to ECT on bipolar depression specifically. PMID:26075100

  9. Manual therapies for primary chronic headaches: a systematic review of randomized controlled trials.

    PubMed

    Chaibi, Aleksander; Russell, Michael Bjørn

    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

  10. 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

  11. 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

  12. Hospital-based proton linear accelerator for particle therapy and radioisotope production

    NASA Astrophysics Data System (ADS)

    Lennox, Arlene J.

    1991-05-01

    Taking advantage of recent advances in linear accelerator technology, it is possible for a hospital to use a 70 MeV proton linac for fast neutron therapy, boron neutron capture therapy, proton therapy for ocular melanomas, and production of radiopharmaceuticals. The linac can also inject protons into a synchrotron for proton therapy of deep-seated tumors. With 180 ?A average current, a single linac can support all these applications. This paper presents a conceptual design for a medical proton linac, switchyard, treatment rooms, and isotope production rooms. Special requirements for each application are outlined and a layout for sharing beam among the applications is suggested.

  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. Family therapy for drug abuse: review and updates 2003-2010.

    PubMed

    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 progress in this specialty with encouraging findings on adolescent-focused models based on rigorous methodology, as well as advances with adult-focused family-based treatments. The current review brings the field up to date with highlights from research conducted in the intervening 7 years, cross-cutting issues, recommendations for new research, and practice implications of these findings. Adolescent-focused family-based models that attend to the ecology of the teen and family show the most consistent and strongest findings in recent studies. Adult-focused models based on behavioral and systems theories of change also show strong effects with drug abusers and their families. The overarching conclusion is that family-based models are not only a viable treatment alternative for the treatment of drug abuse, but are now consistently recognized among the most effective approaches for treating both adults and adolescents with drug problems. PMID:22283381

  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. Radiation therapy

    MedlinePLUS

    Radiation therapy uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells. ... radiation is most harmful to quickly growing cells, radiation therapy damages cancer cells more than normal cells. This ...

  17. Cancer Pain: A Critical Review of Mechanism-based Classification and Physical Therapy Management in Palliative Care

    PubMed Central

    Kumar, Senthil P

    2011-01-01

    Mechanism-based classification and physical therapy management of pain is essential to effectively manage painful symptoms in patients attending palliative care. The objective of this review is to provide a detailed review of mechanism-based classification and physical therapy management of patients with cancer pain. Cancer pain can be classified based upon pain symptoms, pain mechanisms and pain syndromes. Classification based upon mechanisms not only addresses the underlying pathophysiology but also provides us with an understanding behind patient's symptoms and treatment responses. Existing evidence suggests that the five mechanisms – central sensitization, peripheral sensitization, sympathetically maintained pain, nociceptive and cognitive-affective – operate in patients with cancer pain. Summary of studies showing evidence for physical therapy treatment methods for cancer pain follows with suggested therapeutic implications. Effective palliative physical therapy care using a mechanism-based classification model should be tailored to suit each patient's findings, using a biopsychosocial model of pain. PMID:21976851

  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. Botulinum toxin therapy for temporomandibular joint disorders: a systematic review of randomized controlled trials.

    PubMed

    Chen, Y-W; Chiu, Y-W; Chen, C-Y; Chuang, S-K

    2015-08-01

    The objective of this study was to undertake a systematic review to assess the efficacy of botulinum toxin therapy (BTX) for temporomandibular joint disorders (TMDs). A comprehensive search of major databases through PubMed, EMBASE, and Cochrane CENTRAL was conducted to locate all relevant articles published from inception to October 2014. Eligible studies were selected based on inclusion criteria and included English language, peer-reviewed publications of randomized controlled trials comparing BTX versus any alternative intervention or placebo. Quality assessment and data extraction were done according to the Cochrane risk of bias tool and recommendations. The entire systematic search and selection process was done independently by two reviewers. Five relevant study trials were identified, involving 117 participants. Two trials revealed a significant between-group difference in myofascial pain reduction, another trial that compared BTX with fascial manipulation showed equal efficacy of pain relief on TMDs, while the remaining two trials showed no significant difference between the BTX and placebo groups. Because of considerable variations in study methods and evaluation of results, a meta-analysis could not be performed. Based on this review, no consensus could be reached on the therapeutic benefits of BTX on TMDs. A more rigorous design of trials should be carried out in future studies. PMID:25920597

  20. 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

  1. 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.

  2. Horticultural Therapy

    Microsoft Academic Search

    Eunhee Kim

    2003-01-01

    Horticultural therapy is a treatment modality that utilizes plants and gardening activities as vehicles in adjunctive therapy programs for all ages and for diverse diagnoses. This paper provides a brief background of horticultural therapy, and reviews Web sites and bibliographic databases to the literature on horticultural therapy.

  3. Targeted therapy for cutaneous oncology: a review of novel treatment options for non-melanoma skin cancer: part I.

    PubMed

    Walls, Brooke; Jordan, Laura; Diaz, Lisa; Miller, Richard

    2014-08-01

    The field of cutaneous oncology is exploding with innovative treatment options, specifically in the field of targeted therapy. These advances offer new hope to select patients with high risk skin cancers. Here we provide a two part series reviewing targeted therapy for non-melanoma skin cancer. We begin our discussion with basal cell carcinoma, moving beyond the first-in-class hedgehog inhibitors and highlighting promising clinical trials. PMID:25116973

  4. 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

  5. Medical Therapy for Obstructive Sleep Apnea: A Review by the Medical Therapy for Obstructive Sleep Apnea Task Force of the Standards of Practice Committee of the American Academy of Sleep Medicine

    Microsoft Academic Search

    Sigrid C. Veasey; Christian Guilleminault; Kingman P. Strohl; Mark H. Sanders; Robert D. Ballard; Ulysses J. Magalang

    2006-01-01

    A significant number of patients with obstructive sleep apnea neither tolerate positive airway pressure (PAP) therapy nor achieve suc- cessful outcomes from either upper airway surgeries or use of an oral appliance. The purpose of this paper, therefore, was to systematically evaluate available peer-reviewed data on the effectiveness of adjunctive medical therapies and summarize findings from these studies. A review

  6. Adjuncts and alternatives to oxime therapy in organophosphate poisoning--is there evidence of benefit in human poisoning? A review.

    PubMed

    Peter, J V; Moran, J L; Pichamuthu, K; Chacko, B

    2008-05-01

    Organophosphate poisoning is common in developing countries. The morbidity and mortality with organophosphate poisoning is relatively high despite the use of atropine as specific antidotal therapy and oximes to reactivate acetylcholinesterase. Several adjunct and alternative therapies have been explored in animal and human studies. We reviewed the literature to ascertain if there was evidence of benefit of such therapies. Adjunct and alternative therapies included treatments to reduce poison absorption by topical application of creams, enhance toxin elimination by haemoperfusion or bioremediation and neutralise the poison by scavenging free organophosphate with cholinesterase-rich human plasma. In addition, magnesium, clonidine, diazepam, N-acetyl cysteine and adenosine receptor agonists have also been used to counteract poison effects. Detailed assessment was limited by the paucity of trials on adjunct/alternative therapies. The limited evidence from the review process suggested potential benefit from the use of human plasma infusion, early initiation of haemoperfusion and intravenous magnesium, in addition to standard therapy with atropine and pralidoxime. There appeared to be no additional benefit with alkalinisation or use of glycopyrrolate instead of atropine in human trials. Diazepam administration has been advocated by military authorities if symptoms developed following exposure to organophosphate. Bioremediation, clonidine, N-acetyl cysteine and adenosine receptor agonists have been evaluated only in animal models. The impact of adjunct and alternate therapies on outcomes in human poisoning needs to be further explored before implementation as standard treatment. PMID:18564794

  7. 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.

  8. Refractive-index and density matching in concentrated particle suspensions: a review

    NASA Astrophysics Data System (ADS)

    Wiederseiner, Sébastien; Andreini, Nicolas; Epely-Chauvin, Gaël; Ancey, Christophe

    2011-05-01

    Optical measurement techniques such as particle image velocimetry (PIV) and laser Doppler velocimetry (LDV) are now routinely used in experimental fluid mechanics to investigate pure fluids or dilute suspensions. For highly concentrated particle suspensions, material turbidity has long been a substantial impediment to these techniques, which explains why they have been scarcely used so far. A renewed interest has emerged with the development of specific methods combining the use of iso-index suspensions and imaging techniques. This review paper gives a broad overview of recent advances in visualization techniques suited to concentrated particle suspensions. In particular, we show how classic methods such as PIV, LDV, particle tracking velocimetry, and laser induced fluorescence can be adapted to deal with concentrated particle suspensions.

  9. Supercritical fluid particle design for poorly water-soluble drugs (review).

    PubMed

    Sun, Yongda

    2014-01-01

    Supercritical fluid particle design (SCF PD) offers a number of routes to improve solubility and dissolution rate for enhancing the bioavailability of poorly water-soluble drugs, which can be adopted through an in-depth knowledge of SCF PD processes and the molecular properties of active pharmaceutical ingredients (API) and drug delivery system (DDS). Combining with research experiences in our laboratory, this review focuses on the most recent development of different routes (nano-micron particles, polymorphic particles, composite particles and bio-drug particles) to improve solubility and dissolution rate of poorly water-soluble drugs, covering the fundamental concept of SCF and the principle of SCF PD processes which are typically used to control particle size, shape, morphology and particle form and hence enable notable improvement in the dissolution rate of the poorly water-soluble drugs. The progress of the industrialization of SCF PD processes in pharmaceutical manufacturing environment with scaled-up plant under current good manufacturing process (GMP) specification is also considered in this review. PMID:23651403

  10. Tissue decomposition from dual energy CT data for MC based dose calculation in particle therapy

    PubMed Central

    Hünemohr, Nora; Paganetti, Harald; Greilich, Steffen; Jäkel, Oliver; Seco, Joao

    2014-01-01

    Purpose: The authors describe a novel method of predicting mass density and elemental mass fractions of tissues from dual energy CT (DECT) data for Monte Carlo (MC) based dose planning. Methods: The relative electron density ?e and effective atomic number Zeff are calculated for 71 tabulated tissue compositions. For MC simulations, the mass density is derived via one linear fit in the ?e that covers the entire range of tissue compositions (except lung tissue). Elemental mass fractions are predicted from the ?e and the Zeff in combination. Since particle therapy dose planning and verification is especially sensitive to accurate material assignment, differences to the ground truth are further analyzed for mass density, I-value predictions, and stopping power ratios (SPR) for ions. Dose studies with monoenergetic proton and carbon ions in 12 tissues which showed the largest differences of single energy CT (SECT) to DECT are presented with respect to range uncertainties. The standard approach (SECT) and the new DECT approach are compared to reference Bragg peak positions. Results: Mean deviations to ground truth in mass density predictions could be reduced for soft tissue from (0.5±0.6)% (SECT) to (0.2±0.2)% with the DECT method. Maximum SPR deviations could be reduced significantly for soft tissue from 3.1% (SECT) to 0.7% (DECT) and for bone tissue from 0.8% to 0.1%. Mean I-value deviations could be reduced for soft tissue from (1.1±1.4%, SECT) to (0.4±0.3%) with the presented method. Predictions of elemental composition were improved for every element. Mean and maximum deviations from ground truth of all elemental mass fractions could be reduced by at least a half with DECT compared to SECT (except soft tissue hydrogen and nitrogen where the reduction was slightly smaller). The carbon and oxygen mass fraction predictions profit especially from the DECT information. Dose studies showed that most of the 12 selected tissues would profit significantly (up to 2.2%) from DECT material decomposition with no noise present. The ?e associated with an absolute noise of ±0.01 and Zeff associated with an absolute noise of ±0.2 resulted in ±10% standard variation in the carbon and oxygen mass fraction prediction. Conclusions: Accurate stopping power prediction is mainly determined by the correct mass density prediction. Theoretical improvements in range predictions with DECT data in the order of 0.1%–2.1% were observed. Further work is needed to quantify the potential improvements from DECT compared to SECT in measured image data associated with artifacts and noise. PMID:24877809

  11. Lipid profile of HIV-infected patients in relation to antiretroviral therapy: a review.

    PubMed

    Souza, Suelen Jorge; Luzia, Liania Alves; Santos, Sigrid Sousa; Rondó, Patrícia Helen Carvalho

    2013-01-01

    This study reviewed the lipid profile of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in relation to use of antiretroviral therapy (ART), and its different classes of drugs. A total of 190 articles published in peer-reviewed journals were retrieved from PubMed and LILACS databases; 88 of them met the selection criteria and were included in the review. Patients with HIV/AIDS without ART presented an increase of triglycerides and decreases of total cholesterol, low density lipoprotein (LDL-c), and high density lipoprotein (HDL-c) levels. Distinct ART regimens appear to promote different alterations in lipid metabolism. Protease inhibitors, particularly indinavir and lopinavir, were commonly associated with hypercholesterolemia, high LDL-c, low HDL-c, and hypertriglyceridemia. The protease inhibitor atazanavir is apparently associated with a more advantageous lipid profile. Some nucleoside reverse-transcriptase inhibitors (didanosine, stavudine, and zidovudine) induced lipoatrophy and hypertriglyceridemia, whereas abacavir increased the risk of cardiovascular diseases even in the absence of apparent lipid disorders, and tenofovir resulted in lower levels of cholesterol and triglycerides. Although non-nucleoside reverse-transcriptase inhibitors predisposed to hypertriglyceridemia and hypercholesterolemia, nevirapine was particularly associated with high HDL-c levels, a protective factor against cardiovascular diseases. Therefore, the infection itself, different classes of drugs, and some drugs from the same class of ART appear to exert distinct alterations in lipid metabolism. PMID:23582562

  12. 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.

  13. 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

  14. 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...

  15. 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

  16. Review of Basic Physics of Laser-Accelerated Charged-Particle Beams

    SciTech Connect

    Suk, H.; Hur, M. S.; Jang, H.; Kim, J. [Center for Advanced Accelerators, KERI, Seongju-Dong 28-1, Changwon, 641-120 (Korea, Republic of)

    2007-07-11

    Laser-plasma wake wave can accelerate charged particles, especially electrons with an enormously large acceleration gradient. The electrons in the plasma wake wave have complicated motions in the longitudinal and transverse directions. In this paper, basic physics of the laser-accelerated electron beam is reviewed.

  17. A review and numerical assessment of the random walk particle tracking method

    Microsoft Academic Search

    Peter Salamon; Daniel Fernàndez-Garcia; J. Jaime Gómez-Hernández

    2006-01-01

    We review the basic mathematical concepts of random walk particle tracking (RWPT) and its advantages and limitations. Three different numerical approaches to overcome the local mass conservation problem of the random walk methodology are examined: (i) the interpolation method, (ii) the reflection principle, and (iii) the generalized stochastic differential equations (GSDE). Analytical solutions of the spatial moments for a two-layer

  18. Particle Image Velocimetry measurement of indoor airflow field: A review of the technologies and applications

    E-print Network

    Chen, Qingyan "Yan"

    and mechanical ventilation, have been widely used and discussed in indoor environment quality studies [1Particle Image Velocimetry measurement of indoor airflow field: A review of the technologies@tju.edu.cn Abstract Quantifying the airflow field in building room or vehicle cabin indoor space is crucial

  19. EFFECTS OF TEMPERATURE AND PRESSURE ON PARTICLE COLLECTION MECHANISMS: THEORETICAL REVIEW

    EPA Science Inventory

    The report is a critical review and evaluation of the mechanics of aerosols at high temperatures and pressures. It discusses equations and models used to predict particle behavior at normal conditions, with regard to their applicability at high temperatures and pressures. It disc...

  20. Methodology for the systematic reviews on occupational therapy for individuals with work-related injuries and illnesses.

    PubMed

    Arbesman, Marian; Lieberman, Deborah; Thomas, V Judith

    2011-01-01

    Systematic reviews of literature relevant to individuals with work-related injuries and illnesses are important to the practice of occupational therapy. This article describes the four questions that served as the focus for the systematic reviews of the effectiveness of occupational therapy interventions for individuals with work-related injuries and illnesses of the low back; hand, wrist, and forearm; elbow; and shoulder. The article includes 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 results; the strengths and limitations of the findings; and the implications for practice, education, and research are presented. PMID:21309366

  1. Standard and pegylated interferon therapy of HDV infection: A systematic review and meta- analysis

    PubMed Central

    Alavian, Seyed-Moayed; Tabatabaei, Seyed Vahid; Behnava, Bita; Rizzetto, Mario

    2012-01-01

    Background: Hepatitis D virus (HDV) infection is characterized by rapidly progressive liver disease with adverse prognosis in most patients. Although interferon is the only approved anti-HDV therapy, evidence regarding the efficacy and safety of its various regimens is either old or scattered. Materials and Methods: We searched systematically Medline, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and ISI. The studies that evaluated treatment of chronic HDV infection with standard or pegylated interferon for at least 48 weeks were identified. Our inclusion criteria were positive anti-HDV antibody for 6 months and positive HDV-PCR at the start of study. We performed a meta-analysis for proportions using the arcsine transformation in random effects model. Sustained virological response (SVR) rate (negative Polymerase chain reaction (PCR) 6 months after cessation of therapy) was the end point of interest. Results: Data were abstracted from 14 studies containing 227 chronic HDV-infected patients who received standard or pegylated interferon alpha-2a or -2b. Twenty-one and 30 patients of 71 and 156 who received standard or peginterferon, respectively, beyond 48 weeks achieved SVR. Pooled SVR rates were 29% [95% confidence interval (CI) 19; 41] and 19% (95% CI 10; 29), respectively. The rates of treatment withdrawal were similar. Conclusion: Our systematic review indicates that the literature lacks sufficient evidence to establish precise recommendations for treatment of HDV infection. Meta-analysis of these studies shows that standard dose of peginterferon is more effective than high dose of standard interferon as anti-HDV therapy. PMID:23825999

  2. Systematic review of the effectiveness of occupational therapy-related interventions for people with Parkinson's disease.

    PubMed

    Foster, Erin R; Bedekar, Mayuri; Tickle-Degnen, Linda

    2014-01-01

    We describe the results of a systematic review of the literature on occupational therapy-related interventions for people with Parkinson's disease (PD). Three broad categories of intervention emerged: (1) exercise or physical activity; (2) environmental cues, stimuli, and objects; and (3) self-management and cognitive-behavioral strategies. Moderate to strong evidence exists for task-specific benefits of targeted physical activity training on motor performance, postural stability, and balance. Low to moderate evidence indicates that more complex, multimodal activity training supports improvement in functional movement activities. The evidence is moderate that the use of external supports during functional mobility or other movement activities has positive effects on motor control. In addition, moderate evidence is available that individualized interventions focused on promoting participant wellness initiatives and personal control by means of cognitive-behavioral strategies can improve targeted areas of quality of life. The implications for practice, education, and research are discussed. PMID:24367954

  3. RADIATION EXPOSURE TO CAREGIVERS FROM PATIENTS UNDERGOING COMMON RADIONUCLIDE THERAPIES: A REVIEW.

    PubMed

    Stefanoyiannis, A P; Ioannidou, S P; Round, W H; Carinou, E; Mavros, M N; Liotsou, T; Geronikola-Trapali, X; Armeniakos, I; Chatziioannou, S N

    2014-11-27

    The contribution of radionuclide therapies (RNTs) to effective patient treatment is widely appreciated. The administration of high doses has necessitated investigating the potential radiation hazard to caregivers from patients undergoing RNTs. This work aimed to review the literature regarding measured effective doses to caregivers from such patients. The main selection criterion was the presence of real radiation exposure measurements. The results were categorised according to the treatment protocol and dose parameters. Analysis of the collected data demonstrated that the measured effective dose values were within the dose constraints defined by the International Commission on Radiological Protection, provided that the radiation protection instructions were followed by both patients and caregivers. In conclusion, the radiation risk for caregivers was almost negligible. In this context, treatments could be administered more often on an outpatient basis, once cost-effectiveness criteria were established and radiation protection training and procedures were appropriately applied. PMID:25431487

  4. Volumetric modulated arc therapy: a review of current literature and clinical use in practice

    PubMed Central

    Teoh, M; Clark, C H; Wood, K; Whitaker, S; Nisbet, A

    2011-01-01

    Volumetric modulated arc therapy (VMAT) is a novel radiation technique, which can achieve highly conformal dose distributions with improved target volume coverage and sparing of normal tissues compared with conventional radiotherapy techniques. VMAT also has the potential to offer additional advantages, such as reduced treatment delivery time compared with conventional static field intensity modulated radiotherapy (IMRT). The clinical worldwide use of VMAT is increasing significantly. Currently the majority of published data on VMAT are limited to planning and feasibility studies, although there is emerging clinical outcome data in several tumour sites. This article aims to discuss the current use of VMAT techniques in practice and review the available data from planning and clinical outcome studies in various tumour sites including prostate, pelvis (lower gastrointestinal, gynaecological), head and neck, thoracic, central nervous system, breast and other tumour sites. PMID:22011829

  5. Nanotechnology-Based Drug Delivery Systems for Melanoma Antitumoral Therapy: A Review

    PubMed Central

    Rigon, Roberta Balansin; Oyafuso, Márcia Helena; Fujimura, Andressa Terumi; do Prado, Alice Haddad; Gremião, Maria Palmira Daflon

    2015-01-01

    Melanoma (MEL) is a less common type of skin cancer, but it is more aggressive with a high mortality rate. The World Cancer Research Fund International (GLOBOCAN 2012) estimates that there were 230,000 new cases of MEL in the world in 2012. Conventional MEL treatment includes surgery and chemotherapy, but many of the chemotherapeutic agents used present undesirable properties. Drug delivery systems are an alternative strategy by which to carry antineoplastic agents. Encapsulated drugs are advantageous due to such properties as high stability, better bioavailability, controlled drug release, a long blood circulation time, selective organ or tissue distribution, a lower total required dose, and minimal toxic side effects. This review of scientific research supports applying a nanotechnology-based drug delivery system for MEL therapy. PMID:26078967

  6. Racial/Ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review.

    PubMed

    Roberts, Megan C; Wheeler, Stephanie B; Reeder-Hayes, Katherine

    2015-07-01

    We examined the current literature to understand factors that influence endocrine therapy (ET) adherence among racial/ethnic and socioeconomic subpopulations of breast cancer patients. We searched PubMed and PsycINFO databases for studies from January 1, 1978, to June 20, 2014, and January 1, 1991, to June 20, 2014, respectively, and hand-searched articles from relevant literature reviews. We abstracted and synthesized results within a social ecological framework. Fourteen articles met all inclusion criteria. The majority of included articles reported significant underuse of ET among minority and low-income women. Modifiable intrapersonal, interpersonal, and community-level factors are associated with ET use, and these factors vary across subgroups. Both race/ethnicity and socioeconomic status are associated with ET use in most settings. Variation in factors associated with ET use across subgroups indicates the need for more nuanced research and targeted interventions among breast cancer patients. PMID:25905855

  7. 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

  8. The levonorgestrel-releasing intrauterine system for endometrial protection during estrogen replacement therapy: a clinical review.

    PubMed

    Depypere, H; Inki, P

    2015-08-01

    Estrogen replacement therapy (ERT) is a well-established method of managing climacteric symptoms in women approaching the menopause, but it is associated with a significant risk of endometrial hyperplasia if unopposed by concomitant progestogen administration. The levonorgestrel-releasing intrauterine system (LNG-IUS) offers a highly effective method of minimizing this risk and has additional benefits beyond endometrial protection. The LNG-IUS provides excellent contraception, which may still be necessary in perimenopausal women, and is suitable for women with underlying conditions that may preclude their use of estrogen-containing contraceptive methods. It can effectively manage bleeding problems through the transition from perimenopause into menopause, with many women developing amenorrhea. The LNG-IUS is well tolerated with a favorable safety profile, which generally mirrors that of women of reproductive age using it for contraception only. Moreover, the LNG-IUS plus ERT combination does not appear to be associated with clinically relevant effects on plasma lipids or other markers of cardiovascular risk. Women using the LNG-IUS plus ERT also experience improvements in quality of life, and adherence and continuation rates are high. This review will summarize the clinical evidence for the use of the LNG-IUS plus ERT in peri- and postmenopausal women and present the key attributes of this combined therapy. PMID:25553775

  9. Reviewing effectiveness of ankle assessment techniques for use in robot-assisted therapy.

    PubMed

    Zhang, Mingming; Davies, T Claire; Zhang, Yanxin; Xie, Shane

    2014-01-01

    This article provides a comprehensive review of studies that investigated ankle assessment techniques to better understand those that can be used in the real-time monitoring of rehabilitation progress for implementation in conjunction with robot-assisted therapy. Seventy-six publications published between January 1980 and August 2013 were selected based on eight databases. They were divided into two main categories (16 qualitative and 60 quantitative studies): 13 goniometer studies, 18 dynamometer studies, and 29 studies about innovative techniques. A total of 465 subjects participated in the 29 quantitative studies of innovative measurement techniques that may potentially be integrated in a real-time monitoring device, of which 19 studies included less than 10 participants. Results show that qualitative ankle assessment methods are not suitable for real-time monitoring in robot-assisted therapy, though they are reliable for certain patients, while the quantitative methods show great potential. The majority of quantitative techniques are reliable in measuring ankle kinematics and kinetics but are usually available only for use in the sagittal plane. Limited studies determine kinematics and kinetics in all three planes (sagittal, transverse, and frontal) where motions of the ankle joint and the subtalar joint actually occur. PMID:25144166

  10. A narrative review of yoga and mindfulness as complementary therapies for addiction.

    PubMed

    Khanna, Surbhi; Greeson, Jeffrey M

    2013-06-01

    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 and practices for living a meaningful, purposeful, moral and self-disciplined life. Traditional yoga practices, including postures and meditation, direct attention toward 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

  11. 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

  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. Plasminogen activation system in oral cancer: Relevance in prognosis and therapy (Review).

    PubMed

    Wyganowska-?wi?tkowska, Marzena; Jankun, Jerzy

    2015-07-01

    Research on carcinogenesis and progress in cancer treatment have reduced mortality of cancer patients. Mortality rates decreased by 1.5% per year from 2001 through 2010 for most types of cancer in men and women. However, oral cancer is still a significant global health problem since incidence and mortality rates are increasing. Oral cavity cancer is ranked the 8th in men and the 14th in women based on data collected between 2006 and 2010 by the National Institute of Health. Furthermore, an increasing incidence of head and neck neoplasms, particularly the tongue cancer among young adults has been reported recently. It is most likely due to increasing human papillomavirus (HPV) infection or the early start of tobacco and alcohol consumption. Treatment of oral cancer patients is mainly surgical and often leads to esthetic and functional deformities, with severe impact on the quality of life. Thus, novel form of treatments and selection of patients with high and low risk of mortality is of high priority for clinical studies. The expression of proteolytic enzymes in tumor and stromal tissues has been shown to have prognostic significance in many human cancers and inhibiting proteolysis can reduce tumor growth in many in vivo and in vitro models. Plasmin, with its activators and inhibitors are of great importance in many human malignances and collectively are called plasminogen activation system (PAS). In this comprehensive review we examine expression, possible prognostic markers and importance for therapy of the PAS members in oral cancer. Literature review suggests that overexpression of urokinase and its receptor are markers of poor outcome, thus, their inhibition can be explored in oral cancer therapy. Role of plasminogen activator inhibitor (PAI-1) is complex and depends on its concentration. Overexpression of PAI-1 favors angiogenesis, metastasis and poor prognosis, although when applied in very high concentrations it inhibits angiogenesis and tumor growth, the phenomenon is described as the PAI-1 paradox. PMID:26004216

  15. 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

  16. Thermophoresis of spherical and non-spherical particles: a review of theories and experiments.

    PubMed

    Zheng, F

    2002-03-29

    Thermophoresis is an important mechanism of micro-particle transport due to a temperature gradient in the surrounding medium and has found numerous applications, especially in the field of aerosol technology. Extensive studies, both theoretical and experimental, have been done to understand the nature of this phenomenon. However, it is clear that a lot more of work needs to be done before we can predict thermophoresis accurately for any given gas-particle system as well as particle shape and orientation in any flow regime. This paper reviews the existing theories and data in two major categories, for spherical particles and for non-spherical particles, as well as the various techniques in making thermophoresis measurements. The current state of development for thermophoresis studies is that for spheres the theories and experimental data agree with each other fairly well but for non-spherical particles in the transition regime the theories are yet to be developed and experimental data showing the effect of particle shape are much needed in all Knudsen number range. The best techniques of thermophoretic force measurements involve the use of electrodynamic balances to work on single micro-particles and the use of microgravity to minimize the effect of convection. A combination of the above two has not been attempted and should provide the most accurate data. PMID:12027022

  17. A review of stereotactic body radiotherapy – is volumetric modulated arc therapy the answer?

    PubMed Central

    Sapkaroski, Daniel; Osborne, Catherine; Knight, Kellie A

    2015-01-01

    Stereotactic body radiotherapy (SBRT) is a high precision radiotherapy technique used for the treatment of small to moderate extra-cranial tumours. Early studies utilising SBRT have shown favourable outcomes. However, major disadvantages of static field SBRT include long treatment times and toxicity complications. Volumetric modulated arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) may potentially mitigate these disadvantages. This review aims to assess the feasibility of emerging VMAT and IMRT-based SBRT treatment techniques and qualify which offers the best outcome for patients, whilst identifying any emerging and advantageous SBRT planning trends. A review and synthesis of data from current literature up to September 2013 was conducted on EMBASE, Medline, PubMed, Science Direct, Proquest central, Google Scholar and the Cochrane Database of Systematic reviews. Only full text papers comparing VMAT and or IMRT and or Static SBRT were included. Ten papers were identified that evaluated the results of VMAT/IMRT SBRT. Five related to medically inoperable stage 1 and 2 non-small-cell lung cancer (NSCLC), three to spinal metastasis, one related to abdominal lymph node malignancies, with the final one looking at pancreatic adenocarcinoma. Overall treatment times with VMAT were reduced by 66–70% for lung, 46–58% for spine, 42% and 21% for lymph node and pancreatic metastasis respectively, planning constraints were met with several studies showing improved organs at risk sparing with IMRT/VMAT to static SBRT. Both IMRT and VMAT were able to meet all planning constraints in the studies reviewed, with VMAT offering the greatest treatment efficiency. Early clinical outcomes with VMAT and IMRT SBRT have demonstrated excellent local control and favourable survival outcomes.

  18. 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…

  19. Use of vacuum-assisted closure negative pressure wound therapy in combat-related injuries--literature review.

    PubMed

    Hinck, Daniel; Franke, Axel; Gatzka, Friedrich

    2010-03-01

    Despite surgical and technological advances, managing combat-related injuries remains challenging both within and outside of the war theater. Unique characteristics of a war theater such as environmental contamination, varying evacuation procedures, and differing levels of medical care, add to the complexity. The advent of body armor has increased blast survival rates and soldiers are surviving with increasingly mangled limbs that require lengthy, multifaceted care. An inherent high risk of infection contraindicates immediate closure for these wounds. There is growing reported use of negative pressure wound therapy with reticulated open-cell foam (NPWT/ROCF) as delivered by vacuum-assisted closure (VAC) therapy (KCI Licensing Inc., San Antonio, TX) as an adjunctive therapy in these open soft-tissue combat wounds. This review evaluates the efficacy of NPWT/ROCF for adjunctive treatment of wartime wounds. Following a literature review, data are summarized and presented. PMID:20358706

  20. Preparation and characterization of temperature-responsive magnetic composite particles for multi-modal cancer therapy

    Microsoft Academic Search

    Aihua YaoQi; Qi Chen; Fanrong Ai; Deping Wang; Wenhai Huang

    The temperature-responsive magnetic composite particles were synthesized by emulsion-free polymerization of N-isopropylacrylamide (NIPAAm) and acrylamide (Am) in the presence of oleic acid-modified Fe3O4 nanoparticles. The magnetic properties and heat generation ability of the composite particles were characterized. Furthermore,\\u000a temperature and alternating magnetic field (AMF) triggered drug release behaviors of vitamin B12-loaded composite particles were also examined. It was found that

  1. 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…

  2. Measuring Homework Compliance in Cognitive-Behavioral Therapy for Adolescent Depression. Review, Preliminary Findings, and Implications for Theory and Practice

    ERIC Educational Resources Information Center

    Gaynor, Scott T.; Lawrence, P. Scott; Nelson-Gray, Rosemery O.

    2006-01-01

    Despite the importance placed on completion of extra-session homework in cognitive-behavioral therapy (CBT), a review of the available literature suggests there is much about the nature of homework compliance that remains to be empirically evaluated. This is especially true among youth receiving CBT. The present study begins to address how best to…

  3. 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…

  4. Economic and quality of life outcomes of antiretroviral therapy for HIV\\/AIDS in developing countries: a systematic literature review

    Microsoft Academic Search

    Jennifer Beard; Frank Feeley; Sydney Rosen

    2009-01-01

    The impacts of antiretroviral therapy (ART) on quality of life, mental health, labor productivity, and economic wellbeing for people living with HIV\\/AIDS in developing countries are only beginning to be measured. We conducted a systematic literature review to analyze the effect of ART on these economic and quality of life indicators in developing countries and assess the state of research

  5. Memantine and cholinesterase inhibitor combination therapy for Alzheimer's disease: a systematic review

    PubMed Central

    Farrimond, Lucy E; Roberts, Emmert

    2012-01-01

    Background Memantine is licensed for moderate-to-severe Alzheimer's disease (AD). National Institute for Clinical Excellence (NICE) guidance does not recommend the use of memantine in combination with cholinesterase inhibitors (acetylcholinesterase inhibitor (AChEI)). The underpinning meta-analysis was disputed by the manufacturer. Objectives To compare the efficacy of AChEI monotherapy with combination memantine and AChEI therapy in patients with moderate-to-severe AD and to examine the impact of including unpublished data on the results. Design Systematic review and meta-analysis of randomised controlled trials. Data sources The Cochrane Dementia Group trial register, ALOIS, searched for the last time on 3 May 2011. Data synthesis Data from four domains (clinical global, cognition, function, behaviour and mood) were pooled. Sensitivity analyses examined the impact on the NICE-commissioned meta-analysis of restricting data to patients with moderate-to-severe AD and of including an unpublished trial of an extended release preparation of memantine. Results Pooled data from the trials, which were included in the NICE-commissioned meta-analysis but which were restricted to moderate-to-severe AD only, showed a small effect of combination therapy on cognition (standardised mean difference (SMD)=?0.29, 95% CI ?0.45 to ?0.14). Adding data from an unpublished trial of an extended release memantine (total three trials, 1317 participants) showed a small benefit of combination therapy on global scores (SMD=?0.20, 95% CI ?0.31 to ?0.09), cognition (SMD=?0.25, 95% CI ?0.36 to ?0.14) and behaviour and mood (SMD=?0.17, 95% CI ?0.32 to ?0.03) but not on function (SMD=?0.04, 95% CI ?0.21 to 0.13) at 6?months. No clinical data have been reported from a 1-year trial, although this found ‘no significant benefit’ on any clinical measures at 1?year. Conclusions These results suggest that there may be a small benefit at 6?months of adding memantine to AChEIs. However, the impact on clinical global impression depends on exactly which studies are included, and there is no benefit on function, so its clinical relevance is not robustly demonstrated. Currently available information from randomised controlled trails indicates no benefit of combination therapy over monotherapy at 1?year. Legislation on the form and content of registry posted results is needed in Europe. PMID:22689908

  6. V.A.C. Therapy in the management of paediatric wounds: clinical review and experience.

    PubMed

    Baharestani, Mona; Amjad, Ibrahim; Bookout, Kim; Fleck, Tatjana; Gabriel, Allen; Kaufman, David; McCord, Shannon Stone; Moores, Donald C; Olutoye, Oluyinka O; Salazar, Jorge D; Song, David H; Teich, Steven; Gupta, Subhas

    2009-08-01

    Usage of negative pressure wound therapy (NPWT) in the management of acute and chronic wounds has grown exponentially in the past decade. Hundreds of studies have been published regarding outcomes and methods of therapy used for adult wounds. This treatment is increasingly being used to manage difficult-to-treat paediatric wounds arising from congenital defects, trauma, infection, tumour, burns, pressure ulceration and postsurgical complications in children, although relatively few studies have been aimed at this population. Given the anatomical and physiological differences between adults and children, a multidisciplinary expert advisory panel was convened to determine appropriate use of NPWT with reticulated open cell foam (NPWT/ROCF) as delivered by Vacuum Assisted Closure (V.A.C. Therapy, KCI Licensing, Inc., San Antonio, TX) for the treatment of paediatric wounds. The primary objectives of the expert advisory panel were to exchange state-of-practice information on paediatric wound care, review the published data regarding the use of NPWT/ROCF in paediatric wounds, evaluate the strength of the existing data and establish guidelines on best practices with NPWT/ROCF for the paediatric population. The proposed paediatrics-specific clinical practice guidelines are meant to provide practitioners an evidence base from which decisions could be made regarding the safe and efficacious selection of pressure settings, foam type, dressing change frequency and use of interposing contact layer selections. The guidelines reflect the state of knowledge on effective and appropriate wound care at the time of publication. They are the result of consensus reached by expert advisory panel members based on their individual clinical and published experiences related to the use of NPWT/ROCF in treating paediatric wounds. Best practices are described herein for novice and advanced users of NPWT/ROCF. Recommendations by the expert panel may not be appropriate for use in all circumstances. Decisions to adopt any particular recommendation must be made by the collaborating medical team, including the surgeon and wound care specialist based on available resources, individual patient circumstances and experience with the V.A.C. Therapy System. PMID:19614789

  7. Two Cases of Hypophosphatemic Osteomalacia After Long-term Low Dose Adefovir Therapy in Chronic Hepatitis B and Literature Review.

    PubMed

    Jeong, Hye Jin; Lee, Ji Min; Lee, Tae Han; Lee, Ji Yeon; Kim, Han Byeol; Heo, Mi Hwa; Choi, Go; Chae, Jin Nyeong; Kim, Ji-Min; Kim, Sang-Hyon; Kwon, Kun Young

    2014-02-01

    Adefovir dipivoxil (ADV) is a nucleotide used as long-term therapy of chronic hepatitis B. Many published reports have shown that long-term high-dose therapy with adefovir can be associated with proximal renal tubular dysfunction resulting in significant hypophosphatemia, renal insufficiency and osteomalacia. We have encountered two patients who developed evidence of hypophosphatemic osteomalacia while on long-term low-dose adefovir therapy for chronic hepatitis B. We report on its clinical features and its potential resolution with cessation of the drug and supplementation with phosphate. We also reviewed the other published cases associated with hypophosphatemic osteomalacia after low-dose adefovir therapy. The symptoms and the hypophosphatemia improved after cessation of the drug and supplementation with phosphate in most cases. Patients taking adefovir long-term should receive regular investigation of the phosphate level and renal function. PMID:24707470

  8. A review of the use of adjunctive therapies in severe acute asthma exacerbation in critically ill children.

    PubMed

    Wong, Judith J M; Lee, Jan Hau; Turner, David A; Rehder, Kyle J

    2014-08-01

    Asthma is a common and potentially life threatening childhood condition. Asthma involves not only chronic airway remodeling, but may also include frequent exacerbations resulting from bronchospasm, edema, and mucus production. In children with severe exacerbations, standard therapy with ?2-agonists, anti-cholinergic agents, oxygen, and systemic steroids may fail to reverse the severe airflow obstruction and necessitate use of adjunctive therapies. These therapies include intravenous or inhaled magnesium, inhaled helium-oxygen mixtures, intravenous methylxanthines, intravenous ?2-agonists, and intravenous ketamine. Rarely, these measures are not successful and following the initiation of invasive mechanical ventilation, inhaled anesthetics or extracorporeal life support may be required. In this review, we discuss the mechanisms and evidence for adjunctive therapies in the setting of severe acute asthma exacerbations in children. PMID:24993063

  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)

    2003-01-01

    BOOK REVIEWS (71) Calculations for A-Level Physics, 4th edition The Science of Soccer New Higher Physics, 2nd edition Standard Grade Physics, 2nd edition Particle Physics WEB WATCH (75) 'Fly me to the Moon ...'

  11. New antimicrobial therapies used against fungi present in subgingival sites--a brief review.

    PubMed

    Sardi, Janaina Cássia Orlandi; Almeida, Ana Marisa Fusco; Mendes Giannini, Maria José Soares

    2011-10-01

    Although the main reservoir of Candida spp. is believed to be the buccal mucosa, these microorganisms can coaggregate with bacteria in subgingival biofilm and adhere to epithelial cells. The treatment of periodontal disease includes scaling and root planning (SRP) associated with proper oral hygiene. However, some patients may have negative responses to different therapeutic procedures, with a continuous loss of insertion, so the use of antimicrobials is needed as an adjuvant to SRP treatment. The use of a broad-spectrum antibiotic, such as tetracycline and metronidazole, as an aid in periodontal treatment has also been a factor for the development of superinfections by resistant bacteria and Candida species, even in patients with HIV. In the dental practice, the most commonly used antifungals are nystatin and fluconazole. However, the introduction of new drugs like the next generation of azoles is essential before the onset of emergent species in periodontal disease. Plants are good options for obtaining a wide variety of drugs. This alternative could benefit a large population that uses plants as a first treatment option. Plants have been used in medicine for a long time and are extensively used in folk medicine, because they represent an economic alternative, are easily accessible and are applicable to various diseases. Herein, we briefly review the literature pertaining the presence of Candida sp. in periodontal pockets, the conventional antifungal resistance and new therapies that include natural antifungal agents are reviewed. PMID:21676377

  12. A systematic review of the use of rituximab as induction therapy in renal transplantation.

    PubMed

    Macklin, Philip S; Morris, Peter J; Knight, Simon R

    2015-04-01

    Rituximab is a B-lymphocyte depleting agent used to treat lymphoma and autoimmune diseases. There has been recent interest in its use both for management of highly-sensitised and ABO-incompatible recipients but also for induction therapy before transplantation. This systematic review evaluates the evidence for its use as part of induction protocols in ABO-compatible, non-sensitised recipients. 4 databases and 3 trial registries were searched for studies of the use of rituximab as part of induction protocols. The small number of identified studies precluded meta-analysis and thus a narrative review was conducted. 12 manuscripts met the inclusion criteria, relating to 5 individual studies. No significant improvements in patient and graft survival or acute rejection rates were identified with rituximab induction. A single small study reported a trend towards improved graft function with the addition of rituximab induction to a standard immunosuppressive regimen. Rituximab was not found to be associated with increased infectious complications in any study but concerns were raised over possible associations with leukopaenia and cardiovascular mortality. Overall, no convincing benefit of rituximab induction was found and some safety concerns were identified. The results of on-going trials are awaited but further studies may be required before we can draw firm conclusions regarding the efficacy and safety of rituximab in this setting. PMID:25555541

  13. Desvenlafaxine in major depressive disorder: an evidence-based review of its place in therapy

    PubMed Central

    Lieberman, Daniel Z; Massey, Suena H

    2010-01-01

    Introduction: Desvenlafaxine, the active metabolite of venlafaxine, is a serotonin norepinephrine reuptake inhibitor (SNRI) recently approved for the treatment of major depressive disorder. It is one of only three medications in this class available in the United States. Aims: The objective of this article is to review the published evidence for the safety and efficacy of desvenlafaxine, and to compare it to other antidepressants to delineate its role in the treatment of depression. Evidence review: At the recommended dose of 50 mg per day the rate of response and remission was similar to other SNRIs, as was the adverse effect profile. The rate of discontinuation was no greater than placebo, and a discontinuation syndrome was not observed at this dose. Higher doses were not associated with greater efficacy, but they did lead to more side effects, and the use of a taper prior to discontinuation. The most common side effects reported were insomnia, somnolence, dizziness, and nausea. Some subjects experienced clinically significant blood pressure elevation. Place in therapy: Like duloxetine, desvenlafaxine inhibits the reuptake of both norepinephrine and serotonin at the starting dose. Dual reuptake inhibitors have been shown to have small but statistically significantly greater rates of response and remission compared to selective serotonin reuptake inhibitors, and they have also shown early promise in the treatment of neuropathic pain. Desvenlafaxine may prove to be a valuable treatment option by expanding the limited number of available dual reuptake inhibitors. PMID:20694066

  14. Health-related Quality of Life Assessment after Antiretroviral Therapy: A Review of the Literature

    PubMed Central

    Gakhar, Harleen; Kamali, Amanda

    2015-01-01

    Antiretroviral (ARV) treatment for HIV infection has resulted in significant improvement in immunologic and virologic parameters, as well as a reduction in AIDS-defining illnesses and death. Over 25 medications are approved for use, usually in combination regimens of three or four ARVs. Several ARVs are now available as combinatorial products, which have been associated with better adherence. However, while ARV therapy has prolonged life, ARVs also pose a challenge for quality of life as they can cause significant side effects in addition to the potential for drug toxicity and interaction. Given the many complications, side effects and symptoms of HIV/AIDS in addition to associated medical and psychiatric co-morbidities, the need to understand and assess how these interactions may affect health-related quality of life (HRQOL) has grown. Numerous instruments (some validated, others not) are available and have been applied to understanding how ARV treatment affects HRQOL in those with HIV infection, both in clinical trials and clinical practice. In general, ARV treatment improves HRQOL, but this is dependent on the population being studied, the HRQOL instrument being used and the timeframe during which HRQOL has been studied. This article provides a review of the literature on quality of-life assessment as it relates to ARV treatment in developed countries and briefly reviews the HRQOL instruments used, how they have been applied to ARV utilization, and where future research should be applied in HRQOL assessment and HIV infection. PMID:23591907

  15. Adapted cognitive-behavioral therapy for religious individuals with mental disorder: a systematic review.

    PubMed

    Lim, Caroline; Sim, Kang; Renjan, Vidhya; Sam, Hui Fang; Quah, Soo Li

    2014-06-01

    Cognitive-behavioral therapy (CBT) is considered an evidence-based psychological intervention for various mental disorders. However, mental health clinicians should be cognizant of the population that was used to validate the intervention and assess its acceptability to a target group that is culturally different. We systematically reviewed published empirical studies of CBT adapted for religious individuals with mental disorder to determine the extent to which religiously modified CBT can be considered an empirically supported treatment following the criteria delineated by the American Psychological Association Task Force on Promotion and Dissemination of Psychological Procedures. Overall, nine randomized controlled trials and one quasi-experimental study were included that compared the effectiveness of religiously modified CBT to standard CBT or other treatment modalities for the treatment of depressive disorders, generalized anxiety disorder, and schizophrenia. The majority of these studies either found no difference in effectiveness between religiously modified CBT compared to standard CBT or other treatment modalities, or early effects that were not sustained. Considering the methodological limitations of the reviewed studies, religiously modified CBT cannot be considered a well-established psychological intervention for the treatment of the foregoing mental disorders following the a priori set criteria at this juncture. Nevertheless, melding religious content with CBT may be an acceptable treatment modality for individuals with strong religious convictions. PMID:24813028

  16. Cognitive behavioral therapy for depression and anxiety in Parkinson's disease: a clinical review.

    PubMed

    Armento, Maria E A; Stanley, Melinda A; Marsh, Laura; Kunik, Mark E; York, Michele K; Bush, Amber L; Calleo, Jessica S

    2012-01-01

    Parkinson's disease (PD) is the second most common neurodegenerative disorder. It is generally defined by its progressive motor features; but increased attention is being paid to its non-motor neuropsychiatric symptoms, which profoundly impact quality of life for patients and caregivers. Anxiety and depression are particularly problematic and are the strongest predictors of quality of life in PD. Recent research has focused on non-pharmacological approaches to treating depression and anxiety in patients with PD. Cognitive-behavioral therapy (CBT) is a potentially efficacious non-pharmacological treatment for mood and anxiety symptoms associated with PD. Accordingly, this review examines empirical studies of CBT-based treatments for depression and anxiety symptoms in PD. Medical Subject Headings were used in searches of PsychInfo and PubMed of English-language articles published in peer-reviewed journals, resulting in the identification of 10 articles. Four additional articles were identified from the references of these articles and upon the suggestions of experts, for 15 articles in all. Results of individual studies varied significantly; however, the randomized controlled trials showed encouraging results and support the need for further investigation of the utility of CBT for depressed and anxious patients with PD. CBT is potentially a useful treatment for patients with PD and comorbid depression and/or anxiety, but more systematic research will be necessary to measure its effects. PMID:23939438

  17. review The American Society of Gene Therapy Molecular Therapy vol. 17 no. 7, 11251135 july 2009 1125

    E-print Network

    Cai, Long

    1125 IntroductIon Although pediatric cancer survival rates have improved greatly over the past 30 years chemotherapy or radiotherapy, or the toxicities from such therapies become too great, type-1 (HSVs-1). HSV-1 is a unique virus that offers promise in treating several pediatric cancers

  18. Multisystemic therapy for child non-externalizing psychological and health problems: a preliminary review.

    PubMed

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

    2013-03-01

    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, specifically difficulties related to child maltreatment, serious psychiatric illness [Serious psychiatric illness was defined throughout the current review paper as the "presence of symptoms of suicidal ideation, homicidal ideation, psychosis, or threat of harm to self or others due to mental illness severe enough to warrant psychiatric hospitalization based on the American Academy of Child and Adolescent Psychiatry (Level of care placement criteria for psychiatric illness. American Academy of Child and Adolescent Psychiatry, Washington, DC, 1996) level of care placement criteria for psychiatric illness" (Henggeler et al. in J Am Acad Child Psy 38:1331-1345, p. 1332, 1999b). Additionally, youth with "serious emotional disturbance (SED)" defined as internalizing and/or externalizing problems severe enough to qualify for mental health services in public school who were "currently in or at imminent risk of a costly out-of-home placement" (Rowland et al. in J Emot Behav Disord 13:13-23, pp. 13-14, 2005) were also included in the serious psychiatric illness category.], and health problems (i.e., obesity and treatment adherence for diabetes). PubMed, Web of Science, MEDLINE, and PsycINFO databases; Clinicaltrials.gov; DARE; Web of Knowledge; and Cochrane Central Register of Controlled Trials were searched; and MST developers were queried to ensure identification of all relevant articles. Of 242 studies identified, 18 met inclusion criteria for review. These were combined in a narrative synthesis and critiqued in the context of review questions. Study quality ratings were all above mean scores reported in prior reviews. Mixed support was found for the efficacy of MST versus other treatments. In many cases, treatment effects for MST or comparison groups were not sustained over time. MST was efficacious for youth with diverse backgrounds. No studies discussed efficacy of MST provided in different treatment settings. Four studies found MST more cost-effective than a comparison treatment, leading to fewer out-of-home placements for youth with serious psychiatric illness or lower treatment costs for youth with poorly controlled diabetes. PMID:23385370

  19. Topical therapies for the treatment of plaque psoriasis: systematic review and network meta-analyses.

    PubMed

    Samarasekera, E J; Sawyer, L; Wonderling, D; Tucker, R; Smith, C H

    2013-05-01

    The majority of people with psoriasis have localized disease, where topical therapy forms the cornerstone of treatment. We set out to summarize evidence on the relative efficacy, safety and tolerability of different topical treatments used in plaque psoriasis. We undertook a systematic review and meta-analyses of randomized trial data of U.K.-licensed topical therapies. The primary outcome was clear or nearly clear status stratified for (i) trunk and limbs; and (ii) scalp. Network meta-analyses allowed ranking of treatment efficacy. In total, 48 studies were available for trunk and limb psoriasis, and 17 for scalp psoriasis (22,028 patients in total); the majority included people with at least moderate severity psoriasis. Strategies containing potent corticosteroids (alone or in combination with a vitamin D analogue) or very potent corticosteroids dominated the treatment hierarchy at both sites (trunk and limbs, scalp); coal tar and retinoids were no better than placebo. No significant differences in achievement of clear or nearly clear status were observed between twice- and once-daily application of the same intervention or between any of the following: combined vitamin D analogue and potent corticosteroid (applied separately or in a single product), very potent corticosteroids, or potent corticosteroids (applied twice daily). Investigator and patient assessment of response differed significantly for some interventions (response rates to very potent corticosteroids: 78% and 39%, respectively). No significant differences were noted for tolerability or steroid atrophy, but data were limited. In conclusion, corticosteroids are highly effective in psoriasis when used continuously for up to 8 weeks and intermittently for up to 52 weeks. Coal tar and retinoids are of limited benefit. There is a lack of long-term efficacy and safety data available on topical interventions used for psoriasis. PMID:23413913

  20. The effectiveness of extracorporeal shock wave therapy for the treatment of lower limb ulceration: a systematic review.

    PubMed

    Butterworth, Paul A; Walsh, Tom P; Pennisi, Yvonne D; Chesne, Anna D; Schmitz, Christoph; Nancarrow, Susan A

    2015-01-01

    Extracorporeal shock wave therapy has been reported as an effective treatment for lower limb ulceration. The aim of this systematic review was to investigate the effectiveness of extracorporeal shock wave therapy for the treatment of lower limb ulceration. Five electronic databases (Ovid MEDLINE, CINAHL, Web of Knowledge, Scopus and Ovid AMED) and reference lists from relevant studies were searched in December 2013. All study designs, with the exception of case-reports, were eligible for inclusion in this review. Assessment of each study's methodological quality was performed using the Quality Index tool. The effectiveness of studies was measured by calculating effect sizes (Cohen's d) from means and standard deviations. Five studies, including; three randomised controlled trials, one quasi-experimental study and one case-series design met our inclusion criteria and were reviewed. Quality assessment scores ranged from 38 to 63% (mean 53%). Improvements in wound healing were identified in these studies following extracorporeal shock wave therapy. The majority of wounds assessed were associated with diabetes and the effectiveness of ESWT as an addition to standard care has only been assessed in one randomised controlled trial. Considering the limited evidence identified, further research is needed to support the use of extracorporeal shock wave therapy in the treatment of lower limb ulceration. PMID:25722746

  1. 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

  2. Risk of Community-Acquired Pneumonia with Outpatient Proton-Pump Inhibitor Therapy: A Systematic Review and Meta-Analysis

    PubMed Central

    Lambert, Allison A.; Lam, Jennifer O.; Paik, Julie J.; Ugarte-Gil, Cesar; Drummond, M. Bradley; Crowell, Trevor A.

    2015-01-01

    Background Proton-pump inhibitors (PPIs) are among the most frequently prescribed medications. Community-acquired pneumonia (CAP) is a common cause of morbidity, mortality and healthcare spending. Some studies suggest an increased risk of CAP among PPI users. We conducted a systematic review and meta-analysis to determine the association between outpatient PPI therapy and risk of CAP in adults. Methods We conducted systematic searches of MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Scopus and Web of Science on February 3, 2014. Case-control studies, case-crossover, cohort studies and randomized controlled trials reporting outpatient PPI exposure and CAP diagnosis for patients ?18 years old were eligible. Our primary outcome was the association between CAP and PPI therapy. A secondary outcome examined the risk of hospitalization for CAP and subgroup analyses evaluated the association between PPI use and CAP among patients of different age groups, by different PPI doses, and by different durations of PPI therapy. Results Systematic review of 33 studies was performed, of which 26 studies were included in the meta-analysis. These 26 studies included 226,769 cases of CAP among 6,351,656 participants. We observed a pooled risk of CAP with ambulatory PPI therapy of 1.49 (95% CI 1.16, 1.92; I2 99.2%). This risk was increased during the first month of therapy (OR 2.10; 95% CI 1.39, 3.16), regardless of PPI dose or patient age. PPI therapy also increased risk for hospitalization for CAP (OR 1.61; 95% CI: 1.12, 2.31). Discussion Outpatient PPI use is associated with a 1.5-fold increased risk of CAP, with the highest risk within the first 30 days after initiation of therapy. Providers should be aware of this risk when considering PPI use, especially in cases where alternative regimens may be available or the benefits of PPI use are uncertain. PMID:26042842

  3. 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

  4. Cellular, particle and environmental parameters influencing attachment in surface waters: a review.

    PubMed

    Liao, C; Liang, X; Soupir, M L; Jarboe, L R

    2015-08-01

    Effective modelling of the fate and transport of water-borne pathogens is needed to support federally required pollution-reduction plans, for water quality improvement planning, and to protect public health. Lack of understanding of microbial-particle interactions in water bodies has sometimes led to the assumption that bacteria move in surface waters not associated with suspended mineral and organic particles, despite a growing body of evidence suggesting otherwise. Limited information exists regarding the factors driving interactions between micro-organisms and particles in surface waters. This review discusses cellular, particle and environmental factors potentially influencing interactions and in-stream transport. Bacterial attachment in the aquatic environment can be influenced by properties of the cell such as genetic predisposition and physiological state, surface structures such as flagella and fimbriae, the hydrophobicity and electrostatic charge of the cell surface, and the presence of outer-membrane proteins and extracellular polymeric substances. The mechanisms and degree of attachment are also affected by characteristics of mineral and organic particles including the size, surface area, charge and hydrophobicity. Environmental conditions such as the solution chemistry and temperature are also known to play an important role. Just as the size and surface of chemical particles can be highly variable, bacterial attachment mechanisms are also diverse. PMID:26033178

  5. Acupuncture Therapy for the Treatment of Myelosuppression after Chemotherapy: A Literature Review over the Past 10 Years.

    PubMed

    Fu, Hongwei; Chen, Bo; Hong, Shouhai; Guo, Yi

    2015-06-01

    The aim of this study is to review current studies on the effect of acupuncture therapy on bone marrow suppression after chemotherapy. The authors of the present paper have searched related literature over the past 10 years at home and abroad, analyzing the features and the effects of acupuncture therapy (including acupuncture, moxibustion, point injection, point application, etc.) for treating myelosuppression after tumor chemotherapy. We also discuss the year of publication, document type, acupuncture therapy, acupoint selection, and adverse effects with figures. We analyzed 159 articles related to acupuncture therapy from 2004 to 2013, and the analysis revealed that point injection was the most frequently used therapy for clinical applications, and that Zusanli (ST36) was the most frequently used acupoint. The results showed that some problems regarding the design method, acupoint selection, and acupuncture intervention measure existed in those research studies. We hope to provide readers with an overall and objective understanding of acupuncture and moxibustion therapy for treating myelosuppression after tumor chemotherapy. PMID:26100065

  6. [Treatment-resistant anxiety disorders: A literature review of drug therapy strategies].

    PubMed

    Ammar, G; Naja, W J; Pelissolo, A

    2015-06-01

    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

  7. Measurement of Automotive Nonvolatile Particle Number Emissions within the European Legislative Framework: A Review

    Microsoft Academic Search

    Barouch Giechaskiel; Athanasios Mamakos; Jon Andersson; Panagiota Dilara; Giorgio Martini; Wolfgang Schindler; Alexander Bergmann

    2012-01-01

    In 2011, the European Commission introduced a limit for nonvolatile particle number (PN) emissions >23 nm from light-duty (LD) vehicles and the stated intent is to implement similar legislation for on-road heavy-duty (HD) engines at the next legislative stage. This paper reviews the recent literature regarding the operation-dependent emission of PN from LD vehicles and HD engines, and the measurement

  8. Measurement of Automotive Non-Volatile Particle Number Emissions within the European Legislative Framework: A Review

    Microsoft Academic Search

    BAROUCH GIECHASKIEL; ATHANASIOS MAMAKOS; JON ANDERSSON; PANAGIOTA DILARA; GIORGIO MARTINI; WOLFGANG SCHINDLER; ALEXANDER BERGMANN

    2012-01-01

    In 2011 the European Commission introduced a limit for non-volatile particle number (PN) emissions >23 nm from light-duty vehicles and the stated intent is to implement similar legislation for on-road heavy-duty engines at the next legislative stage. This paper reviews the recent literature regarding the operation-dependent emission of PN from light-duty vehicles and heavy-duty engines, and the measurement procedure used

  9. 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

  10. Poor Reliability between Cochrane Reviewers and Blinded External Reviewers When Applying the Cochrane Risk of Bias Tool in Physical Therapy Trials

    PubMed Central

    Armijo-Olivo, Susan; Ospina, Maria; da Costa, Bruno R.; Egger, Matthias; Saltaji, Humam; Fuentes, Jorge; Ha, Christine; Cummings, Greta G.

    2014-01-01

    Objectives To test the inter-rater reliability of the RoB tool applied to Physical Therapy (PT) trials by comparing ratings from Cochrane review authors with those of blinded external reviewers. Methods Randomized controlled trials (RCTs) in PT were identified by searching the Cochrane Database of Systematic Reviews for meta-analysis of PT interventions. RoB assessments were conducted independently by 2 reviewers blinded to the RoB ratings reported in the Cochrane reviews. Data on RoB assessments from Cochrane reviews and other characteristics of reviews and trials were extracted. Consensus assessments between the two reviewers were then compared with the RoB ratings from the Cochrane reviews. Agreement between Cochrane and blinded external reviewers was assessed using weighted kappa (?). Results In total, 109 trials included in 17 Cochrane reviews were assessed. Inter-rater reliability on the overall RoB assessment between Cochrane review authors and blinded external reviewers was poor (? ?=? 0.02, 95%CI: ?0.06, 0.06]). Inter-rater reliability on individual domains of the RoB tool was poor (median ? ?=?0.19), ranging from ? ?=? ?0.04 (“Other bias”) to ? ?=? 0.62 (“Sequence generation”). There was also no agreement (? ?=? ?0.29, 95%CI: ?0.81, 0.35]) in the overall RoB assessment at the meta-analysis level. Conclusions Risk of bias assessments of RCTs using the RoB tool are not consistent across different research groups. Poor agreement was not only demonstrated at the trial level but also at the meta-analysis level. Results have implications for decision making since different recommendations can be reached depending on the group analyzing the evidence. Improved guidelines to consistently apply the RoB tool and revisions to the tool for different health areas are needed. PMID:24824199

  11. Recovery from infectious mononucleosis: a case for more than symptomatic therapy? A systematic review.

    PubMed Central

    Candy, Bridget; Chalder, Trudie; Cleare, Anthony J; Wessely, Simon; White, Peter D; Hotopf, Matthew

    2002-01-01

    Infectious mononucleosis is usually an acute, transiently incapacitating condition, but for some sufferers it precipitates chronic illness. It is unclear which patients are at risk of a prolonged state of illness following onset of infectious mononucleosis and if there are any useful preventive measures that would facilitate recovery. The aim of this study was to review all cohort studies and intervention trials that provide information on: (a) the longitudinal course of ill health subsequent to the onset of infectious mononucleosis; (b) the relationship between psychosocial and clinical factors and recovery rate; and (c) the effect of interventions on recovery. A systematic review was conducted, based on a search of the PSYCHINFO, MEDLINE, EMBASE and CINHAL databases up to October 2001, and ISI Science and Social Sciences Citation Indices up to 22 November 2001. Eight papers were identified that gave data on illness following onset of infectious mononucleosis. The best evidence concluded that there is a distinct fatigue syndrome after infectious mononucleosis. Eight papers explored risk factors for prolonged illness following acute infectious mononucleosis. Results varied on the association of acute illness characteristics and psychological features with prolonged ill health. Poor physical functioning, namely lengthy convalescence and being less fit or active, consistently predicted chronic ill health. Three trials reported on interventions that aimed to shorten the time taken to resolve symptoms after uncomplicated infectious mononucleosis. None of the drug trials found any evidence that drug therapy shortens recovery time. The trial that compared the effect of activity with imposed bed rest, found that those patients allowed out of bed as soon as they felt able reported a quicker recovery. More information is needed on the course of ill health subsequent to the onset of infectious mononucleosis. Certain risk factors associated with delay may be amenable to a simple intervention in primary care. PMID:12392128

  12. 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.

  13. 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.

  14. Patient-specific dosimetry in peptide receptor radionuclide therapy: a clinical review.

    PubMed

    Chalkia, M T; Stefanoyiannis, A P; Chatziioannou, S N; Round, W H; Efstathopoulos, E P; Nikiforidis, G C

    2015-03-01

    Neuroendocrine tumours (NETs) belong to a relatively rare class of neoplasms. Nonetheless, their prevalence has increased significantly during the last decades. Peptide receptor radionuclide therapy (PRRT) is a relatively new treatment approach for inoperable or metastasised NETs. The therapeutic effect is based on the binding of radiolabelled somatostatin analogue peptides with NETs' somatostatin receptors, resulting in internal irradiation of tumours. Pre-therapeutic patient-specific dosimetry is essential to ensure that a treatment course has high levels of safety and efficacy. This paper reviews the methods applied for PRRT dosimetry, as well as the dosimetric results presented in the literature. Focus is given on data concerning the therapeutic somatostatin analogue radiopeptides (111)In-[DTPA(0),D-Phe(1)]-octreotide ((111)In-DTPA-octreotide), (90)Y-[DOTA(0),Tyr(3)]-octreotide ((90)Y-DOTATOC) and (177)Lu-[DOTA(0),Tyr(3),Thr(8)]-octreotide ((177)Lu-DOTATATE). Following the Medical Internal Radiation Dose (MIRD) Committee formalism, dosimetric analysis demonstrates large interpatient variability in tumour and organ uptake, with kidneys and bone marrow being the critical organs. The results are dependent on the image acquisition and processing protocol, as well as the dosimetric imaging radiopharmaceutical. PMID:25427548

  15. Goeckerman therapy for the treatment of eczema: a practical guide and review of efficacy.

    PubMed

    Dennis, Madison; Bhutani, Tina; Koo, John; Liao, Wilson

    2013-02-01

    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 ultraviolet B 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

  16. Stereotactic body radiation therapy for abdominal oligometastases: a biological and clinical review

    PubMed Central

    2012-01-01

    Advances in imaging and biological targeting have led to the development of stereotactic body radiation therapy (SBRT) as an alternative treatment of extracranial oligometastases. New radiobiological concepts, such as ceramide-induced endothelial apoptosis after hypofractionated high-dose SBRT, and the identification of patients with oligometastatic disease by microRNA expression may yet lead to further developments. Key factors in SBRT are delivery of a high dose per fraction, proper patient positioning, target localisation, and management of breathing–related motion. Our review addresses the radiation doses and schedules used to treat liver, abdominal lymph node (LN) and adrenal gland oligometastases and treatment outcomes. Reported local control (LC) rates for liver and abdominal LN oligometastases are high (median 2-year actuarial LC: 61 -100% for liver oligometastases; 4-year actuarial LC: 68% in a study of abdominal LN oligometastases). Early toxicity is low-to-moderate; late adverse effects are rare. SBRT of adrenal gland oligometastases shows promising results in the case of isolated lesions. In conclusion, properly conducted SBRT procedures are a safe and effective treatment option for abdominal oligometastases. PMID:22852764

  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. 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

  19. 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

  20. 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. PMID:25879049

  1. Pharmacological Smoking Cessation Therapies in Older Adults: A Review of the Evidence.

    PubMed

    Cawkwell, Philip B; Blaum, Caroline; Sherman, Scott E

    2015-06-01

    Nearly 12 % of adults 65 years and over in Europe and 9 % in the USA are current cigarette smokers. Numerous studies have demonstrated tangible benefits of smoking cessation, regardless of advanced age. However, it is unclear which pharmacotherapy strategies are most effective in the elderly population. To that end, the literature on smoking cessation in older adults was reviewed with the aim of identifying the safest and most effective cessation pharmacotherapies. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for all articles pertaining to elderly smoking cessation strategies. Randomized controlled trials and cohort studies were included. Studies were included without regard to population or intervention, as long as results were analyzed with a group of smokers aged 60 years and above and at least one arm of the study involved a pharmacotherapy. Only 12 studies were identified that met our inclusion criteria. The limited existing literature does not allow for a definitive answer to the most effective pharmacotherapy for smoking cessation in older adult smokers. Nicotine replacement therapy (NRT) is the pharmacotherapy most studied in older adults, and the limited evidence that exists suggests that NRT is effective for smoking cessation among this population. Higher-quality studies that directly compare cessation strategies, including bupropion and varenicline, are needed in the older population in order to guide treatment decision making. PMID:26025119

  2. Early intervention services, cognitive–behavioural therapy and family intervention in early psychosis: systematic review

    PubMed Central

    Bird, Victoria; Premkumar, Preethi; Kendall, Tim; Whittington, Craig; Mitchell, Jonathan; Kuipers, Elizabeth

    2010-01-01

    Background Early intervention services for psychosis aim to detect emergent symptoms, reduce the duration of untreated psychosis, and improve access to effective treatments. Aims To evaluate the effectiveness of early intervention services, cognitive–behavioural therapy (CBT) and family intervention in early psychosis. Method Systematic review and meta-analysis of randomised controlled trials of early intervention services, CBT and family intervention for people with early psychosis. Results Early intervention services reduced hospital admission, relapse rates and symptom severity, and improved access to and engagement with treatment. Used alone, family intervention reduced relapse and hospital admission rates, whereas CBT reduced the severity of symptoms with little impact on relapse or hospital admission. Conclusions For people with early psychosis, early intervention services appear to have clinically important benefits over standard care. Including CBT and family intervention within the service may contribute to improved outcomes in this critical period. The longer-term benefits of this approach and its component treatments for people with early and established psychosis need further research. PMID:21037211

  3. 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

  4. [Acupuncture combined with traction therapy for lumbar disc herniation: a systematic review].

    PubMed

    Li, Xiu-zhen; Chen, Hai-yong; Zheng, Xiao; Liu, Nong-yu

    2014-09-01

    To evaluate the efficacy and safety of acupuncture combined with traction therapy for lumbar disc herniation, providing the basis for future research strategies. Randomized control trials. (RCT) of acupuncture combined with traction therapy for lumber disc herniation at home and abroad from 2000 to 2013 were searched, analysis and evaluation of literature and strength of evidence were based on the principles and methods of Evidence-based Medicine. The total effective rate and curative rate were considered as primary outcome measures; pain improvement, quality of life, relapse rate and adverse effects were considered as secondary outcome measures. Seventeen RCTs were identified, Meta-analysis showed that (1) total effective rate and curative rate: acupuncture combined with traction therapy was better than single therapy (acupuncture or traction); (2) pain improvement: acupuncture combined with traction therapy was better than traction therapy; (3) relapse rate: current evidence could not support the conclusion that acupuncture combined with traction therapy was better than traction therapy. Acupuncture combined with traction therapy for lumbar disc herniation was effective. However, the included studies were with high risk of bias, important outcome measures such as quality of life, relapse rate and adverse effects were not found in most of the studies. Current evidence has not yet been able to fully reflect acupuncture combined with traction therapy for lumbar disc herniation is better than single therapy, so more RCTs of higher quality are needed to further confirm its efficacy and safety. PMID:25509761

  5. Gastroenteritis Therapies in Developed Countries: Systematic Review and Meta-Analysis

    PubMed Central

    Freedman, Stephen B.; Pasichnyk, Dion; Black, Karen J. L.; Fitzpatrick, Eleanor; Gouin, Serge; Milne, Andrea; Hartling, Lisa

    2015-01-01

    Context Gastroenteritis remains a leading cause of childhood morbidity. Objective Because prior reviews have focused on isolated symptoms and studies conducted in developing countries, this study focused on interventions commonly considered for use in developed countries. Intervention specific, patient-centered outcomes were selected. Data Sources MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, trial registries, grey literature, and scientific meetings. Study Selection Randomized controlled trials, conducted in developed countries, of children aged <18 years, with gastroenteritis, performed in emergency department or outpatient settings which evaluated oral rehydration therapy (ORT), antiemetics, probiotics or intravenous fluid administration rate. Data Extraction The study was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. Data were independently extracted by multiple investigators. Analyses employed random effects models. Results 31 trials (4,444 patients) were included. ORT: Compared with intravenous rehydration, hospitalization (RR 0.80, 95%CI 0.24, 2.71) and emergency department return visits (RR 0.86, 95%CI 0.39, 1.89) were similar. Antiemetics: Fewer children administered an antiemetic required intravenous rehydration (RR 0.40, 95%CI 0.26, 0.60) While the data could not be meta-analyzed, three studies reported that ondansetron administration does increase the frequency of diarrhea. Probiotics: No studies reported on the primary outcome, three studies evaluated hospitalization within 7 days (RR 0.87, 95%CI 0.25, 2.98). Rehydration: No difference in length of stay was identified for rapid vs. standard intravenous or nasogastric rehydration. A single study found that 5% dextrose in normal saline reduced hospitalizations compared with normal saline alone (RR 0.70, 95% CI 0.53, 0.92). Conclusions There is a paucity of patient-centered outcome evidence to support many interventions. Since ORT is a low-cost, non-invasive intervention, it should continue to be used. Routine probiotic use cannot be endorsed at this time in outpatient children with gastroenteritis. Despite some evidence that ondansetron administration increases diarrhea frequency, emergency department use leads to reductions in intravenous rehydration and hospitalization. No benefits were associated with ondansetron use following emergency department discharge. PMID:26075617

  6. Couple/family therapy for posttraumatic stress disorder: review to facilitate interpretation of VA/DOD Clinical Practice Guideline.

    PubMed

    Monson, Candice M; Macdonald, Alexandra; Brown-Bowers, Amy

    2012-01-01

    A well-documented association exists among Veterans' posttraumatic stress disorder (PTSD) symptoms, family relationship problems, and mental health problems in partners and children of Veterans. This article reviews the recommendations regarding couple/family therapy offered in the newest version of the Department of Veterans Affairs (VA)/Department of Defense (DOD) VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress. We then provide a heuristic for clinicians, researchers, and policy makers to consider when incorporating couple/family interventions into Veterans' mental health services. The range of research that has been conducted on couple/family therapy for Veterans with PTSD is reviewed using this heuristic, and suggestions for clinical practice are offered. PMID:23015582

  7. 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.

  8. 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

  9. Telerehabilitation store and forward applications: a review of applications and privacy considerations in physical and occupational therapy practice.

    PubMed

    Peterson, Christopher; Watzlaf, Valerie

    2014-01-01

    An overview of store and forward applications commonly used in physical and occupational therapy practice is reviewed with respect to regulation, privacy, security, and clinical applications. A privacy and security checklist provides a clear reference of pertinent regulatory issues regarding these software applications. A case study format is used to highlight clinical applications of store and forward software features. Important considerations of successful implementation of store and forward applications are also identified and discussed. PMID:25945231

  10. Does targeting manual therapy and\\/or exercise improve patient outcomes in nonspecific low back pain? A systematic review

    Microsoft Academic Search

    Peter Kent; Hanne L Mjøsund; Ditte HD Petersen

    2010-01-01

    BACKGROUND: A central element in the current debate about best practice management of non-specific low back pain (NSLBP) is the efficacy of targeted versus generic (non-targeted) treatment. Many clinicians and researchers believe that tailoring treatment to NSLBP subgroups positively impacts on patient outcomes. Despite this, there are no systematic reviews comparing the efficacy of targeted versus non-targeted manual therapy and\\/or

  11. 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

  12. The efficacy and safety of growth hormone therapy in children with noonan syndrome: a review of the evidence.

    PubMed

    Noonan, Jacqueline A; Kappelgaard, Anne-Marie

    2015-01-01

    Noonan syndrome is a genetic disorder associated with short stature. We reviewed 15 studies in which growth hormone (GH) therapy was used in children with Noonan syndrome. Data show consistent increases in mean height standard deviation score (SDS), with first-year changes of up to 1.26 SDS. Among studies reporting adult or near-adult height, GH therapy over 5-7 years resulted in adult height SDS from -0.6 to -2.1, with up to 60% of subjects in some studies achieving adult height within 1 SDS of mid-parental height. GH treatment results in an acceleration of bone age, likely reflecting normalization from the retarded bone age common in Noonan syndrome patients at the start of therapy. BMI is not affected by GH treatment, but favorable changes in fat mass and body composition are achievable. Longer-term studies and observational studies suggest a waning of the effect of GH therapy over time, as is seen in other GH-treated conditions, and early initiation of therapy and prepubertal status are important predictors of response. GH treatment does not appear to be associated with adverse cardiac or metabolic effects, and data on malignancy during GH treatment give no cause for concern, although they are limited. PMID:25503994

  13. 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

  14. Role of neo-adjuvant hormonal therapy in the treatment of breast cancer: a review of clinical trials

    PubMed Central

    Abrial, Catherine; Durando, Xavier; Mouret-Reynier, Marie-Ange; Thivat, Emilie; Bayet-Robert, Mathilde; Nayl, Béatrice; Dubray, Pascale; Pomel, Christophe; Chollet, Philippe; Penault-Llorca, F

    2009-01-01

    The clinical benefits of endocrine therapy for patients with hormonosensitive breast cancer are well established. For many years, 5 years of tamoxifen was the gold standard of adjuvant treatment. The recent development of new endocrine agents provides physicians with a more effective therapeutic approach. Nevertheless, the success of neoadjuvant endocrine therapy is much more recent and less reported in the literature. This article reviews the studies published about neoadjuvant endocrine treatment (tamoxifen and aromatase inhibitors). According to the literature, neoadjuvant endocrine therapy seems to be effective. In contrast to neoadjuvant chemotherapy, neoadjuvant endocrine therapy is well tolerated, with very few patients having to discontinue the treatment because of side effects. It does not constitute a standard treatment but could have potential for elderly women with operable, hormonosensitive, well differentiated and slowly progressing (SBR I) tumor or for patients with lobular MSBR 1 carcinoma (low chemosensitivity). The newer generation of aromatase inhibitors (letrozole, anastrozole, exemestane) appears to be more active (in terms of overall response rates and conservative surgery rate) than tamoxifen. Patients with an estrogen receptor Allred score of 6 and over are more likely to respond and gain a clinical benefit. The optimal duration of neoadjuvant therapy has not yet been investigated in detail. These preliminary results should be confirmed by further studies. PMID:20360896

  15. 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

  16. Effectiveness of targeted therapy in patients with previously untreated metastatic breast cancer: a systematic review and meta-analysis.

    PubMed

    Kawalec, Pawe?; ?opuch, Sylwia; Mikrut, Alicja

    2015-04-01

    Breast cancer is the most common cancer and the most frequent cause of death in women. Targeted therapies offer a possibility of effective and individualized therapy based on the molecular profile of the tumor. The aim of this systematic review was to evaluate the efficacy and safety of targeted agents added to chemotherapy or endocrine therapy in patients with previously untreated metastatic breast cancer (MBC) depending on their human epidermal growth factor receptor 2 (HER2) and hormone receptor (HR) status (positive or negative). The systematic literature search was performed in PubMed, EMBASE, and the Cochrane Library to identify randomized controlled trials (RCTs). Thirteen trials were included. The addition of trastuzumab, pertuzumab, bevacizumab, or lapatinib to chemotherapy significantly (P < .05) improved objective response rate (ORR), time to failure (TTF), and overall survival (OS) in patients with HER2-positive (HER2(+)) disease. Trastuzumab or lapatinib combined with endocrine therapy significantly (P < .05) improved ORR, time to progression (TTP), and progression-free survival (PFS) in patients with HER2(+) and HR(+) disease. In patients with HER2-negative (HER2(-)) cancer, bevacizumab or lapatinib added to chemotherapy significantly (P < .05), improved ORR but did not prolong PFS and OS (P > .05). In patients with HER2(-) and HR(-) disease, trastuzumab combined with chemotherapy did not significantly improve (P > .05) ORR or PFS. Targeted therapies also increased the overall risk of adverse events. So far, there is a lack of published results for everolimus and trastuzumab emtansine trials in patients with previously untreated MBC. The addition of targeted therapy to chemotherapy or endocrine therapy using HER2 and HR status significantly improved ORR, PFS, and OS in patients with previously untreated MBC. PMID:25441421

  17. 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.

  18. Locally ablative therapies for primary radiation failures: A review and critical assessment of the efficacy

    Microsoft Academic Search

    William C. Huang; Courtney L. Lee; James A. Eastham

    2007-01-01

    A significant number of men with prostate cancer will experience biochemical failure following treatment with primary radiation\\u000a therapy. For patients with biopsyproven recurrent cancer confined to the prostate, local salvage therapy may be a potentially\\u000a curative treatment option. Most men, however, do not undergo local salvage therapy owing to difficulties in diagnosis as well\\u000a as concerns over treatment-related complications in

  19. 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

  20. 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.

  1. PHYSICAL REVIEW E 87, 043009 (2013) Stokesian dynamics of pill-shaped Janus particles with stick and slip boundary conditions

    E-print Network

    Chan, Derek Y C

    2013-01-01

    of hydrodynamic flow fields to control pill-shaped particles with Janus hydro- dynamic boundary conditions. WePHYSICAL REVIEW E 87, 043009 (2013) Stokesian dynamics of pill-shaped Janus particles with stick of different aspect ratios where half of the surface obeys the no-slip boundary condition and the other half

  2. Effective occupational therapy interventions in the rehabilitation of individuals with work-related low back injuries and illnesses: a systematic review.

    PubMed

    Snodgrass, Jeff

    2011-01-01

    A systematic review of the literature related to effective occupational therapy interventions in rehabilitation of individuals with work-related low back injuries and illnesses was carried out as part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association. This review evaluated research on a broad range of occupational therapy-related intervention procedures and approaches. Findings from the review indicate that the evidence is insufficient to support or refute the effectiveness of exercise therapy and other conservative treatments for subacute and chronic low back injuries. The research reviewed strongly suggests that for interventions to be effective, occupational therapy practitioners should use a holistic, client-centered approach. The research supports the need for occupational therapy practitioners to consider multiple strategies for addressing clients' needs. Specifically, interventions for individuals with low back injuries and illnesses should incorporate a biopsychosocial, client-centered approach that includes actively involving the client in the rehabilitation process at the beginning of the intervention process and addressing the client's psychosocial needs in addition to his or her physical impairments. The implications for occupational therapy practice, research, and education are also discussed. PMID:21309370

  3. Indacaterol: a review of its use as maintenance therapy in patients with chronic obstructive pulmonary disease.

    PubMed

    McKeage, Kate

    2012-03-01

    Indacaterol inhalation powder (Onbrez® Breezhaler®) is a long-acting, selective ?(2)-adrenoceptor agonist that is indicated for the maintenance bronchodilator treatment of airflow obstruction in adults with chronic obstructive pulmonary disease (COPD). This article reviews the clinical efficacy and tolerability of indacaterol 150 and 300??g once daily in adults with moderate to severe COPD, as well as reviewing indacaterol's pharmacological properties and results of a cost-utility analysis. Indacaterol has a fast onset of action after the first dose and is effective over 24 hours, allowing for once-daily administration. In short-term trials (?21 days) in patients with COPD, once-daily indacaterol 150 or 300??g significantly improved lung function, exercise endurance and lung hyperinflation relative to placebo. In large, longer-term clinical studies (12 weeks to 1 year) in patients with moderate to severe COPD, once-daily indacaterol 150 or 300??g improved lung function (primary endpoint) significantly more than placebo, and improvements were significantly greater than twice-daily formoterol 12??g or salmeterol 50??g, and noninferior to once-daily tiotropium bromide 18??g (all agents were administered via inhalation). Overall, indacaterol improved dyspnoea, use of rescue medication and general health status significantly more than placebo, salmeterol or tiotropium bromide, and the degree of improvement in these endpoints was similar to or greater than that achieved with formoterol. Improvements were sustained over the long term (1 year), with no evidence of tolerance. Combination therapy with indacaterol plus tiotropium bromide improved lung function, dyspnoea, rescue medication use and general health status significantly more than tiotropium bromide alone in patients with moderate to severe COPD. Indacaterol is generally well tolerated when used alone or in combination with tiotropium bromide in patients with COPD and has not been associated with any safety issues. The most common adverse event in clinical trials was COPD worsening, which occurred more commonly with placebo than indacaterol. Indacaterol was not associated with an increased risk of cardiovascular adverse events. In a cost-utility analysis from a German healthcare payer perspective, once-daily indacaterol 150??g was dominant (i.e. more effective with lower total costs) to once-daily tiotropium bromide 18??g and twice-daily salmeterol 50??g in the treatment of patients with COPD. In conclusion, indacaterol provides a valuable option for the maintenance treatment of adults with COPD. PMID:22356291

  4. 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

  5. Risk of Cardiovascular Disease from Antiretroviral Therapy for HIV: A Systematic Review

    PubMed Central

    Bavinger, Clay; Bendavid, Eran; Niehaus, Katherine; Olshen, Richard A.; Olkin, Ingram; Sundaram, Vandana; Wein, Nicole; Holodniy, Mark; Hou, Nanjiang; Owens, Douglas K.; Desai, Manisha

    2013-01-01

    Background Recent studies suggest certain antiretroviral therapy (ART) drugs are associated with increases in cardiovascular disease. Purpose We performed a systematic review and meta-analysis to summarize the available evidence, with the goal of elucidating whether specific ART drugs are associated with an increased risk of myocardial infarction (MI). Data Sources We searched Medline, Web of Science, the Cochrane Library, and abstract archives from the Conference on Retroviruses and Opportunistic Infections and International AIDS Society up to June 2011 to identify published articles and abstracts. Study Selection Eligible studies were comparative and included MI, strokes, or other cardiovascular events as outcomes. Data Extraction Eligibility screening, data extraction, and quality assessment were performed independently by two investigators. Data Synthesis Random effects methods and Fisher’s combined probability test were used to summarize evidence. Findings Twenty-seven studies met inclusion criteria, with 8 contributing to a formal meta-analysis. Findings based on two observational studies indicated an increase in risk of MI for patients recently exposed (usually defined as within last 6 months) to abacavir (RR 1.92, 95% CI 1.51–2.42) and protease inhibitors (PI) (RR 2.13, 95% CI 1.06–4.28). Our analysis also suggested an increased risk associated with each additional year of exposure to indinavir (RR 1.11, 95% CI 1.05–1.17) and lopinavir (RR 1.22, 95% CI 1.01–1.47). Our findings of increased cardiovascular risk from abacavir and PIs were in contrast to four published meta-analyses based on secondary analyses of randomized controlled trials, which found no increased risk from cardiovascular disease. Conclusion Although observational studies implicated specific drugs, the evidence is mixed. Further, meta-analyses of randomized trials did not find increased risk from abacavir and PIs. Our findings that implicate specific ARTs in the observational setting provide sufficient evidence to warrant further investigation of this relationship in studies designed for that purpose. PMID:23555704

  6. 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

  7. 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

  8. Dosimetric characterization of radionuclides for systemic tumor therapy: Influence of particle range, photon emission, and subcellular distribution

    SciTech Connect

    Uusijaervi, Helena; Bernhardt, Peter; Ericsson, Thomas; Forssell-Aronsson, Eva [Department of Radiation Physics, Goeteborg University, Sahlgrenska University Hospital, SE-413 45 Goeteborg (Sweden); Department of Mathematical Sciences, Chalmers University of Technology, SE-412 96 Goeteborg (Sweden); Department of Radiation Physics, Goeteborg University, Sahlgrenska University Hospital, SE-413 45 Goeteborg (Sweden)

    2006-09-15

    Various radionuclides have been proposed for systemic tumor therapy. However, in most dosimetric analysis of proposed radionuclides the charged particles are taken into consideration while the potential photons are ignored. The photons will cause undesirable irradiation of normal tissue, and increase the probability of toxicity in, e.g., the bone marrow. The aim of this study was to investigate the dosimetric properties according to particle range, photon emission, and subcellular radionuclide distribution, of a selection of radionuclides used or proposed for radionuclide therapy, and to investigate the possibility of dividing radionuclides into groups according to their dosimetric properties. The absorbed dose rate to the tumors divided by the absorbed dose rate to the normal tissue (TND) was estimated for different tumor sizes in a mathematical model of the human body. The body was simulated as a 70-kg ellipsoid and the tumors as spheres of different sizes (1 ng-100 g). The radionuclides were either assumed to be uniformly distributed throughout the entire tumor and normal tissue, or located in the nucleus or the cytoplasm of the tumor cells and on the cell membrane of the normal cells. Fifty-nine radionuclides were studied together with monoenergetic electrons, positrons, and alpha particles. The tumor and normal tissue were assumed to be of water density. The activity concentration ratio between the tumor and normal tissue was assumed to be 25. The radionuclides emitting low-energy electrons combined with a low photon contribution, and the alpha emitters showed high TND values for most tumor sizes. Electrons with higher energy gave reduced TND values for small tumors, while a higher photon contribution reduced the TND values for large tumors. Radionuclides with high photon contributions showed low TND value for all tumor sizes studied. The radionuclides studied could be divided into four main groups according to their TND values: beta emitters, Auger electron emitters, photon emitters, and alpha emitters. The TND values of the beta emitters were not affected by the subcellular distribution of the radionuclide. The TND values of the Auger electron emitters were affected by the subcellular radionuclide distribution. The photon emitters showed low TND values that were only slightly affected by the subcellular radionuclide distribution. The alpha emitters showed high TND values that were only slightly affected by the subcellular radionuclide distribution. This dosimetric characterization of radionuclides may be valuable in choosing the appropriate radionuclides for specific therapeutic applications.

  9. 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

  10. A review of biomass burning emissions part III: intensive optical properties of biomass burning particles

    NASA Astrophysics Data System (ADS)

    Reid, J. S.; Eck, T. F.; Christopher, S. A.; Koppmann, R.; Dubovik, O.; Eleuterio, D. P.; Holben, B. N.; Reid, E. A.; Zhang, J.

    2004-09-01

    Because of its wide coverage over much of the globe, biomass burning has been widely studied in the context of direct radiative forcing. Such study is warranted as smoke particles scatter and at times absorb solar radiation efficiently. Further, as much of what is known about smoke transport and impacts is based on remote sensing measurements, the optical properties of smoke particles have far reaching effects into numerous aspects of biomass burning studies. Global estimates of direct forcing have been widely varying, ranging from near zero to -1 Wm-2. A significant part of this difference can be traced to varying assumptions on the optical properties of smoke. This manuscript is the third part of four examining biomass-burning emissions. Here we review and discuss the literature concerning measurement and modeling of optical properties of biomass-burning particles. These include available data from published sensitivity studies, field campaigns, and inversions from the Aerosol Robotic Network (AERONET) of Sun photometer sites. As a whole, optical properties reported in the literature are varied, reflecting both the dynamic nature of fires, variations in smoke aging processes and differences in measurement technique. We find that forward modeling or "internal closure" studies ultimately are of little help in resolving outstanding measurement issues due to the high degree of degeneracy in solutions when using "reasonable" input parameters. This is particularly notable with respect to index of refraction and the treatment of black carbon. Consequently, previous claims of column closure may in fact be more ambiguous. Differences between in situ and retrieved ?o values have implications for estimates of mass scattering and mass absorption efficiencies. In this manuscript we review and discuss this community dataset. Strengths and lapses are pointed out, future research topics are prioritized, and best estimates and uncertainties of key smoke particle parameters are provided.

  11. A review of biomass burning emissions part III: intensive optical properties of biomass burning particles

    NASA Astrophysics Data System (ADS)

    Reid, J. S.; Eck, T. F.; Christopher, S. A.; Koppmann, R.; Dubovik, O.; Eleuterio, D. P.; Holben, B. N.; Reid, E. A.; Zhang, J.

    2005-03-01

    Because of its wide coverage over much of the globe, biomass burning has been widely studied in the context of direct radiative forcing. Such study is warranted as smoke particles scatter and at times absorb solar radiation efficiently. Further, as much of what is known about smoke transport and impacts is based on remote sensing measurements, the optical properties of smoke particles have far reaching effects into numerous aspects of biomass burning studies. Global estimates of direct forcing have been widely varying, ranging from near zero to -1 W m-2. A significant part of this difference can be traced to varying assumptions on the optical properties of smoke. This manuscript is the third part of four examining biomass-burning emissions. Here we review and discuss the literature concerning measurement and modeling of optical properties of biomass-burning particles. These include available data from published sensitivity studies, field campaigns, and inversions from the Aerosol Robotic Network (AERONET) of Sun photometer sites. As a whole, optical properties reported in the literature are varied, reflecting both the dynamic nature of fires, variations in smoke aging processes and differences in measurement technique. We find that forward modeling or ''internal closure'' studies ultimately are of little help in resolving outstanding measurement issues due to the high degree of degeneracy in solutions when using ''reasonable'' input parameters. This is particularly notable with respect to index of refraction and the treatment of black carbon. Consequently, previous claims of column closure may in fact be more ambiguous. Differences between in situ and retrieved ?o values have implications for estimates of mass scattering and mass absorption efficiencies. In this manuscript we review and discuss this community dataset. Strengths and lapses are pointed out, future research topics are prioritized, and best estimates and uncertainties of key smoke particle parameters are provided.

  12. Spectroscopy, Manipulation and Trapping of Neutral Atoms, Molecules, and Other Particles Using Optical Nanofibers: A Review

    PubMed Central

    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

  13. A systematic review of four injection therapies for lateral epicondylosis: prolotherapy, polidocanol, whole blood and platelet rich plasma

    PubMed Central

    Best, Thomas M.; Zgierska, Aleksandra E.; Zeisig, Eva; Ryan, Michael; Crane, David

    2009-01-01

    Objective To appraise existing evidence for prolotherapy, polidocanol, autologous whole blood and platelet-rich plasma injection therapies for lateral epicondylosis (LE) Design Systematic Review Data sources Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine. Search strategy: names and descriptors of the therapies and LE. Study Selection All human studies assessing the four therapies for LE. Main results Results of five prospective case series and four controlled trials (3 prolotherapy, 2 polidocanol, 3 autologous whole blood and 1 platelet-rich plasma) suggest each of the four therapies is effective for LE. In follow-up periods ranging from 9 to 108 weeks, studies reported sustained, statistically significant(p<0.05) improvement on visual analog scale primary outcome pain score measures and disease specific questionnaires; relative effect sizes ranged from 51% to 94%; Cohen’s d ranged from 0.68 to 6.68. Secondary outcomes also improved, including biomechanical elbow function assessment (polidocanol and prolotherapy), presence of abnormalities and increased vascularity on ultrasound (autologous whole blood and polidocanol). Subjects reported satisfaction with therapies on single-item assessments. All studies were limited by small sample size. Conclusions There is strong pilot-level evidence supporting the use of prolotherapy, polidocanol, autologous whole blood and platelet-rich plasma injections in the treatment of LE. Rigorous studies of sufficient sample size, assessing these injection therapies using validated clinical, radiological and biomechanical measures, and tissue injury/healing-responsive biomarkers, are needed to determine long-term effectiveness and safety, and whether these techniques can play a definitive role in the management of LE and other tendinopathies. PMID:19028733

  14. Biological Effects Induced by Non-thermal Ultrasound and Implications for Cancer Therapy: A Review of the Current Literature.

    PubMed

    Tang, Justin; Guha, Chandan; Tomé, Wolfgang A

    2015-04-01

    Recent advancements in imaging and targeting have expanded the utility of ultrasound therapy with increasing attention being paid to the application of ultrasound in cancer therapy. We present in this article a review of the biological effects of non-thermal ultrasound that could find application in cancer treatment in the near and long term. A careful examination of the ultrasound parameters that elicited these observed effects is needed so that one may refine and apply these results for clinical application. Reported biological effects from non-thermal ultrasound have been categorized into mechanical and chemical means of action. Cavitation and acoustic radiation force are the main contributors to sonomechanical effects of ultrasound while reactive oxygen species contribute to its sonochemical effects. These two categories are responsible for observations such as induction of apoptosis in cancer cells, disturbance of the cytoskeleton, enhancement of gene transfection and chemotherapeutic potency, and modulation of cellular proliferation and protein synthesis. In this review we have considered the biological effects of non-thermal ultrasound, the range of parameters at which these biological effects are observed, and the applicability of the observed biological effects to cancer therapy. PMID:24502548

  15. 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

  16. 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.

  17. 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

  18. [Pharmacologic therapy of cranio-cervico-mandibular disorders. Review of the literature].

    PubMed

    Catapano, S; Gavagna, M; Baldissara, S; Baldissara, P

    1998-06-01

    The recommended treatments of craniomandibular disorders (CMD) are drug therapy, physiotherapy, relaxation procedures, occlusal therapy with and without splint. The purpose of this study is to carry out a survey of the literature on drug therapy in patients affected by CMD. It is essential to recognize the cause of pain (muscular or articular) and the phase of disorder (acute or chronic) in order to establish an adequate pharmacological protocol for each type of CMD. Non-steroidal anti-inflammatory drugs (NSAID) are generally accepted for treatment of internal derangement and myofacial pain, sometimes in association with benzodiazepine. PMID:9738360

  19. 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

  20. Irradiation performance of experimental fuel particles coated with silicon-alloyed pyrocarbon: A review

    NASA Astrophysics Data System (ADS)

    Bullock, R. E.

    1983-01-01

    A review has been conducted on the use of silicon-alloyed pyrocarbon (Si-PyC) as an improved coating material for the two types of fuel particles used in the cores of high-temperature gas-cooled reactors. Based on recent data from extensive irradiation testing and postirradiation annealing of such experimental fuel particles, it is concluded that Si-PyC coatings offer considerable promise as replacements for the standard pure pyrocarbon (PyC) coatings used on thorium-based fertile fuels that have BISO coating designs. The primary advantage here is improved retention of fission products from bred U-233, with diffusion coefficients being as much as 100 times smaller for Si-PyC than for PyC. However, there is no significant improvement in mechanical performance of Si-PyC coatings over standard PyC coatings under irradiation. As a result, there is no incentive for using these coatings on TRISO particle designs of the type used on uranium-based fissile fuels, because here a silicon carbide barrier layer provides superior fission-product retention.

  1. Therapies for Treatment-Resistant Depression: A Review of the Research

    MedlinePLUS

    ... skulls should not have ECT. What else should I think about? ECT has changed and has become safer ... and temporary changes in hearing. What else should I think about? rTMS is newer than other therapies. This ...

  2. Meditative Movement Therapies and Health-Related Quality-of-Life in Adults: A Systematic Review of Meta-Analyses.

    PubMed

    Kelley, George A; Kelley, Kristi S

    2015-01-01

    Poor health-related quality-of-life (HRQOL) is a significant public health issue while the use of meditative movement therapies has been increasing. The purpose of this investigation was to carry out a systematic review of previous meta-analyses that examined the effects of meditative movement therapies (yoga, tai chi and qigong) on HRQOL in adults. Previous meta-analyses of randomized controlled trials published up through February, 2014 were included by searching nine electronic databases and cross-referencing. Dual-selection and data abstraction occurred. The Assessment of Multiple Systematic Reviews Instrument (AMSTAR) was used to assess methodological quality. Standardized mean differences that were pooled using random-effects models were included. In addition, 95% prediction intervals were calculated as well as the number needed-to-treat and percentile improvements. Of the 510 citations screened, 10 meta-analyses representing a median of 3 standardized mean differences in 82 to 528 participants (median = 270) with breast cancer, schizophrenia, low back pain, heart failure and diabetes, were included. Median methodological quality was 70%. Median length, frequency and duration of the meditative movement therapies were 12 weeks, 3 times per week, for 71 minutes per session. The majority of results (78.9%) favored statistically significant improvements (non-overlapping 95% confidence intervals) in HRQOL, with standardized mean differences ranging from 0.18 to 2.28. More than half of the results yielded statistically significant heterogeneity (Q ? 0.10) and large or very large inconsistency (I2 ? 50%). All 95% prediction intervals included zero. The number-needed-to-treat ranged from 2 to 10 while percentile improvements ranged from 9.9 to 48.9. The results of this study suggest that meditative movement therapies may improve HRQOL in adults with selected conditions. However, a need exists for a large, more inclusive meta-analysis (PROSPERO Registration #CRD42014014576). PMID:26053053

  3. Meditative Movement Therapies and Health-Related Quality-of-Life in Adults: A Systematic Review of Meta-Analyses

    PubMed Central

    2015-01-01

    Poor health-related quality-of-life (HRQOL) is a significant public health issue while the use of meditative movement therapies has been increasing. The purpose of this investigation was to carry out a systematic review of previous meta-analyses that examined the effects of meditative movement therapies (yoga, tai chi and qigong) on HRQOL in adults. Previous meta-analyses of randomized controlled trials published up through February, 2014 were included by searching nine electronic databases and cross-referencing. Dual-selection and data abstraction occurred. The Assessment of Multiple Systematic Reviews Instrument (AMSTAR) was used to assess methodological quality. Standardized mean differences that were pooled using random-effects models were included. In addition, 95% prediction intervals were calculated as well as the number needed-to-treat and percentile improvements. Of the 510 citations screened, 10 meta-analyses representing a median of 3 standardized mean differences in 82 to 528 participants (median = 270) with breast cancer, schizophrenia, low back pain, heart failure and diabetes, were included. Median methodological quality was 70%. Median length, frequency and duration of the meditative movement therapies were 12 weeks, 3 times per week, for 71 minutes per session. The majority of results (78.9%) favored statistically significant improvements (non-overlapping 95% confidence intervals) in HRQOL, with standardized mean differences ranging from 0.18 to 2.28. More than half of the results yielded statistically significant heterogeneity (Q ? 0.10) and large or very large inconsistency (I2 ? 50%). All 95% prediction intervals included zero. The number-needed-to-treat ranged from 2 to 10 while percentile improvements ranged from 9.9 to 48.9. The results of this study suggest that meditative movement therapies may improve HRQOL in adults with selected conditions. However, a need exists for a large, more inclusive meta-analysis (PROSPERO Registration #CRD42014014576). PMID:26053053

  4. 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

    2015-06-01

    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

  5. Chronic Mechanical Neck Pain in Adults Treated by Manual Therapy: A Systematic Review of Change Scores in Randomized Controlled Trials of a Single Session

    Microsoft Academic Search

    Howard Vernon; Barry Kim HumpHreys

    reviews of the treatment of neck pain by manual therapy13-39. In a recent report40, we reviewed all studies of manual thera- pies for chronic neck pain, focusing on the change scores obtained after courses of treatments of various manual thera- pies. However, the issue of change scores in studies of single sessions of these treat- ments has received little attention.

  6. Ultrasound Assessment of Carotid Plaque Echogenicity Response to Statin Therapy: A Systematic Review and Meta-Analysis

    PubMed Central

    Ibrahimi, Pranvera; Jashari, Fisnik; Bajraktari, Gani; Wester, Per; Henein, Michael Y.

    2015-01-01

    Objective: To evaluate in a systematic review and meta-analysis model the effect of statin therapy on carotid plaque echogenicity assessed by ultrasound. Methods: We have systematically searched electronic databases (PubMed, MEDLINE, EMBASE and Cochrane Center Register) up to April, 2015, for studies evaluating the effect of statins on plaque echogenicity. Two researchers independently determined the eligibility of studies evaluating the effect of statin therapy on carotid plaque echogenicity that used ultrasound and grey scale median (GSM) or integrated back scatter (IBS). Results: Nine out of 580 identified studies including 566 patients’ carotid artery data were meta-analyzed for a mean follow up of 7.2 months. A consistent increase in the echogenicity of carotid artery plaques, after statin therapy, was reported. Pooled weighted mean difference % (WMD) on plaque echogenicity after statin therapy was 29% (95% CI 22%–36%), p < 0.001, I2 = 92.1%. In a meta-regression analysis using % mean changes of LDL, HDL and hsCRP as moderators, it was shown that the effects of statins on plaque echogenicity were related to changes in hsCRP, but not to LDL and HDL changes from the baseline. The effect of statins on the plaque was progressive; it showed significance after the first month of treatment, and the echogenicity continued to increase in the following six and 12 months. Conclusions: Statin therapy is associated with a favorable increase of carotid plaque echogenicity. This effect seems to be dependent on the period of treatment and hsCRP change from the baseline, independent of changes in LDL and HDL. PMID:25984600

  7. Radioactive iodine (131I) therapy for differentiated thyroid cancer in Japan: current issues with historical review and future perspective.

    PubMed

    Higashi, Tatsuya; Kudo, Takashi; Kinuya, Seigo

    2012-02-01

    Radioactive iodine (RAI, (131)I) has been used as a therapeutic agent for differentiated thyroid cancer (DTC) with over 50 years of history. Recently, it is now attracting attention in medical fields as one of the molecular targeting therapies, which is known as targeted radionuclide therapy. Radioactive iodine therapy (RIT) for DTC, however, is now at stake in Japan, because Japan is confronting several problems, including the recent occurrence of the Great East Japan Disaster (GEJD) in March 2011. RIT for DTC is strictly limited in Japan and requires hospitalization. Because of strict regulations, severe lack of medical facilities for RIT has become one of the most important medical problems, which results in prolonged waiting time for Japanese patients with DTC, including those with distant metastasis, who wish to receive RIT immediately. This situation is also due to various other factors, such as prolonged economic recession, super-aging society, and subsequent rapidly changing medical environment. In addition, due to the experience of atomic bombings in Hiroshima and Nagasaki, Japanese people have strong feeling of "radiophobia". There is fear that GEJD and related radiation contamination may worsen this feeling, which might be reflected in more severe regulation of RIT. To overcome these difficulties, it is essential to collect and disclose all information about the circumstances around this therapy in Japan. In this review, we would like to look at this therapy through several lenses, including historical, cultural, medical, and socio-economic points of view. We believe that clarifying the problems is sure to lead to the resolution of this complicated situation. We have also included several recommendations for future improvements. PMID:22081274

  8. The use of low level laser therapy in the treatment of temporomandibular joint disorders. Review of the literature

    PubMed Central

    Herranz-Aparicio, Judit; Vázquez-Delgado, Eduardo; Arnabat-Domínguez, Josep; España-Tost, Antoni

    2013-01-01

    Introduction: The temporomandibular disorders (TMDs) have been identified as the most important cause of pain in the facial region. The low level laser therapy (LLLT) has demonstrated to have an analgesic, anti-inflammatory and biostimulating effects. The LLLT is a noninvasive, quick and safe, non-pharmaceutical intervention that may be beneficial for patients with TMDs. However the clinical efficiency of LLLT in the treatment of this kind of disorders is controversial. Objectives: Literature review in reference to the use of LLLT in the treatment of TMDs, considering the scientific evidence level of the published studies. Material and Methods: A MEDLINE and COCHRANE database search was made for articles. The keywords used were “temporomandibular disorders” and “low level laser therapy” or “phototherapy” and by means of the Boolean operator “AND”. The search provided a bank of 35 articles, and 16 relevant articles were selected to this review. These articles were critically analyzed and classified according to their level of scientific evidence. This analysis produced 3 literature review articles and 13 are clinical trials. The SORT criteria (Strength of Recommendation Taxonomy) was used to classify the articles. Results: Only one article presented an evidence level 1, twelve presented an evidence level 2, and three presented an evidence level 3. According to the principle of evidence-based dentistry, currently there is a scientific evidence level B in favor of using LLLT for treatment of TMDs. Discussion and conclusions: Publications on the use of LLLT for treatment of TMDs are limited making difficult to compare the different studies due to the great variability of the studied variables and the selected laser parameters. The great majority of the studies concluded that the results should be taken with caution due to the methodological limitations. Key words:Low level laser therapy; phototherapy; temporomandibular joint disorders. PMID:23722130

  9. The effect of androgen deprivation therapy on body composition in men with prostate cancer: Systematic review and meta-analysis

    Microsoft Academic Search

    Farhana Haseen; Liam J. Murray; Chris R. Cardwell; Joe M. O’Sullivan; Marie M. Cantwell

    2010-01-01

    Introduction  The use of androgen deprivation therapy (ADT) in the treatment of prostate cancer is associated with changes in body composition\\u000a including increased fat and decreased lean mass. Limited information exists regarding the rate and extent of these changes.\\u000a This systematic review was conducted to determine the effects of ADT on body composition in prostate cancer patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Literature searches were conducted

  10. Systematic Review of the Efficacy of Cognitive-Behavior Therapy Related Treatments for Victims of Natural Disasters: A Worldwide Problem

    PubMed Central

    Lopes, Alessandra Pereira; Macedo, Tânia Fagundes; Coutinho, Evandro Silva Freire; Figueira, Ivan; Ventura, Paula Rui

    2014-01-01

    Natural disasters can have devastating consequences. Each year, about 225 million people are victims of natural disasters worldwide, and up to 13,5 million of these people can develop post-traumatic stress disorder (PTSD) in the first or second year following the disaster. Cognitive-behavior therapy (CBT) is the first-choice treatment for this disorder. In order to evaluate the efficacy of psychotherapeutic treatment based on cognitive-behavior therapy for people who developed post traumatic stress disorder after natural disasters we conducted a systematic search of published studies. We used the terms reported below in the electronic databases ISI Web of Science, PsycINFO, PubMed, PILOTS and Scopus with no restrictions of language or publication date. Articles that described randomized controlled, non-randomized controlled and non controlled studies on the efficacy of cognitive-behavior therapy for individuals diagnosed with post-traumatic stress disorder after exposure to a natural disaster were eligible for inclusion. The studies were required to use a standardized measure of effectiveness before and after the intervention and have a group of patients who had used cognitive-behavior therapy as the only intervention. Our search identified 820 studies, and 11 were selected for this review. These 11 studies involved 742 subjects, 10 related to earthquakes and 1 to a hurricane. The cognitive-behavior therapy techniques used were various: 7 studies used exposure therapy, 2 studies used problem solving, and the only 2 studies with adolescents used techniques including reconstructions and reprocessing of the traumatic experience. As limitations, the search involved only five electronic databases, no experts in the field were consulted, and the heterogeneity of the findings made it impossible to perform a meta-analysis. The results suggest the efficacy of cognitive-behavior therapy, particularly exposure techniques, for the treatment of post-traumatic stress disorder after earthquakes. However, further studies with stronger methodologies, i.e. randomized-control trials and non-randomized controlled trials, are needed. PMID:25296020

  11. 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).

  12. Systematic review of the effectiveness of occupational therapy-related interventions for people with amyotrophic lateral sclerosis.

    PubMed

    Arbesman, Marian; Sheard, Kendra

    2014-01-01

    We describe the results of a systematic review of the literature on occupational therapy-related interventions for people with amyotrophic lateral sclerosis (ALS). The review included 14 studies. We found limited to moderate evidence that people involved in multidisciplinary programs have longer survival than those in general care and limited evidence that those in multidisciplinary programs have a higher percentage of appropriate assistive devices and higher quality of life in social functioning and mental health. Limited evidence indicates that people with ALS are satisfied with the comfort and ease of use of their power wheelchairs (PWCs). In addition, limited evidence is available that PWCs allow people to have increased interaction in the community. Evidence also is limited that some assistive devices are more helpful than others. Moderate evidence indicates that a home exercise program of daily stretching and resistance exercise results in improved function. The implications for practice, education, and research are discussed. PMID:24367951

  13. Propofol for the management of emergence agitation after electroconvulsive therapy: review of a case series.

    PubMed

    O'Reardon, John P; Takieddine, Nadia; Datto, Catherine J; Augoustides, John G

    2006-12-01

    We report the successful use of propofol in the management of a case series (n = 10) of patients with severe, treatment-resistant, postictal agitation (PIA) in the setting of electroconvulsive therapy (ECT). Despite prior inadequate response to intravenous midazolam and other agents, propofol therapy was highly effective with good control of PIA achieved in all cases. Propofol was well tolerated with occasional, transient, and reversible drops in blood the pressure being the only adverse event noted. The administration of propofol was also versatile being effective, as either a bolus or a bolus followed by an infusion. It appeared to be synergistic with existing therapy. Although further study is needed, these results suggest that propofol may be a very valuable additional agent for the ECT clinician in the management of PIA, which is a common entity in the setting of ECT. PMID:17143155

  14. Hyperbaric Oxygen Therapy—A Novel Treatment Modality in Oral Submucous Fibrosis: A Review

    PubMed Central

    Kumar, M. Ashwini; Radhika, Besta; Reddy, Satya Prakash; Yaga, Uday Shankar

    2015-01-01

    Oral submucous fibrosis (OSMF) is a chronic, debilitating disease characterized by juxta epithelial fibrosis of the oral cavity and regarded as a potentially malignant disorder. Numerous treatment modalities ranging from various drugs to behavioral therapy have been tried with inconsistent results with varying degrees of success reflecting low predictability, requiring further evaluation and standardization. Novel treatment modality such as Hyperbaric oxygen therapy (HBOT) involves inhalation of 100% oxygen at increased atmospheric pressure usually ranging between 2.0 and 2.5 atmospheres for periods between 60 and 120 min. HBOT which can increase oxygen tension and delivery to oxygen-deficient tissue, is a supplementary therapy to improve hypoxic environment of OSMF and also possesses potent anti-inflammatory properties. This article enlightens on possible beneficial effects of HBOT in the management of OSMF at cellular and molecular level.

  15. Photodynamic therapy of cerebral glioma--a review Part I--a biological basis.

    PubMed

    Stylli, Stanley S; Kaye, Andrew H

    2006-07-01

    Photodynamic therapy (PDT) has been investigated extensively in the laboratory for decades, and for over 25 years in the clinical environment, establishing it as a useful adjuvant to standard treatments for many cancers. A combination of both photochemical and photobiological processes occur that lead to the eventual selective destruction of the tumour cells. It is a potentially valuable adjuvant therapy that can be used in conjunction with other conventional therapies for the treatment of cerebral glioma. PDT has undergone extensive laboratory studies and clinical trials with a variety of photosensitizers (PS) and tumour models of cerebral glioma. Many environmental and genetically based factors influence the outcome of the PDT response. The biological basis of PDT is discussed with reference to laboratory and preclinical studies. PMID:16554159

  16. A severe course of Cronkhite-Canada syndrome and the review of clinical features and therapy in 49 Chinese patients.

    PubMed

    She, Qiang; Jiang, Jian-Xia; Si, Xin-Min; Tian, Xue-Ying; Shi, Rui-Hua; Zhang, Guo-Xin

    2013-01-01

    We describe a severe case of Cronkhite-Canada syndrome and review the clinical features and therapy in 49 Chinese patients. A 67-year-old man who underwent severe chronic diarrhea had typical clinical manifestations of hyperpigmentation, hair loss, and dystrophic changes in the fingernails. Although sufficient nutrition support and other therapies reported in the literature were provided, the patient died of systemic failure one year later. Cronkhite-Canada syndrome is characterized by generalized gastrointestinal polyps associated with hyperpigmentation, hair loss, and onycholysis. Anemia, positive stool occult blood, serum electrolyte disturbances, and low serum proteins are the main clinical features of patients with Cronkhite-Canada syndrome. Most patients were diagnosed by esophagogastroduodenoscopy and/or colonoscopy, and polyps were found in the entire alimentary tract, except the notable exception of the esophagus. The polyp-like samples of mucosa, hyperplasia, and adenoma were characterized by acute/chronic inflammation. Four cases were complicated with cancer. The treatment of Cronkhite-Canada syndrome includes symptomatic and support therapy, administration of corticosteroids, antibiotics and acid inhibitors, therapeutic endoscopy, and surgery. While the mortality rate was reported as 47.3% (9/19), some patients may live a long life with controlled symptoms. PMID:24226722

  17. Cognitive rehabilitation therapies for Alzheimer's disease: A review of methods to improve treatment engagement and self-efficacy

    PubMed Central

    Choi, Jimmy; Twamley, Elizabeth W.

    2013-01-01

    Cognitive rehabilitation therapies for Alzheimer’s disease (AD) are becoming more readily available to the geriatric population in an attempt to curb the insidious decline in cognitive and functional performance. However, people with AD may have difficulty adhering to these cognitive treatments due to denial of memory deficits, compromised brain systems, cognitive incapacity for self-awareness, general difficulty following through on daily tasks, lack of motivation, hopelessness, and apathy, all of which may be either due to the illness or be secondary to depression. Cognitive rehabilitation training exercises are also labor intensive and, unfortunately, serve as a repeated reminder about the memory impairments and attendant functional consequences. In order for cognitive rehabilitation methods to be effective, patients must be adequately engaged and motivated to not only begin a rehabilitation program but also to remain involved in the intervention until a therapeutic dosage can be attained. We review approaches to cognitive rehabilitation in AD, neuropsychological as well as psychological obstacles to effective treatment in this population, and methods that target adherence to treatment and may therefore be applicable to cognitive rehabilitation therapies for AD. The goal is to stimulate discussion among researchers and clinicians alike on how treatment effects may be mediated by engagement in treatment, and what can be done to enhance patient adherence for cognitive rehabilitation therapies in order to obtain greater cognitive and functional benefits from the treatment itself. PMID:23400790

  18. [The role of surgical embolectomy and extracorporeal membrane oxygen therapy in the treatment of massive pulmonary embolism - a review].

    PubMed

    Šimek, M; Hutyra, M; Gwozdziewicz, M; Fluger, I; Steriovský, A; Kone?ný, J

    2015-03-01

    Acute massive pulmonary embolism remains potentially lethal with mortality varying between 2553%. In the thrombolytic era, surgical pulmonary embolectomy is deemed as a rescue approach for patients with absolute contraindication of thrombolysis or its failure. However, close interdisciplinary cooperation, meticulous choice of optimal reperfusion strategy, standardization of surgical approach, and mainly the inclusion of mechanical circulatory support into the treatment algorithm have led to a drop in in-hospital mortality below 10% in the last 10 years. Nevertheless, cardiac arrest and refractory cardiogenic shock still remain independent risk factors of death with mortality exceeding 70%. Extracorporeal membrane oxygen therapy provides rapid circulatory support, end-organ perfusion and oxygenation which are essential for right-sided obstruction haemodynamic. Subsequently, optimal reperfusion strategy can be chosen or patients may be transported for it. The review highlights the contemporary role of surgical pulmonary embolectomy and extracorporeal membrane oxygen therapy in the treatment algorithm for acute massive pulmonary embolism, summarising current perspectives on the indications and contraindications for these treatment strategies and their results.Key words: massive pulmonary embolism - surgical pulmonary embolectomy - extracorporeal membrane oxygen therapy. PMID:25754478

  19. Photodynamic therapy of cerebral glioma - a review. Part II - clinical studies.

    PubMed

    Stylli, Stanley S; Kaye, Andrew H

    2006-08-01

    Photodynamic therapy (PDT) is a binary treatment modality that has been used to treat malignant brain tumours for 25 years. The treatment involves the selective uptake of a photosensitizer (PS) by the tumour cells followed by irradiation of the tumour with light of the appropriate wavelength to excite and activate the PS resulting in selective tumour destruction and is a potentially valuable adjunct to surgical excision and other conventional therapies. PDT has undergone extensive laboratory studies and clinical trials with a variety of PS and tumour models. These are discussed with reference mainly to clinical studies involving the PDT of brain tumours. PMID:16567094

  20. 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

  1. [Design and study of parallel computing environment of Monte Carlo simulation for particle therapy planning using a public cloud-computing infrastructure].

    PubMed

    Yokohama, Noriya

    2013-07-01

    This report was aimed at structuring the design of architectures and studying performance measurement of a parallel computing environment using a Monte Carlo simulation for particle therapy using a high performance computing (HPC) instance within a public cloud-computing infrastructure. Performance measurements showed an approximately 28 times faster speed than seen with single-thread architecture, combined with improved stability. A study of methods of optimizing the system operations also indicated lower cost. PMID:23877155

  2. Treatment of chronic rhinosinusitis refractory to other treatments with topical antibiotic therapy delivered by means of a large-particle nebulizer: Results of a controlled trial

    Microsoft Academic Search

    Martin Y. Desrosiers; Milagros Salas-Prato

    2001-01-01

    Objective: To study the efficacy of nebulized topical saline-tobramycin solution in patients with chronic rhinosinusitis refractory to medical and surgical therapy. Study Design and Setting: Twenty patients in whom endoscopic sinus surgery failed to relieve symptoms entered a randomized, double-blind trial of tobramycin-saline solution or saline-only solution administered thrice daily to the nasal passages by means of a large-particle nebulizer

  3. Experimental Models of Brain Ischemia: A Review of Techniques, Magnetic Resonance Imaging, and Investigational Cell-Based Therapies

    PubMed Central

    Canazza, Alessandra; Minati, Ludovico; Boffano, Carlo; Parati, Eugenio; Binks, Sophie

    2013-01-01

    Stroke continues to be a significant cause of death and disability worldwide. Although major advances have been made in the past decades in prevention, treatment, and rehabilitation, enormous challenges remain in the way of translating new therapeutic approaches from bench to bedside. Thrombolysis, while routinely used for ischemic stroke, is only a viable option within a narrow time window. Recently, progress in stem cell biology has opened up avenues to therapeutic strategies aimed at supporting and replacing neural cells in infarcted areas. Realistic experimental animal models are crucial to understand the mechanisms of neuronal survival following ischemic brain injury and to develop therapeutic interventions. Current studies on experimental stroke therapies evaluate the efficiency of neuroprotective agents and cell-based approaches using primarily rodent models of permanent or transient focal cerebral ischemia. In parallel, advancements in imaging techniques permit better mapping of the spatial-temporal evolution of the lesioned cortex and its functional responses. This review provides a condensed conceptual review of the state of the art of this field, from models and magnetic resonance imaging techniques through to stem cell therapies. PMID:24600434

  4. Second Solid Cancers After Radiation Therapy: A Systematic Review of the Epidemiologic Studies of the Radiation Dose-Response Relationship

    SciTech Connect

    Berrington de Gonzalez, Amy, E-mail: berringtona@mail.nih.gov [Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Gilbert, Ethel; Curtis, Rochelle; Inskip, Peter; Kleinerman, Ruth; Morton, Lindsay; Rajaraman, Preetha; Little, Mark P. [Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States)] [Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States)

    2013-06-01

    Rapid innovations in radiation therapy techniques have resulted in an urgent need for risk projection models for second cancer risks from high-dose radiation exposure, because direct observation of the late effects of newer treatments will require patient follow-up for a decade or more. However, the patterns of cancer risk after fractionated high-dose radiation are much less well understood than those after lower-dose exposures (0.1-5 Gy). In particular, there is uncertainty about the shape of the dose-response curve at high doses and about the magnitude of the second cancer risk per unit dose. We reviewed the available evidence from epidemiologic studies of second solid cancers in organs that received high-dose exposure (>5 Gy) from radiation therapy where dose-response curves were estimated from individual organ-specific doses. We included 28 eligible studies with 3434 second cancer patients across 11 second solid cancers. Overall, there was little evidence that the dose-response curve was nonlinear in the direction of a downturn in risk, even at organ doses of ?60 Gy. Thyroid cancer was the only exception, with evidence of a downturn after 20 Gy. Generally the excess relative risk per Gray, taking account of age and sex, was 5 to 10 times lower than the risk from acute exposures of <2 Gy among the Japanese atomic bomb survivors. However, the magnitude of the reduction in risk varied according to the second cancer. The results of our review provide insights into radiation carcinogenesis from fractionated high-dose exposures and are generally consistent with current theoretical models. The results can be used to refine the development of second solid cancer risk projection models for novel radiation therapy techniques.

  5. Influence of periodontal therapy on C-reactive protein level: a systematic review and meta-analysis

    PubMed Central

    de FREITAS, Camila Oliveira Teixeira; GOMES-FILHO, Isaac Suzart; NAVES, Roberta Catapano; NOGUEIRA FILHO, Getúlio da Rocha; da CRUZ, Simone Seixas; SANTOS, Carlos Antonio de Souza Teles; DUNNINGHAM, Leonardo; de MIRANDA, Lituânia Fialho; BARBOSA, Mônica Dourado da Silva

    2012-01-01

    The influence of oral infections, especially periodontal disease, on systemic diseases has been extensively discussed in the literature. Because periodontal disease is a persistent infection, it promotes an inflammatory response. C-reactive protein is a marker for inflammatory reactions that is frequently studied, since elevated levels of this protein are related to coronary events. Objective The aim of this study was to investigate the effect of periodontal therapy on reducing the serum levels of C-reactive protein, by means of a systematic review of the literature and meta-analysis. Material and Methods A systematic review of the English-language literature was conducted in the PUBMED-MEDLINE database, using the key words "periodontal disease", "C-reactive protein", "periodontal therapy" and "periodontal treatment", in accordance with the terms for Medical Subject Headings (MeSH), to evaluate the effect of periodontal therapy on C-reactive protein levels. A qualitative analysis of studies of randomized clinical trial design was performed using CONSORT, with subsequent meta-analysis. Results The literature search initially retrieved 46 potentially relevant studies available in the databases. From these, in accordance with the inclusion criteria, only 11 were selected, of which only 4 fulfilled the criteria of randomized clinical trial design. According to CONSORT, the studies evaluated generally presented good quality with regard to the criteria analyzed. Through meta-analysis, the reduction in mean levels of C-reactive protein (-0.231; p=0.000) after introducing periodontal treatment was estimated. The result was statistically significant, without evidence of heterogeneity between the studies (p=0.311). Conclusions The findings indicated that non-surgical periodontal treatment had a positive effect with regard to reduction of the serum levels of C-reactive protein. PMID:22437670

  6. Nanocrystalline materials for the dosimetry of heavy charged particles: A review

    NASA Astrophysics Data System (ADS)

    Salah, Numan

    2011-01-01

    Thermally stimulated luminescence or better known as thermoluminescence (TL) is a powerful technique extensively used for dosimetry of ionizing radiations. TL dosimeter (TLD) materials presently in use are inorganic crystalline materials. They are in the form of chips, single crystals or microcrystalline size powder. The most popular are LiF:Mg,Ti, LiF:Mg,Cu,P, CaSO 4:Dy, CaF 2:Dy and Al 2O 3:C. However, these TLD materials are not capable of precisely detecting heavy charged particles (HCP) irradiations in their present forms. The saturation effect is the major problem, which occurs at relatively low fluences (doses). Moreover, there is a significant variation in the TL glow curves structure with increase in doses, which is undesirable for the use in dosimetry. However, with the use of very tiny particles such as nanoscale TLD materials, this problem is overcome to a major extent. The TL results of the recently reported nanomaterials have revealed very imperative characteristics such as high sensitivity and saturation at very high doses. Recent studies on different luminescent nanomaterials showed that they have a potential application in dosimetry of heavy charged particles using TL technique, where the conventional microcrystalline phosphors saturate. This paper is a review on the prepared TLD nanomaterials, studied for their TL response to HCP. These are CaSO 4:Dy, LiF:Mg,Cu,P, K 2Ca 2(SO 4) 3:Eu and Ba 0.97Ca 0.03SO 4:Eu nanomaterials. The important results obtained in these nanomaterials and the possibility of using them as HCP dosimeters are discussed.

  7. Oral antibiotic therapy for the treatment of infective endocarditis: a systematic review

    PubMed Central

    2014-01-01

    Background The role of oral antibiotic therapy in treating infective endocarditis (IE) is not well established. Methods We searched MEDLINE, EMBASE and Scopus for studies in which oral antibiotic therapy was used for the treatment of IE. Results Seven observational studies evaluating the use oral beta-lactams (five), oral ciprofloxacin in combination with rifampin (one), and linezolid (one) for the treatment of IE caused by susceptible bacteria reported cure rates between 77% and 100%. Two other observational studies using aureomycin or sulfonamide, however, had failure rates >75%. One clinical trial comparing oral amoxicillin versus intravenous ceftriaxone for streptococcal IE reported 100% cure in both arms but its reporting had serious methodological limitations. One small clinical trial (n = 85) comparing oral ciprofloxacin and rifampin versus conventional intravenous antibiotic therapy for uncomplicated right-sided S. aureus IE in intravenous drug users (IVDUs) reported cure rates of 89% and 90% in each arm, respectively (P =0.9); however, drug toxicities were more common in the latter group (62% versus 3%; P <0.01). Major limitations of this trial were lack of allocation concealment and blinding at the delivery of the study drug(s) and assessment of outcomes. Conclusion Reported cure rates for IE treated with oral antibiotic regimens vary widely. The use of oral ciprofloxacin in combination with rifampin for uncomplicated right-sided S. aureus IE in IVDUs is supported by one small clinical trial of relatively good quality and could be considered when conventional IV antibiotic therapy is not possible. PMID:24624933

  8. Surfactant Lavage Therapy for Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis

    Microsoft Academic Search

    Hyun Jin Choi; Seokyung Hahn; Joongyub Lee; Byung-Joo Park; Soon Min Lee; Han-Suk Kim; Chong-Woo Bae

    2012-01-01

    Background: Lung lavage with diluted surfactant has emerged as an innovative treatment for meconium aspiration syndrome (MAS). However, the treatment effect has not yet been fully established. Objective: To investigate the effects of surfactant lavage therapy for MAS by a systematic meta-analysis. Methods: Relevant studies were identified by database searches in MEDLINE (from 1950), EMBASE (from 1980), and CENTRAL, up

  9. Parenteral nutritional therapy and risk of infection: review with proposed management guidelines

    Microsoft Academic Search

    P. DELLA LOGGIA; V. KIREN; D. GIACOMAZZI; R. LUZZATI

    2009-01-01

    Parenteral nutritional therapy increases the risk of infection when compared with enteral feeding or delayed nutrition. On the other hand, some clinical circumstances require the delivery of nu- trition by central vascular catheter for both critically ill and chronically ill patients. Catheter-related bloodstream infection remains one of the most frequent infective complications in these patients, with an incidence ranging from

  10. Sex issues in HIV1-infected persons during highly active antiretroviral therapy: a systematic review

    Microsoft Academic Search

    Emanuele Nicastri; Sebastiano Leone; Claudio Angeletti; Lucia Palmisano; Loredana Sarmati; Antonio Chiesi; Andrea Geraci; Stefano Vella; Pasquale Narciso; Angela Corpolongo; Massimo Andreoni

    2007-01-01

    Background: Since the introduction of highly active antiretroviral therapy (HAART), morbidity and mortality rates have sharply decreased among HIV-infected patients. Studies of possible differences between men and women in the course of HIV infection give conflicting results. The objective of this study was to assess sex differences during HAART. Methods: A literature search by using the MEDLINE database between March

  11. A review of the impact of l-carnitine therapy on patient functionality in maintenance hemodialysis

    Microsoft Academic Search

    Brent Miller; Suhail Ahmad

    2003-01-01

    Goals of maintenance hemodialysis therapy include not only the preservation of an individual patient’s life in the presence of kidney failure, but also restoration of optimal quality of life. Although many conceptual and method problems are associated with the definition and assessment of quality of life in the chronically ill, there is broad agreement that patient quality of life is

  12. Radiation Therapy for Idiopathic Orbital Myositis: Two Case Reports and Literature Review

    Microsoft Academic Search

    Koichi Isobe; Takashi Uno; Hiroyuki Kawakami; Naoyuki Ueno; Tetsuya Kawata; Hideki Abe; Katsuyuki Minowa; Shuichi Yamamoto; Hisao Ito

    We report two cases of idiopathic orbital myositis treated with radiation therapy (RT). Both patients visited our hospital with complaints of orbital pain on eye movement and eyelid swelling. There was no history of thyroid disease or trauma, and no signs of infection, neoplasm, or collagen disease. The laboratory investigations, including a thyroid function test, showed no abnormalities in either

  13. Clinical application of expectorant therapy in chronic inflammatory airway diseases (Review)

    PubMed Central

    ZHANG, TING; ZHOU, XIANGDONG

    2014-01-01

    Airway mucus hypersecretion is a significant clinical and pathological feature of chronic inflammatory airway diseases. Its clinical presentations include recurrent coughing and phlegm. Airway mucus is closely associated with the occurrence, development and prognosis of chronic inflammatory airway diseases and critically affects the lung function, quality of life, hospitalization rate and mortality of patients with chronic inflammatory airway diseases. Therefore, expectorant therapies targeting the potential mechanisms of mucus hypersecretion have been the focus of numerous studies. Conventional expectorants are mainly mucoactive medicines, including nausea-stimulating expectorants, mucolytics, mucokinetics, and proteases and nucleases. In addition, certain traditional Chinese herbal medicines and non-mucoactive agents, including muscarinic acetylcholine receptor antagonists, corticosteroids, leukotriene receptor antagonists and macrolide antibiotics, have also shown expectorant effects. Several novel medicines for expectorant therapy have emerged, including cholesterol-lowering statins, epidermal growth factor receptor tyrosine kinase inhibitors, phosphodiesterase-4 inhibitors, stanozolol, surfactants, flavonoids, tachykinin receptor antagonists, protease inhibitors, cytokine antagonists and purinergic agonists. With the increasing number of multidisciplinary studies, the effectiveness of expectorant therapy for the treatment of chronic inflammatory airway diseases has been confirmed. Therefore, the development of novel expectorants and the standardization of expectorant therapy are the direction and focus of future studies, thus benefiting patients who have a chronic inflammatory airway disease. PMID:24660026

  14. A review of cutaneous toxicities from targeted therapies in the treatment of colorectal cancers

    PubMed Central

    Urban, Christopher

    2013-01-01

    Currently there are three targeted therapies approved for the treatment of colorectal cancers. These include the epidermal growth factor receptor (EGFR) inhibitors, cetuximab and panitumumab, and the multikinase inhibitor regorafenib. It is important to understand and recognize the common presentations of cutaneous toxicity that result from these agents to effectively manage symptoms and prevent premature discontinuation of anticancer treatment. PMID:23997943

  15. A Review of the Principles for Culturally Appropriate Art Therapy Assessment Tools

    ERIC Educational Resources Information Center

    Betts, Donna

    2013-01-01

    In an increasingly diverse society, and with the broadening scope of art therapy, the duty of art therapists to ensure responsible and appropriate assessment is ever more important. This article discusses considerations that are necessary for the successful adaptation and use of drawing-based assessments in cross-cultural and multicultural…

  16. Coming out through Art: A Review of Art Therapy with LGBT Clients

    ERIC Educational Resources Information Center

    Pelton-Sweet, Laura M.; Sherry, Alissa

    2008-01-01

    This paper examines sexual identity development and the integration of art therapy in counseling with lesbian, gay, bisexual, and transgendered (LGBT) clients. Especially during the coming out process for LGBT clients, research has shown that levels of emotional and physical well-being decrease considerably. However, there is growing evidence in…

  17. Art Therapy and Flow: A Review of the Literature and Applications

    ERIC Educational Resources Information Center

    Chilton, Gioia

    2013-01-01

    Flow is a construct developed by Mihaly Csikszentmihalyi that describes a psychological state of optimal attention and engagement. Creativity and improved well-being have been empirically linked to the flow experience; therefore, the study of flow has implications for art therapy research and practice. Art therapists may facilitate personal growth…

  18. Fluorescence diagnosis and photodynamic therapy for lower genital tract diseases – A review

    Microsoft Academic Search

    Peter Hillemanns; Philipp Soergel; Martin Löning

    2009-01-01

    Fluorescence diagnosis (FD) and photodynamic therapy (PDT) are modern methods which are evaluated in different fields in gynecology. FD is under investigation as a method gynecological conditions such as cervical intraepithelial neoplasia (CIN), vulvar intraepithelial neoplasia (VIN), endometriosis and ovarian cancer. PDT is being evaluated in a multicentric randomized phase-II study for the treatment of human papillomavirus (HPV)-associated CIN using

  19. Use of Negative Pressure Wound Therapy for Abdominal Wounds: A Review of Recent Literature

    Microsoft Academic Search

    Evan T. Excell

    2008-01-01

    Introduction: Negative Pressure Wound Therapy (NPWT) is used extensively in the acute and chronic wound care arena of health care. It has become a standard of care for many types of wounds from non-healing diabetic foot ulcers and burns to traumatic and surgical wounds. Recently attention has been paid to using this system for the treatment of catastrophic abdominal wounds.

  20. Massive digoxin ingestion. Report of a case and review of currently available therapies.

    PubMed Central

    Bremner, W F; Third, J L; Lawrie, T D

    1977-01-01

    Recent reports of treatment of massive digoxin overdosage have emphasized the success of medical therapy. This report describes a fatal outcome to this problem despite aggressive medical management, including pervenous cardiac pacing and draws attention to deficiencies in current treatment of a serious problem. PMID:328024

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

    ERIC Educational Resources Information Center

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

    2010-01-01

    Objective: Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. Therefore, our objective was to conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples. Method: We conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and…

  2. Massage Therapy for Neck and Shoulder Pain: A Systematic Review and Meta-Analysis

    PubMed Central

    Kong, Ling Jun; Zhan, Hong Sheng; Cheng, Ying Wu; Yuan, Wei An; Chen, Bo; Fang, Min

    2013-01-01

    Objective. To evaluate the effectiveness of massage therapy (MT) for neck and shoulder pain. Methods. Seven English and Chinese databases were searched until December 2011 for randomized controlled trials (RCTs) of MT for neck and shoulder pain. The methodological quality of RCTs was assessed based on PEDro scale. The meta-analyses of MT for neck and shoulder pain were performed. Results. Twelve high-quality studies were included. In immediate effects, the meta-analyses showed significant effects of MT for neck pain (standardised mean difference, SMD, 1.79; 95% confidence intervals, CI, 1.01 to 2.57; P < 0.00001) and shoulder pain (SMD, 1.50; 95% CI, 0.55 to 2.45; P = 0.002) versus inactive therapies. And MT showed short-term effects for shoulder pain (SMD, 1.51; 95% CI, 0.53 to 2.49; P = 0.003). But MT did not show better effects for neck pain (SMD, 0.13; 95% CI, ?0.38 to 0.63; P = 0.63) or shoulder pain (SMD, 0.88; 95% CI, ?0.74 to 2.51; P = 0.29) than active therapies. In addition, functional status of the shoulder was not significantly affected by MT. Conclusion. MT may provide immediate effects for neck and shoulder pain. However, MT does not show better effects on pain than other active therapies. No evidence suggests that MT is effective in functional status. PMID:23533504

  3. Abdominal Massage Therapy for Chronic Constipation: A Systematic Review of Controlled Clinical Trials

    Microsoft Academic Search

    E. Ernst

    1999-01-01

    SummaryAbdominal massage therapy was once an accepted treatment for constipation. Subsequently interest faded, but recent years have seen a revival of interest in massage. It is therefore timely to ask whether or not it is an effective form of treatment for this condition. Computerized literature searches were carried out to retrieve all controlled clinical trials. Data were extracted in a

  4. Acoustic CR Neuromodulation Therapy for Subjective Tonal Tinnitus: A Review of Clinical Outcomes in an Independent Audiology Practice Setting

    PubMed Central

    Williams, Mark; Hauptmann, Christian; Patel, Nitesh

    2015-01-01

    Objective: To describe the quantitative treatment outcomes of patients undergoing acoustic coordinated reset (CR) neuromodulation at a single independent audiology practice over a 22- to 26-week period as part of an open label, non-randomized, non-controlled observational study. Methods: Sixty-six patients with subjective tonal tinnitus were treated with acoustic CR neuromodulation with a retrospective review of patient records being performed in order to identify changes of visual analog scale (VAS, n?=?66) and in the score of the tinnitus handicap questionnaire (THQ, n?=?51). Patients had their tinnitus severity recorded prior to the initiation of therapy using the tinnitus handicap inventory in order to categorize patients into slight up to catastrophic impact categories. THQ and VAS for tinnitus loudness/annoyance were obtained at the patient’s initial visit, at 10–14 and 22–26?weeks. Results: Visual analog scale scores were significantly improved, demonstrating a 25.8% mean reduction in tinnitus loudness and a 32% mean reduction in tinnitus annoyance with a clinically significant reduction in percept loudness and annoyance being recorded in 59.1 and 72.7% of the patient group. THQ scores were significantly improved by 19.4% after 22–26?weeks of therapy compared to baseline. Conclusion: Acoustic CR neuromodulation therapy appears to be a practical and promising treatment for subjective tonal tinnitus. However, due to the lack of a control group it is difficult to reach an absolute conclusion regarding to what extent the observed effects are related directly to the acoustic CR neuromodulation therapy. Also, as the observed patient group was made up of paying clients it is unknown as to whether this could have caused any additional placebo like effects to influence the final results. PMID:25838816

  5. Surgical Management of Early-Stage Non-small Cell Lung Carcinoma and the Present and Future Roles of Adjuvant Therapy: A Review for the Radiation Oncologist

    SciTech Connect

    Medford-Davis, Laura [Department of Emergency Medicine, Ben Taub General Hospital, Houston, TX (United States)] [Department of Emergency Medicine, Ben Taub General Hospital, Houston, TX (United States); DeCamp, Malcom [Division of Thoracic Surgery, Department of Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois (United States)] [Division of Thoracic Surgery, Department of Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois (United States); Recht, Abram [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States)] [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Flickinger, John [Department of Radiation Oncology, Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States)] [Department of Radiation Oncology, Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Belani, Chandra P. [Department of Medical Oncology, Penn State Hershey Cancer Institute, Hershey, Pennsylvania (United States)] [Department of Medical Oncology, Penn State Hershey Cancer Institute, Hershey, Pennsylvania (United States); Varlotto, John, E-mail: jvarlotto@hmc.psu.edu [Division of Radiation Oncology, Penn State Hershey Cancer Institute, Hershey, Pennsylvania (United States)] [Division of Radiation Oncology, Penn State Hershey Cancer Institute, Hershey, Pennsylvania (United States)

    2012-12-01

    We review the evidence for optimal surgical management and adjuvant therapy for patients with stages I and II non-small cell lung cancer (NSCLC) along with factors associated with increased risks of recurrence. Based on the current evidence, we recommend optimal use of mediastinal lymph node dissection, adjuvant chemotherapy, and post-operative radiation therapy, and make suggestions for areas to explore in future prospective randomized clinical trials.

  6. Analysis of inter- and intrafraction accuracy of a commercial thermoplastic mask system used for image-guided particle radiation therapy

    PubMed Central

    Amelio, Dante; Winter, Marcus; Habermehl, Daniel; Jäkel, Oliver; Debus, Jurgen; Combs, Stephanie E.

    2013-01-01

    The present paper reports and discusses the results concerning both the inter- and intrafraction accuracy achievable combining the immobilization system employed in patients with head-and-neck, brain and skull base tumors with image guidance at our particle therapy center. Moreover, we investigated the influence of intrafraction time on positioning displacements. A total of 41 patients treated between January and July 2011 represented the study population. All the patients were immobilized with a tailored commercial thermoplastic head mask with standard head-neck rest (HeadSTEP®, IT-V). Patient treatment position was verified by two orthogonal kilovoltage images acquired through a ceiling imaging robot (Siemens, Erlangen, Germany). The analysis of the applied daily corrections during the first treatment week before and after treatment delivery allowed the evaluation of the interfraction and intrafraction reproducibility of the thermoplastic mask, respectively. Concerning interfraction reproducibility, translational and rotational systematic errors (?s) were ?2.2 mm and 0.9º, respectively; translational and rotational random errors (?s) were ?1.6 mm and 0.6º, respectively. Regarding the intrafraction accuracy translational and rotational ?s were ?0.4 mm and 0.4º, respectively; translational and rotational ?s were ? 0.5 mm and 0.3º, respectively. Concerning the time-intrafraction displacements correlation Pearson coefficient was 0.5 for treatment fractions with time between position checks less than or equal to median value, and 0.2 for those with time between position controls longer than the median figure. These results suggest that intrafractional patient motion is smaller than interfractional patient motion. Moreover, we can state that application of different imaging verification protocols translate into a relevant difference of accuracy for the same immobilization device. The magnitude of intrafraction displacements correlates with the time for short treatment sessions or during the early phase of long treatment delivery. PMID:23824130

  7. Pegylated interferons: a nurses' review of a novel multiple sclerosis therapy.

    PubMed

    Howley, Anne; Kremenchutzky, Marcelo

    2014-04-01

    Most multiple sclerosis (MS) therapies are injectable drugs, and the frequency of injections has been shown to be inversely proportional to overall compliance. One method of improving therapeutic compliance and thus clinical outcomes is to develop medications that require less frequent dosing. One of the most promising modification techniques to extend the bioavailability of a drug is poly(ethylene glycol) conjugation (pegylation), which increases the size of a molecule by attaching polyethylene glycol moieties to the parent compound, resulting in slower clearance and metabolism. This approach has been used to improve the efficacy of a number of therapeutic molecules, including interferons. Peginterferon beta-1a, a pegylated form of interferon beta-1a, is currently in phase III clinical trials for relapsing MS and has the potential to improve patient compliance by reducing the number of injections while maintaining clinical efficacy. The role of nurses in educating patients about the effective use of this new MS therapy is discussed. PMID:24556656

  8. Alternative therapies useful in the management of diabetes: A systematic review

    PubMed Central

    Pandey, Awanish; Tripathi, Poonam; Pandey, Rishabh; Srivatava, Rashmi; Goswami, Shambaditya

    2011-01-01

    Diabetes mellitus is a metabolic disorder in the endocrine system. This dreadful disease is found in all parts of the world and becoming a serious threat of mankind health. There are lots of chemical agents available to control and to treat diabetic patients, but total recovery from diabetes has not been reported up to this date. In addition to adverse effects, drug treatments are not always satisfactory in maintaining euglycemia and avoiding late stage diabetic complications. Alternative to these synthetic agents, plants provided a potential source of hypoglycemic drugs and are widely used in several traditional systems of medicine to prevent diabetes. Several medicinal plants have been investigated for their beneficial effect in different type of diabetes. Other alternative therapies such as dietary supplements, acupuncture, hydrotherapy, and yoga therapies less likely to have the side effects of conventional approaches for diabetes. PMID:22219583

  9. PHYSICAL REVIEW E 83, 059904(E) (2011) Erratum: Mean square displacement analysis of single-particle trajectories with localization error

    E-print Network

    Michalet, Xavier

    2011-01-01

    PHYSICAL REVIEW E 83, 059904(E) (2011) Erratum: Mean square displacement analysis of single-particle trajectories with localization error: Brownian motion in an isotropic medium [Phys. Rev. E 82, 041914 (2010) and b (plain black symbols) for different trajectory sizes N = 10 (triangle), 100 (circle) or 1000

  10. Quaternary Science Reviews 26 (2007) 26312643 Charcoal and fly-ash particles from Lake Lucerne sediments (Central

    E-print Network

    Gilli, Adrian

    2007-01-01

    Quaternary Science Reviews 26 (2007) 2631­2643 Charcoal and fly-ash particles from Lake Lucerne Abstract In order to link the charcoal record from sedimentary archives with the combustion processes emitted in the area of Lake Lucerne (Central Europe) throughout the last 7200 years. Charcoal

  11. A review of dispersion modelling and its application to the dispersion of particles: An overview of different dispersion models available

    Microsoft Academic Search

    N. S. Holmes; L. Morawska

    2006-01-01

    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.

  12. Hepatitis C genotype 6: A concise review and response-guided therapy proposal

    PubMed Central

    Bunchorntavakul, Chalermrat; Chavalitdhamrong, Disaya; Tanwandee, Tawesak

    2013-01-01

    Hepatitis C genotype 6 is endemic in Southeast Asia [prevalence varies between 10%-60% among all hepatitis C virus (HCV) infection], as well as also sporadically reported outside the area among immigrations. The diagnosis of HCV genotype can be inaccurate with earlier methods of genotyping due to identical 5’-UTR between genotype 6 and 1b, hence the newer genotyping methods with core sequencing are preferred. Risk factors and clinical course of HCV genotype 6 do not differ considerably from other genotypes. Treatment outcome of HCV genotype 6 with a combination of pegylated interferon and ribavirin is superior to genotype 1, and nearly comparable to genotype 3, with expected sustained virological response (SVR) rates of 60%-90%. Emerging data suggests that a shorter course 24-wk treatment is equally effective as a standard 48-wk treatment, particularly for those patients who attained undetectable HCV RNA at week 4 (RVR). In addition, baseline and on-treatment predictors of response used for other HCV genotypes appear effective with genotype 6. Although some pan-genotypic direct-acting antivirals have completed phase II/III studies (sofosbuvir and simeprevir) with clinical benefit demonstrated in small number of patients with genotype 6, broad availability of these agents in Southeast Asia may not be expected in the near future. While awaiting the newer therapy, response-guided therapy seems appropriate for patients with HCV genotype 6. Patients with RVR (representing > 70% of patients) are suitable for 24-wk treatment with expected SVR rates > 80%. Patients without RVR and/or those with poor response predictors may benefit from 48 wk of therapy, and a detectable HCV RNA at week 12 (with no early virological response) serves as a stopping rule. This treatment scheme is likely to have a major economic impact on HCV therapy, particularly in Southeast Asia, wherein treatment can be truncated securely in the majority of patients with HCV genotype 6. PMID:24073301

  13. Esophageal Adenocarcinoma in Barrett's Esophagus After Endoscopic Ablative Therapy: A Meta-Analysis and Systematic Review

    Microsoft Academic Search

    Sachin Wani; Srinivas R Puli; Nicholas J Shaheen; Brenda Westhoff; Sanjeev Slehria; Ajay Bansal; Amit Rastogi; Hari Sayana; Prateek Sharma

    2009-01-01

    OBJECTIVES:The extent of reduction of esophageal adenocarcinoma (EAC) incidence in Barrett's esophagus (BE) patients after endoscopic ablation is not known. The objective of this study was to determine the cancer incidence in BE patients after ablative therapy and compare these rates to cohort studies of BE patients not undergoing ablation.METHODS:A MEDLINE search of the literature on the natural history and

  14. Adjuvant zoledronic acid therapy for patients with early stage breast cancer: an updated systematic review and meta-analysis

    PubMed Central

    2013-01-01

    Background Zoledronic acid is a potent inhibitor of osteoclast-mediated bone resorption and has been widely used in bone metastasis malignancies and postmenopausal osteoporosis as a preventive therapy against skeletal-related events. The purpose of this study was to evaluate the clinical outcome of zoledronic acid as an adjuvant therapy for patients with early stage breast cancer. Patients and methods Entries in the PubMed and EMBASE databases up to 12 July 2013 were systematically reviewed. Online abstracts from the proceedings of the Annual Meetings of the American Society of Clinical Oncology (ASCO) (1992–2013) and the San Antonio Breast Cancer Symposium (SABCS) (2004–2013) were also reviewed. Primary endpoints included overall survival (OS) and disease-free survival (DFS), while secondary endpoints included bone metastasis-free survival (BMFS), distant metastasis-free survival (DMFS), and fracture-free rate (FFR). Results A total of eight studies including 3,866 subjects and 3,864 controls met our search criteria and were evaluated. The use of zoledronic acid was found to improve OS (relative risk (RR), 0.88; 95% confidence interval (CI), 0.77–1.01; p-value?=?0.06) and DMFS (RR, 0.77; 95% CI, 0.60–1.00; p-value?=?0.05). Furthermore, statistically significant benefits were associated with BMFS (RR, 0.81; 95% CI, 0.66–0.99; p-value?=?0.04) and FFRs (RR, 0.75; 95% CI, 0.61–0.92; p-value?=?0.007). In contrast, there was no significant difference in DFS with the application of zoledronic acid (RR, 0.88; 95% CI, 0.72–1.09; p-value?=?0.24). Sensitivity analysis further identified the improvement of 5-year OS for the adjuvant zoledronic acid therapy in early stage breast cancer patients (RR, 0.86; 95% CI, 0.75–0.99; p-value?=?0.03), while a borderline statistically significant benefit was observed for 5-year DFS (RR, 0.90; 95% CI, 0.81–1.00; p-value?=?0.06). Conclusion Zoledronic acid as an adjuvant therapy appears to improve the 5-year OS rate for early stage breast cancer patients, and was associated with a protective effect for the bone metastases and fractures evaluated in more than 7,000 patients. However, further research is needed to confirm our findings, and sub-group analyses according to menopause status or hormone status may provide further insight. PMID:24283946

  15. Dental complications and management of patients on bisphosphonate therapy: A review article.

    PubMed

    Kalra, Sandeep; Jain, Veena

    2013-01-01

    Bisphosphonates are group of drugs that inhibit bone resorption and are used to treat a range of pathologies including Paget's disease, osteoporosis, multiple myeloma and metastasis associated with breast or prostate cancer. The most common complication in patients on bisphosphonate therapy is osteonecrosis of jaw (ONJ) which can occur after any surgical dental procedure and the risk for the development of osteonecrosis of jaw is higher in patients receiving intravenous bisphosphonate therapy than in patients receiving oral bisphosphonate therapy. Typical presentation is in the form of non-extraction socket, presence of exposed bone, gingival swelling or purulent discharge, when local debridement and antibiotics are ineffective. At present, there is no effective treatment for bisphosphonate induced osteonecrosis, so prevention is extremely important. Maximum precautions should be taken in patients who are at the risk of development of ONJ especially when any dental surgical procedure like extractions, retrograde apicoectomies, periodontal surgery and implant placement is contemplated. Dentists and oral or maxillofacial surgeon must keep up to date with the latest approaches or guidelines to prevention and the risk factors, particularly when treating patients who are on bisphosphonates, or who will be taking bisphosphonates. PMID:25737876

  16. HBV Genotype B/C and Response to Lamivudine Therapy: A Systematic Review

    PubMed Central

    Chen, Xiu-Li; Zhang, Xiao-Lan

    2013-01-01

    A number of nucleoside analogues such as lamivudine (LAM), actually used for the treatment of chronic hepatitis B, can suppress HBV DNA replication, improve transaminase level and liver histology, and enhance the rate of hepatitis B e antigen (HBeAg) clearance. The responses to LAM therapy involve HBeAg clearance and HBV DNA conversion of negative. However, the associations between HBV genotype B/C and response to LAM therapy remain ambiguous. The aim of this meta-analysis is to determine more precise estimations of the relationship. All the publications on the associations between HBV genotype B/C and response to LAM (HBeAg clearance and HBV DNA conversion of negative) through June 2013 were collected. Relative risk (RR) with 95% confidence intervals (95% CI) was calculated in fixed or random model, I2 was calculated to examine heterogeneity, and funnel plots were plotted to examine small study effects with Stata 11 software. Overall, for HBeAg clearance and genotype B/C, the RR (95% CI) was 1.27 (0.94–1.71), while for HBV DNA conversion of negative and genotype B/C, the RR (95% CI) was 1.07 (0.98–1.17). HBV genotype B/C shows no significance associations with response to lamivudine therapy (HBeAg clearance and HBV DNA conversion of negative). PMID:24364035

  17. Targeted focal therapy for prostate cancer: a review of the literature

    PubMed Central

    Sullivan, Kathryn F.; Crawford, E. David

    2009-01-01

    Improvements in prostate cancer diagnosis and treatment have resulted in a decreasing age-adjusted death rate. But improved diagnostic tools have not delivered a proportionate decrease in mortality, primarily because physicians now are diagnosing – and treating – more clinically insignificant tumors. Targeted focal therapy (TFT) uses three dimensional (3D) mapping biopsies to guide cryotherapy so that it targets lesions themselves while sparing surrounding healthy tissues, thereby avoiding side effects associated with more invasive treatments. As such, TFT can provide a bridge between active surveillance and more aggressive treatments for patients with low-risk tumors. It is appropriate for men who either do not want or are not good candidates for more aggressive therapies. Identifying patients who are appropriate candidates for TFT is challenging, but the mapping biopsy technique helps identify individuals who have localized disease and could benefit from this treatment. In recent years, improvements in cryotherapy have increased its efficacy while decreasing complications. At the present time using cryotherapy to target and destroy the cancer(s) is appealing. Other approaches to less aggressive therapies are discussed including gland hemi ablation, high intensity ultrasound (HIFU) and others. Going forward, patients will benefit further from development of better imaging technologies and completion of long-term survival studies. PMID:21789063

  18. Concise review: Nanoparticles and cellular carriers-allies in cancer imaging and cellular gene therapy?

    PubMed Central

    Tang, Catherine; Russell, Pamela J; Martiniello-Wilks, Rosetta; J Rasko, John E; Khatri, Aparajita

    2010-01-01

    Ineffective treatment and poor patient management continue to plague the arena of clinical oncology. The crucial issues include inadequate treatment efficacy due to ineffective targeting of cancer deposits, systemic toxicities, suboptimal cancer detection and disease monitoring. This has led to the quest for clinically relevant, innovative multifaceted solutions such as development of targeted and traceable therapies. Mesenchymal stem cells (MSCs) have the intrinsic ability to “home” to growing tumors and are hypoimmunogenic. Therefore, these can be used as (a) “Trojan Horses” to deliver gene therapy directly into the tumors and (b) carriers of nanoparticles to allow cell tracking and simultaneous cancer detection. The camouflage of MSC carriers can potentially tackle the issues of safety, vector, and/or transgene immunogenicity as well as nanoparticle clearance and toxicity. The versatility of the nanotechnology platform could allow cellular tracking using single or multimodal imaging modalities. Toward that end, noninvasive magnetic resonance imaging (MRI) is fast becoming a clinical favorite, though there is scope for improvement in its accuracy and sensitivity. In that, use of superparamagnetic iron-oxide nanoparticles (SPION) as MRI contrast enhancers may be the best option for tracking therapeutic MSC. The prospects and consequences of synergistic approaches using MSC carriers, gene therapy, and SPION in developing cancer diagnostics and therapeutics are discussed. STEM CELLS 2010; 28:1686–1702. PMID:20629172

  19. A Review of Targeted Therapies Evaluated by the Pediatric Preclinical Testing Program for Osteosarcoma

    PubMed Central

    Sampson, Valerie B.; Gorlick, Richard; Kamara, Davida; Anders Kolb, E.

    2013-01-01

    Osteosarcoma, the most common malignant bone tumor of childhood, is a high-grade primary bone sarcoma that occurs mostly in adolescence. Standard treatment consists of surgery in combination with multi-agent chemotherapy regimens. The development and approval of imatinib for Philadelphia chromosome-positive acute lymphoblastic leukemia in children and the fully human monoclonal antibody, anti-GD2, as part of an immune therapy for high-risk neuroblastoma patients have established the precedent for use of targeted inhibitors along with standard chemotherapy backbones. However, few targeted agents tested have achieved traditional clinical endpoints for osteosarcoma. Many biological agents demonstrating anti-tumor responses in preclinical and early-phase clinical testing have failed to reach response thresholds to justify randomized trials with large numbers of patients. The development of targeted therapies for pediatric cancer remains a significant challenge. To aid in the prioritization of new agents for clinical testing, the Pediatric Preclinical Testing Program (PPTP) has developed reliable and robust preclinical pediatric cancer models to rapidly screen agents for activity in multiple childhood cancers and establish pharmacological parameters and effective drug concentrations for clinical trials. In this article, we examine a range of standard and novel agents that have been evaluated by the PPTP, and we discuss the preclinical and clinical development of these for the treatment of osteosarcoma. We further demonstrate that committed resources for hypothesis-driven drug discovery and development are needed to yield clinical successes in the search for new therapies for this pediatric disease. PMID:23755370

  20. Negative pressure wound therapy for recurrent pilonidal disease: a review of the literature.

    PubMed

    Farrell, Dawn; Murphy, Siobhan

    2011-01-01

    Pilonidal disease arises from hair follicles of the gluteal cleft and may result in a chronic exudative disorder. The management of pilonidal disease following surgical excision remains controversial, despite an abundance of research into different treatment options. Negative pressure wound therapy is an emerging treatment option for complex or recurrent pilonidal disease. We performed a comprehensive literature search, using the electronic databases MEDLINE, Cochrane library, CINAHL, PubMed, and Web of Knowledge. All studies, case reports, and multiple case series evaluating the use of negative pressure wound therapy for treatment of pilonidal disease were included. Despite the breadth of our search parameters, we identified limited studies addressing this issue; all were published between 2003 and 2007. Findings of 5 case reports or multiple case series tentatively suggest that negative pressure wound therapy may be an emerging treatment option for pilonidal disease management. However, we recommend that more rigorous research, including randomized controlled trials, be conducted before implications can be drawn for evidence-based practice. PMID:21606863

  1. A review of therapeutic prospects of non-viral gene therapy in the retinal pigment epithelium

    PubMed Central

    Koirala, Adarsha; Conley, Shannon M.; Naash, Muna I.

    2013-01-01

    Ocular gene therapy has been extensively explored in recent years as a therapeutic avenue to target diseases of the cornea, retina and retinal pigment epithelium (RPE). Adeno-associated virus (AAV)-mediated gene therapy has shown promise in several RPE clinical trials but AAVs have limited payload capacity and potential immunogenicity. Traditionally however, non-viral alternatives have been plagued by low transfection efficiency, short-term expression and low expression levels. Recently, these drawbacks have begun to be overcome by the use of specialty carriers such as polylysine, liposomes, or polyethyleneimines, and by inclusion of suitable DNA elements to enhance gene expression and longevity. Recent advancements in the field have yielded non-viral vectors that have favorable safety profiles, lack immunogenicity, exhibit long-term elevated gene expression, and show efficient transfection in the retina and RPE, making them poised to transition to clinical applications. Here we discuss the advancements in nanotechnology and vector engineering that have improved the prospects for clinical application of non-viral gene therapy in the RPE. PMID:23796578

  2. Complementary and Alternative Therapies for Pediatric Attention Deficit Hyperactivity Disorder: A Descriptive Review

    PubMed Central

    Searight, H. Russell; Robertson, Kayla; Smith, Todd; Perkins, Scott; Searight, Barbara K.

    2012-01-01

    Attention deficit hyperactivity disorder (AD/HD), characterized by impulsivity, distractibility, and inattention, has an estimated pediatric population prevalence of 6–8%. Family physicians and pediatricians evaluate and treat the majority of children with this condition. The evidence-based treatment of choice for ADHD, stimulant medication, continues to be a source of public controversy. Surveys suggest that among parents of children with ADHD, there is considerable interest in complementary and alternative medicine (CAM). These therapies include herbal preparations, mineral supplements, sugar restriction, and polyunsaturated fatty acids. Other AD/HD therapies include neuro-feedback, cognitive training, mindfulness meditation, and exposure to “green space.” In order to assist physicians and mental health professionals in responding to patient and parent queries, this paper briefly describes these CAM therapies and current research regarding their effectiveness. While investigations in this area are hampered by research design issues such as sample size and the absence of double-blind placebo-controlled trials, there is some evidence that omega three fatty acids, zinc supplements, and neuro-feedback may have some efficacy. PMID:23762770

  3. Magnetic particle imaging: advancements and perspectives for real-time in vivo monitoring and image-guided therapy

    NASA Astrophysics Data System (ADS)

    Pablico-Lansigan, Michele H.; Situ, Shu F.; Samia, Anna Cristina S.

    2013-05-01

    Magnetic particle imaging (MPI) is an emerging biomedical imaging technology that allows the direct quantitative mapping of the spatial distribution of superparamagnetic iron oxide nanoparticles. MPI's increased sensitivity and short image acquisition times foster the creation of tomographic images with high temporal and spatial resolution. The contrast and sensitivity of MPI is envisioned to transcend those of other medical imaging modalities presently used, such as magnetic resonance imaging (MRI), X-ray scans, ultrasound, computed tomography (CT), positron emission tomography (PET) and single photon emission computed tomography (SPECT). In this review, we present an overview of the recent advances in the rapidly developing field of MPI. We begin with a basic introduction of the fundamentals of MPI, followed by some highlights over the past decade of the evolution of strategies and approaches used to improve this new imaging technique. We also examine the optimization of iron oxide nanoparticle tracers used for imaging, underscoring the importance of size homogeneity and surface engineering. Finally, we present some future research directions for MPI, emphasizing the novel and exciting opportunities that it offers as an important tool for real-time in vivo monitoring. All these opportunities and capabilities that MPI presents are now seen as potential breakthrough innovations in timely disease diagnosis, implant monitoring, and image-guided therapeutics.

  4. Review of antimicrobial therapy of selected bacterial diseases in broiler chickens in Canada

    PubMed Central

    Agunos, Agnes; Léger, Dave; Carson, Carolee

    2012-01-01

    This paper reviews common therapeutic applications of antimicrobials in broiler chicken production in relation to Canadian guidelines, surveillance data, and emerging public health concerns about antimicrobial use (AMU). Escherichia coli, Clostridium perfringens, and Staphylococcus spp., were reviewed because of their animal health and economic significance. Enterococcus cecorum and Salmonella were included because of their importance in antimicrobial resistance (AMR) surveillance. This review identified that i) antimicrobials are available in Canada to treat infections by these agents, but may be through over the counter or extra-label use, ii) prevalence rates for these diseases are unknown, iii) antimicrobial use estimates in broilers are lacking, and iv) AMR has emerged in clinical isolates, though data are very sparse. This review highlights the need for surveillance of AMU and AMR in broiler chickens in Canada. PMID:23729827

  5. Systematic review and meta-analysis of the risk of major cardiovascular events with etoricoxib therapy

    Microsoft Academic Search

    Sarah Aldington; Philippa Shirtcliffe; Mark Weatherall; Richard Beasley

    2005-01-01

    Abstract Objective To determine the risk of thromboembolic cardiovascular events associated with the use of etoricoxib, a COX-2 inhibitor. Design Systematic review and meta-analysis of placebo-controlled randomised

  6. Primary cutaneous marginal zone lymphoma as a complication of radiation therapy: Case report and review

    E-print Network

    Breton, Anne-Laure; Poulalhon, Nicolas; Balme, Brigitte; Thomas, Luc; Dalle, Stéphane

    2010-01-01

    the site of radiotherapy for breast cancer. Br J Dermatol.the site of radiotherapy for breast cancer. METHODS/RESULTS:radiotherapy for breast carcinoma: a large-scale single-institution review. Cancer.

  7. Narrative review of the literature on adherence to disease-modifying therapies among patients with multiple sclerosis.

    PubMed

    Menzin, Joseph; Caon, Christina; Nichols, Christine; White, Leigh Ann; Friedman, Mark; Pill, Michael W

    2013-01-01

    While no curative treatment exists for multiple sclerosis (MS), several disease-modifying therapies (DMTs) have been developed to reduce relapse rates, slow disability progression, and modify the overall disease course. However, because of the chronic nature of the disease, long-term therapy adherence can be challenging for some patients with MS. Low adherence to DMTs has been shown to be associated with higher rates of disease relapses and progression as well as with an increase in medical resource utilization. As new MS treatments are developed, a comprehensive understanding of current adherence rates and the impact of adherence on clinical and economic outcomes is of particular interest. Our objective was to conduct a review of the published literature to evaluate rates of adherence to DMTs in MS and the impact of adherence on both clinical and economic outcomes from the patient and payer perspectives. Systematic literature searches were conducted using MEDLINE, EMBASE, and the Cochrane Central Register for Controlled Trials. Studies were limited to those completed on human subjects, written in the English language, and published between May 1, 2001, and May 1, 2011. Additional inclusion criteria required that studies involve a population of patients with MS, utilize the administration of DMTs, and report a measurement of adherence. Studies reporting persistence measures (e.g., treatment discontinuation rates) or rates of switching between DMTs (with no other measure of adherence reported) were excluded if they did not also assess adherence. Among the 24 studies meeting inclusion criteria, adherence to DMTs ranged from 41% to 88%. Weighted mean adherence rates were higher for intramuscular (IM) interferon beta-1a (IFN?-1a) administered once a week (69.4%), and subcutaneous (SC) IFN?-1b administered every other day (63.8%) than for SC IFN?-1a administered 3 times a week (58.4%) and glatiramer acetate administered daily (56.8%). There was a numerically greater risk of MS relapse or disease progression among patients nonadherent to therapy versus adherent patients, with findings statistically significant in 2 of 4 studies. Additionally, 2 studies showed statistically significant reductions in inpatient or emergency room utilization and total MS-related medical costs among patients adherent to therapy compared with nonadherent patients. Higher patient out-of-pocket copayments and coinsurance were significantly associated with lower adherence to DMTs, while the use of interventional or disease therapy management programs were associated with improved adherence. Lack of medication adherence remains a problem among patients with MS. Improvements in adherence have the potential to improve patient and payer burden in terms of improved clinical outcomes and lower nonpharmacy medical resource utilization.   PMID:23383731

  8. High-intensity statin therapy in patients with chronic kidney disease: a systematic review and meta-analysis

    PubMed Central

    Yan, Yu-Ling; Qiu, Bo; Wang, Jing; Deng, Song-Bai; Wu, Ling; Jing, Xiao-Dong; Du, Jian-Lin; Liu, Ya-Jie; She, Qiang

    2015-01-01

    Objective To evaluate the efficacy and safety of high-intensity statin therapy in patients with chronic kidney disease (CKD). Design A systematic review and meta-analysis. Data sources Randomised controlled trials (RCTs) comparing high-intensity statin therapy (atorvastatin 80?mg or rosuvastatin 20/40?mg) with moderate/mild statin treatment or placebo were derived from the databases (PubMed, Embase, Ovid, the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, and ISI Web of Knowledge). Outcome measure Primary end points: clinical events (all-cause mortality, stroke, myocardial infarction and heart failure); secondary end points: serum lipid, renal function changes and adverse events. Results A total of six RCTs with 10?993 adult patients with CKD were included. A significant decrease in stroke was observed in the high-intensity statin therapy group (RR 0.69, 95% CI 0.56 to 0.85). However, the roles of high-intensity statin in decreasing all-cause mortality (RR 0.85, 95% CI 0.67 to 1.09), myocardial infarction (RR 0.69, 95% CI 0.40 to 1.18) and heart failure (RR 0.73, 95% CI 0.48 to 1.13) remain unclear with low evidence. High-intensity statin also had obvious effects on lowering the LDL-C level but no clear effects on renal protection. Although pooled results showed no significant difference between the intervention and control groups in adverse event occurrences, it was still insufficient to put off the doubts that high-intensity statin might increase adverse events because of limited data sources and low quality evidences. Conclusions High-intensity statin therapy could effectively reduce the risk of stroke in patients with CKD. However, its effects on all-cause mortality, myocardial infarction, heart failure and renal protection remain unclear. Moreover, it is hard to draw conclusions on the safety assessment of intensive statin treatment in this particular population. More studies are needed to credibly evaluate the effects of high-intensity statin therapy in patients with CKD. PMID:25979868

  9. Outcome analysis of aromatase inhibitor therapy to increase adult height in males with predicted short adult stature and/or rapid pubertal progress: a retrospective chart review

    PubMed Central

    Shams, Kim; Cameo, Tamara; Fennoy, Ilene; Hassoun, Abeer A.; Lerner, Shulamit E.; Aranoff, Gaya S.; Sopher, Aviva B.; Yang, Christine; McMahon, Donald J.; Oberfield, Sharon E.

    2015-01-01

    Background Aromatase inhibitors (AIs) have been used off-label to increase adult height in short adolescent males. Studies have shown that AIs increase the predicted adult height (PAH) while delaying bone age (BA) maturation. We sought to determine whether AI therapy increases PAH in boys with short stature or rapid pubertal progression, and to evaluate any untoward effects. Methods The charts of 27 boys with BA ? 13 and short stature [height ? 2 standard deviation (SD) below the mean or ? 2 SD below mid-parental target height (MPTH)] or rapid pubertal progress, treated with anastrozole were reviewed. Outcome measures included anthropomorphic, hormonal, and metabolic data. Results The AI therapy averaged 21 months (range 14–30 months) for all, with Rx group 1 receiving < 18 months therapy (n = 7) and Rx group 2 receiving 18–30 months therapy (n = 20). Post-therapy, in Rx group 1 and all subjects, there was no significant change in the PAH, height SDS, or BA/chronological age (CA). In Rx group 2, there was a small, nonsignificant increase in PAH, no change in height SDS, and a small decrease in BA/CA. Post-therapy PAH was different from MPTH in all and in both Rx groups 1 and 2, p < 0.02. Eight of them achieved near-final height, averaging 6.73 ± 1.40 cm less than MPTH and 1.91 ± 0.86 cm less than the pre-therapy PAH. Post-therapy, the initially decreased estradiol did not persist but mildly increased testosterone and decreased high-density lipoprotein were noted, as was an increase in hematocrit, and decrease in growth velocity. Conclusions We suggest that although bone age progression may be slightly delayed with longer duration of therapy, an overall short-term AI therapy does not lead to a final height that is greater than the predicted pre-therapy height. PMID:24756052

  10. A review and numerical assessment of the random walk particle tracking method.

    PubMed

    Salamon, Peter; Fernàndez-Garcia, Daniel; Gómez-Hernández, J Jaime

    2006-10-10

    We review the basic mathematical concepts of random walk particle tracking (RWPT) and its advantages and limitations. Three different numerical approaches to overcome the local mass conservation problem of the random walk methodology are examined: (i) the interpolation method, (ii) the reflection principle, and (iii) the generalized stochastic differential equations (GSDE). Analytical solutions of the spatial moments for a two-layer system are compared to model predictions using the different techniques and results demonstrate that the interpolation method reproduces correctly average velocity, but fails to reproduce macrodispersion at higher hydraulic conductivity contrasts between the two layers. On the contrary, the reflection principle and the GSDE approach underestimate average velocity, but reproduce macrodispersion better for high contrasts. The different behavior is based on an artificial shift of mass for increasing heterogeneities for the GSDE approach and the reflection principle, whereas the interpolation method suffers from the smoothing of the dispersion tensor. The behavior of these approaches was furthermore analyzed in two-dimensional heterogeneous hydraulic conductivity fields, which are characterized by different random function models. Solute transport was simulated correctly by all three approaches for the reference fields having Gaussian structures or non-Gaussian structures with an isotropic spatial correlation, even for a variance of the natural log of hydraulic conductivity of sigma(lnK)(2)=4. However, for the non-Gaussian model with a strong anisotropic spatial correlation and a variance of sigma(lnK)(2)=2 and higher, the interpolation method was the only technique modelling solute transport correctly. Furthermore, we discuss the general applicability of random walk particle tracking in comparison to the standard transport models and conclude that in advection-dominated problems using a high spatial discretization or requiring the performance of many model runs, RWPT represents a good alternative for modelling contaminant transport. PMID:16839642

  11. A review and numerical assessment of the random walk particle tracking method

    NASA Astrophysics Data System (ADS)

    Salamon, Peter; Fernàndez-Garcia, Daniel; Gómez-Hernández, J. Jaime

    2006-10-01

    We review the basic mathematical concepts of random walk particle tracking (RWPT) and its advantages and limitations. Three different numerical approaches to overcome the local mass conservation problem of the random walk methodology are examined: (i) the interpolation method, (ii) the reflection principle, and (iii) the generalized stochastic differential equations (GSDE). Analytical solutions of the spatial moments for a two-layer system are compared to model predictions using the different techniques and results demonstrate that the interpolation method reproduces correctly average velocity, but fails to reproduce macrodispersion at higher hydraulic conductivity contrasts between the two layers. On the contrary, the reflection principle and the GSDE approach underestimate average velocity, but reproduce macrodispersion better for high contrasts. The different behavior is based on an artificial shift of mass for increasing heterogeneities for the GSDE approach and the reflection principle, whereas the interpolation method suffers from the smoothing of the dispersion tensor. The behavior of these approaches was furthermore analyzed in two-dimensional heterogeneous hydraulic conductivity fields, which are characterized by different random function models. Solute transport was simulated correctly by all three approaches for the reference fields having Gaussian structures or non-Gaussian structures with an isotropic spatial correlation, even for a variance of the natural log of hydraulic conductivity of ?ln K2 = 4. However, for the non-Gaussian model with a strong anisotropic spatial correlation and a variance of ?ln K2 = 2 and higher, the interpolation method was the only technique modelling solute transport correctly. Furthermore, we discuss the general applicability of random walk particle tracking in comparison to the standard transport models and conclude that in advection-dominated problems using a high spatial discretization or requiring the performance of many model runs, RWPT represents a good alternative for modelling contaminant transport.

  12. ? lactam monotherapy versus ? lactam-aminoglycoside combination therapy for fever with neutropenia: systematic review and meta-analysis

    PubMed Central

    Paul, Mical; Soares-Weiser, Karla; Leibovici, Leonard

    2003-01-01

    Objective To compare the effectiveness of ? lactam monotherapy versus ? lactam-aminoglycoside combination therapy in the treatment of patients with fever and neutropenia. Data sources Medline, Embase, Lilacs, the Cochrane Library, and conference proceedings to 2002. References of included studies and contact with authors. No restrictions on language, year of publication, or publication status. Study selection All randomised trials of ? lactam monotherapy compared with ? lactam-minoglycoside combination therapy as empirical treatment for patients with fever and neutropenia. Data selection Two reviewers independently applied selection criteria, performed quality assessment, and extracted data. An intention to treat approach was used. Relative risks were pooled with the random effect model. Main outcome measure All cause fatality. Results Forty seven trials with 7807 patients met inclusion criteria. Nine trials compared the same ? lactam. There was no significant difference in all cause fatality (relative risk 0.85, 95% confidence interval 0.72 to 1.02). For success of treatment there was a significant advantage with monotherapy (0.92, 0.85 to 0.99), though there was considerable heterogeneity among trials. There was no significant difference between monotherapy and combination treatment in trials that compared the same ? lactam, whereas there was major advantage with monotherapy in trials that compared different ? lactams (0.87, 0.80 to 0.93). Rates of superinfection were similar. Adverse events, including those associated with severe morbidity, were significantly more common in the combination treatment group. Detected flaws in methods did not affect results. Conclusions For patients with fever and neutropenia there is no clinical advantage in treatment with ? lactam-aminoglycoside combination therapy. Broad spectrum ? lactams as monotherapy should be regarded as the standard of care for such patients. PMID:12763980

  13. Therapy in stable chronic obstructive pulmonary disease patients with pulmonary hypertension: a systematic review and meta-analysis

    PubMed Central

    Chen, Xuesong; Tang, Shaowen; Liu, Kouying; Li, Qinling; Kong, Hui; Zeng, Xiaoning; Xie, Weiping

    2015-01-01

    Pulmonary hypertension (PH) is a common complication of chronic obstructive pulmonary disease (COPD) without effective drugs to treat. We conducted a systematic review and meta-analysis in order to evaluate whether PH specific therapies were effective for stable COPD patients. Data were extracted from PubMed, Cochrane Central Register of Controlled Trials and China Knowledge Resource Integrated Database. Randomized controlled trials (RCTs) with PH specific therapy treated more than 4 weeks in COPD were selected. The main outcome was exercise capacity; meanwhile pulmonary arterial pressure (PAP), hypoxemia and health related life quality were also measured. We included nine trials involving 365 subjects, among which two were treated with bosentan and seven with sildenafil. The study time varied from 4 weeks to 18 months and mostly it was 12 weeks. In a pooled analysis of nine trials, exercise capacity of COPD patients was improved by PH-specific therapy [mean difference (MD) 66.39 m, 95% confidence intervals (CI): 59.44-73.34]. COPD with severe PH (mean PAP >35 mmHg by right heart catheterization or systolic PAP >50 mmHg by echocardiography) improved the exercise capacity (MD 67.24 m, 95% CI: 60.26-74.23), but COPD without PH at rest did not (MD ?9.24 m, 95% CI: ?75.08 to 56.31). Meanwhile PAP was decreased (MD ?9.02 mmHg, 95% CI: ?10.71 to ?7.34 mmHg). Although hypoxemia and life quality were not improved, the dyspnea was alleviated or at least not aggravated (Borg dyspnea index, MD ?0.86, 95% CI: ?1.86 to 0.14). In conclusion, PH specific drugs (especially sildenafil) could improve exercise capacity and decrease PAP in COPD patients with severe PH. PMID:25922708

  14. Should we use platelet-rich plasma as an adjunct therapy to treat "acute wounds," "burns," and "laser therapies": A review and a proposal of a quality criteria checklist for further studies.

    PubMed

    Picard, Frédéric; Hersant, Barbara; Bosc, Romain; Meningaud, Jean-Paul

    2015-03-01

    Platelet-rich plasma seems to help wound healing. The goal of this review is to determine if the adjunction of platelet-rich plasma enhances the clinical outcome of acute wounds, burns, and laser therapies. A PubMed and Cochrane library search was performed by two reviewers with the senior author as a consultant. Medical Subject Headings search terms used were the following: ["Platelet-rich plasma" OR "Platelet gel" OR "Platelet growth factor"] AND ["Acute wound" OR "Wound" OR "Burn" OR "Laser"]. We included controlled studies assessing the clinical outcome of acute wounds, burns, and laser therapies treated by platelet-rich plasma. Nine randomized controlled studies, six prospective controlled studies, and two retrospective controlled studies were included. Regarding acute wounds, three randomized controlled trials found a statistical benefit regarding either the healing time, the return back to work time, the quality of life, or the pain and three prospective controlled studies found a statistical difference regarding the velocity of healing. Platelet-rich plasma decreased the intensity or duration of erythema after laser therapy in four randomized studies. Regarding the long-term outcome of laser therapies, two studies found a statistical benefit and two others did not. Platelet-rich plasma accelerates acute wound healing and decreases erythema after laser therapies. Its use on burns has not been enough studied. PMID:25683096

  15. [Graduated compression therapy in prophylaxis of deep vein thrombosis in patients after stroke--scientific evidence review].

    PubMed

    Dymarek, Robert; Rosi?czuk, Joanna; Kuba, Ptaszkowski; S?upska, Lucyna; Taradaj, Jakub; Halski, Tomasz

    2015-01-01

    Graduated compression therapy (GCT) is a clinically proven and scientifically validated method of conservative treatment of many different diseases, particularly angiologic in accordance with the principles of evidence based medicine (EBM). The use of GCT in clinical prevention of life-threatening complications of venous thromboembolism pathogenesis (VTE) in patients after a stroke appears to be fully understood and justified. Its primary aim is to prevent of deep vein thrombosis (DVT) and to minimize the risk of death by followed pulmonary embolism (PE). There are a large number of available scientific reports about the effectiveness and reasonableness issues of the use of GCT in thromboprophylaxis afterstroke. Nevertheless a large part o them characterized by a low level of data reliability. Aim of this study is to present the current standards in the use of GCT methods as part of DVT prevention after stoke episodes. The review was based on the latest scientific findings with a high level of evidence data reliability. PMID:26094334

  16. Systematic Review of the Effectiveness of Occupational Therapy–Related Interventions for People With Parkinson’s Disease

    PubMed Central

    Foster, Erin R.; Bedekar, Mayuri

    2014-01-01

    We describe the results of a systematic review of the literature on occupational therapy–related interventions for people with Parkinson’s disease (PD). Three broad categories of intervention emerged: (1) exercise or physical activity; (2) environmental cues, stimuli, and objects; and (3) self-management and cognitive–behavioral strategies. Moderate to strong evidence exists for task-specific benefits of targeted physical activity training on motor performance, postural stability, and balance. Low to moderate evidence indicates that more complex, multimodal activity training supports improvement in functional movement activities. The evidence is moderate that the use of external supports during functional mobility or other movement activities has positive effects on motor control. In addition, moderate evidence is available that individualized interventions focused on promoting participant wellness initiatives and personal control by means of cognitive–behavioral strategies can improve targeted areas of quality of life. The implications for practice, education, and research are discussed. PMID:24367954

  17. Experimental studies on the biological effects of extracorporeal shock wave therapy on tendon models. A review of the literature

    PubMed Central

    Visco, Vincenzo; Vulpiani, Maria Chiara; Torrisi, Maria Rosaria; Ferretti, Andrea; Pavan, Antonio; Vetrano, Mario

    2014-01-01

    Summary Encouraging results using extracorporeal shock wave therapy (ESWT) for treating chronic tendinopathies were recently obtained, although the specific mechanisms by which it induces therapeutic effects remain largely unknown. In order to provide possible explications of such clinical efficacy, several reports have investigated the effects of ESWT on animal models and different kind of cultured cells. Our contribute in establishing the potential outcome of ESWT on human primary cultured tenocytes, derived from healthy compared to ruptured tendons, have supported the growing evidence that shock waves may supply faster post-injury recovery. The purpose of this review was to summarize and evaluate the available basic scientific evidences for using ESWT in tendon pathologies, suggesting possible shock waves-induced mechanisms of tissue repair. PMID:25489555

  18. A review of the use and potential of the GATE Monte Carlo simulation code for radiation therapy and dosimetry applications.

    PubMed

    Sarrut, David; Bardiès, Manuel; Boussion, Nicolas; Freud, Nicolas; Jan, Sébastien; Létang, Jean-Michel; Loudos, George; Maigne, Lydia; Marcatili, Sara; Mauxion, Thibault; Papadimitroulas, Panagiotis; Perrot, Yann; Pietrzyk, Uwe; Robert, Charlotte; Schaart, Dennis R; Visvikis, Dimitris; Buvat, Irène

    2014-06-01

    In this paper, the authors' review the applicability of the open-source GATE Monte Carlo simulation platform based on the GEANT4 toolkit for radiation therapy and dosimetry applications. The many applications of GATE for state-of-the-art radiotherapy simulations are described including external beam radiotherapy, brachytherapy, intraoperative radiotherapy, hadrontherapy, molecular radiotherapy, and in vivo dose monitoring. Investigations that have been performed using GEANT4 only are also mentioned to illustrate the potential of GATE. The very practical feature of GATE making it easy to model both a treatment and an imaging acquisition within the same framework is emphasized. The computational times associated with several applications are provided to illustrate the practical feasibility of the simulations using current computing facilities. PMID:24877844

  19. A review of the use and potential of the GATE Monte Carlo simulation code for radiation therapy and dosimetry applications

    SciTech Connect

    Sarrut, David, E-mail: david.sarrut@creatis.insa-lyon.fr [Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon (France) [Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon (France); Université Lyon 1 (France); Centre Léon Bérard (France)] [France; Bardiès, Manuel; Marcatili, Sara; Mauxion, Thibault [Inserm, UMR1037 CRCT, F-31000 Toulouse, France and Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse (France)] [Inserm, UMR1037 CRCT, F-31000 Toulouse, France and Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse (France); Boussion, Nicolas [INSERM, UMR 1101, LaTIM, CHU Morvan, 29609 Brest (France)] [INSERM, UMR 1101, LaTIM, CHU Morvan, 29609 Brest (France); Freud, Nicolas; Létang, Jean-Michel [Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, Centre Léon Bérard, 69008 Lyon (France)] [Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, Centre Léon Bérard, 69008 Lyon (France); Jan, Sébastien [CEA/DSV/I2BM/SHFJ, Orsay 91401 (France)] [CEA/DSV/I2BM/SHFJ, Orsay 91401 (France); Loudos, George [Department of Medical Instruments Technology, Technological Educational Institute of Athens, Athens 12210 (Greece)] [Department of Medical Instruments Technology, Technological Educational Institute of Athens, Athens 12210 (Greece); Maigne, Lydia; Perrot, Yann [UMR 6533 CNRS/IN2P3, Université Blaise Pascal, 63171 Aubière (France)] [UMR 6533 CNRS/IN2P3, Université Blaise Pascal, 63171 Aubière (France); Papadimitroulas, Panagiotis [Department of Biomedical Engineering, Technological Educational Institute of Athens, 12210, Athens (Greece)] [Department of Biomedical Engineering, Technological Educational Institute of Athens, 12210, Athens (Greece); Pietrzyk, Uwe [Institut für Neurowissenschaften und Medizin, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany and Fachbereich für Mathematik und Naturwissenschaften, Bergische Universität Wuppertal, 42097 Wuppertal (Germany)] [Institut für Neurowissenschaften und Medizin, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany and Fachbereich für Mathematik und Naturwissenschaften, Bergische Universität Wuppertal, 42097 Wuppertal (Germany); Robert, Charlotte [IMNC, UMR 8165 CNRS, Universités Paris 7 et Paris 11, Orsay 91406 (France)] [IMNC, UMR 8165 CNRS, Universités Paris 7 et Paris 11, Orsay 91406 (France); and others

    2014-06-15

    In this paper, the authors' review the applicability of the open-source GATE Monte Carlo simulation platform based on the GEANT4 toolkit for radiation therapy and dosimetry applications. The many applications of GATE for state-of-the-art radiotherapy simulations are described including external beam radiotherapy, brachytherapy, intraoperative radiotherapy, hadrontherapy, molecular radiotherapy, and in vivo dose monitoring. Investigations that have been performed using GEANT4 only are also mentioned to illustrate the potential of GATE. The very practical feature of GATE making it easy to model both a treatment and an imaging acquisition within the same frameworkis emphasized. The computational times associated with several applications are provided to illustrate the practical feasibility of the simulations using current computing facilities.

  20. Ulcerative necrobiosis lipoidica successfully treated with photodynamic therapy: case report and literature review.

    PubMed

    Borgia, Francesco; Vaccaro, Mario; Cantavenera, Laura G; Aragona, Emanuela; Cannavò, Serafinella P

    2014-12-01

    Ulcerative necrobiosis lipoidica (NL) is a rare skin condition refractory to conventional therapies. We treated a forty-four year old woman affected by widespread ulcerative NL with 6 sessions of topical ALA-PDT at two weeks intervals. At the end of the treatment a dramatic improvement of the clinical features was observed, with complete healing of cutaneous ulcers and marked reduction of erythema in all the treated areas. The mechanism of action of PDT in ulcer healing is still unknown; however, it is possible to hypothesize a combination of anti-inflammatory effect, immunomodulatory activity and keratinocytes photoactivation. PMID:25150669

  1. Clinical implementation of total skin electron beam (TSEB) therapy: a review of the relevant literature.

    PubMed

    Diamantopoulos, S; Platoni, K; Dilvoi, M; Nazos, I; Geropantas, K; Maravelis, G; Tolia, M; Beli, I; Efstathopoulos, E; Pantelakos, P; Panayiotakis, G; Kouloulias, V

    2011-04-01

    Total skin electron beam therapy has been in medical service since the middle of the last century in order to confront rare skin malignancies. Since then various techniques have been developed, all aiming at better clinical results in conjunction with less post-irradiation complications. In this article every available technique is presented in addition to physical parameters of technique establishment and common dose fractionation. This study also revealed the preference of the majority of institutes the last 20 years in "six dual field technique" at a high dose rate, which is a safe and effective treatment. PMID:20951072

  2. Stem cell-based therapy for experimental stroke: a systematic review and meta-analysis.

    PubMed

    Lees, Jennifer S; Sena, Emily S; Egan, Kieren J; Antonic, Ana; Koblar, Simon A; Howells, David W; Macleod, Malcolm R

    2012-10-01

    Stem cell therapy holds great promise in medicine, but clinical development should be based on a sound understanding of potential weaknesses in supporting experimental data. The aim of this article was to provide a systematic overview of evidence relating to the efficacy of stem cell-based therapies in animal models of stroke to foster the clinical application of stem cell-based therapies and to inform the design of large-scale clinical trials. We conducted a systematic search for reports of experiments using stem cells in animal models of cerebral ischaemia, and performed DerSimmonian and Laird random effects meta-analysis. We assessed the impact of study characteristics, of publication bias and of measures to reduce bias. We identified 6059 publications, 117 met our prespecified inclusion criteria. One hundred eighty-seven experiments using 2332 animals described changes in structural outcome and 192 experiments using 2704 animals described changes in functional outcome. Median study quality score was 4 (interquartile range 3 to 6) and less than half of studies reported randomization or blinded outcome assessment; only three studies reported a sample size calculation. Nonrandomized studies gave significantly higher estimates of improvement in structural outcome, and there was evidence of a significant publication bias. For structural outcome autologous (i.e. self-derived) stem cells were more effective than allogeneic (donor-derived) cells, but for functional outcome, the reverse was true. A significant dose-response relationship was observed only for structural outcome. For structural outcome, there was an absolute reduction in efficacy of 1·5% (-2·4 to -0·6) for each days delay to treatment; functional outcome was independent of the time of administration. While stem cells appear to be of some benefit in animal models of stroke the internal and external validity of this literature is potentially confounded by poor study quality and by publication bias. The clinical development of stem cell-based therapies, in stroke and elsewhere, should acknowledge these potential weaknesses in the supporting animal data. PMID:22687044

  3. The endocrine effects of long-term oral opioid therapy: a case report and review of the literature.

    PubMed

    Elliott, Jennifer A; Horton, Erica; Fibuch, Eugene E

    2011-01-01

    The negative effects of long-term opioid administration on the body's endocrine system have been known for decades. These effects have been observed and studied with the use of intrathecal opioids and in heroin addicts. However, they have also been noted to occur with the use of oral opioids, especially in those patients who require chronic opioids for the management of nonmalignant and cancer-associated pain. Epidemiologic data in recent years suggest that up to five million men with chronic nonmalignant pain suffer from opioid-induced androgen deficiency (OPIAD) in the United States. Therefore, it is important to understand the physiologic impact of chronic opioid administration in patients. In view of the increasing use of opioids for chronic pain, we must anticipate the potential occurrence of hypogonadism during chronic opioid therapy and monitor patients accordingly. If symptoms of endocrine dysfunction are recognized during chronic opioid therapy, appropriate evaluation, treatment, and follow-up should be instituted. This article describes a case report of a patient who suffered from a clinically significant testosterone deficiency and osteoporosis related to the use of long-term oral opioids for chronic nonmalignant pain. It also includes a review of the existing literature regarding OPIAD and provides recommendations regarding the evaluation and management of OPIAD. PMID:21561038

  4. L-BLP25 as a peptide vaccine therapy in non-small cell lung cancer: a review

    PubMed Central

    Xia, Wenjie; Wang, Jie; Xu, Youtao

    2014-01-01

    Lung cancer is one of the most prevalent malignancies worldwide and the leading cause of cancer-related death. Most cases are non-small cell lung cancer (NSCLC). The median overall survival of patients with advanced stage undergoing current standard chemotherapy is approximately 10 months. The addition of new compounds, including targeted agents, to standard first-line cytotoxic doublets, which are administered concurrently and/or as maintenance therapy in patients who have not experienced disease progression after first-line treatment, has shown potential in improving the efficacy in patients with advanced disease. L-BLP25 is a mucin 1 (MUC1) antigen-specific immunotherapy induces a T-cell response to MUC1 in both a preclinical MUC1-transgenic lung cancer mouse model and patients. This review is aimed at introducing the mechanism by which L-BLP25 targets MUC1, summarizing the achievements gained in the completed clinical trials with L-BLP25 administered as maintenance therapy in the treatment of unresectable stage III/IV NSCLC, and discussing the research trends. PMID:25364531

  5. Stem Cell Therapy in Heart Diseases: A Review of Selected New Perspectives, Practical Considerations and Clinical Applications

    PubMed Central

    Abdelwahid, Eltyeb; Siminiak, Tomasz; Guarita-Souza, Luiz César; de Carvalho, Katherine Athayde Teixeira; Gallo, Pasquale; Shim, Winston; Condorelli, Gianluigi

    2011-01-01

    Degeneration of cardiac tissues is considered a major cause of mortality in the western world and is expected to be a greater problem in the forthcoming decades. Cardiac damage is associated with dysfunction and irreversible loss of cardiomyocytes. Stem cell therapy for ischemic heart failure is very promising approach in cardiovascular medicine. Initial trials have indicated the ability of cardiomyocytes to regenerate after myocardial injury. These preliminary trials aim to translate cardiac regeneration strategies into clinical practice. In spite of advances, current therapeutic strategies to ischemic heart failure remain very limited. Moreover, major obstacles still need to be solved before stem cell therapy can be fully applied. This review addresses the current state of research and experimental data regarding embryonic stem cells (ESCs), myoblast transplantation, histological and functional analysis of transplantation of co-cultured myoblasts and mesenchymal stem cells, as well as comparison between mononuclear and mesenchymal stem cells in a model of myocardium infarction. We also discuss how research with stem cell transplantation could translate to improvement of cardiac function. PMID:22758618

  6. Systematic review of interventions used in occupational therapy to promote motor performance for children ages birth-5 years.

    PubMed

    Case-Smith, Jane; Frolek Clark, Gloria J; Schlabach, Theresa L

    2013-01-01

    We examined the research evidence for interventions used in occupational therapy to promote the motor performance of young children ages 0-5 yr. We identified 24 trials, Levels I-III, that met our review criteria. The studies fell into three categories: (1) developmental interventions for infants (ages 0-3 yr), (2) interventions for young children with or at risk for cerebral palsy (CP), and (3) visual-motor interventions for preschool children (ages 3-5 yr). Developmental interventions showed low positive short-term effects with limited evidence for long-term effects, and findings on the benefits of neurodevelopmental treatment were inconclusive. Interventions using specific protocols for children with CP resulted in positive effects. Visual-motor interventions for children with developmental delays (ages 3-5 yr) resulted in short-term effects on children's visual-motor performance. Of the intervention approaches used in occupational therapy, those that embed behavioral and learning principles appear to show positive effects. PMID:23791316

  7. Barriers to Hepatitis C Antiviral Therapy in HIV/HCV Co-Infected Patients in the United States: A Review

    PubMed Central

    Moore, Heather N.; Toliver, Joshua C.

    2014-01-01

    Abstract This review synthesized the literature for barriers to HCV antiviral treatment in persons with HIV/HCV co-infection. Searches of PubMed, Embase, CINAHL, and Web of Science were conducted to identify relevant articles. Articles were excluded based on the following criteria: study conducted outside of the United States, not original research, pediatric study population, experimental study design, non-HIV or non-HCV study population, and article published in a language other than English. Sixteen studies met criteria and varied widely in terms of study setting and design. Hepatic decompensation was the most commonly documented absolute/nonmodifiable medical barrier. Substance use was widely reported as a relative/modifiable medical barrier. Patient-level barriers included nonadherence to medical care, refusal of therapy, and social circumstances. Provider-level barriers included provider inexperience with antiviral treatment and/or reluctance of providers to refer patients for treatment. There are many ongoing challenges that are unique to managing this patient population effectively. Documenting and evaluating these obstacles are critical steps to managing and caring for these individuals in the future. In order to improve uptake of HCV therapy in persons with HIV/HCV co-infection, it is essential that barriers, both new and ongoing, are addressed, otherwise, treatment is of little benefit. PMID:24738846

  8. Review on urban vegetation and particle air pollution - Deposition and dispersion

    NASA Astrophysics Data System (ADS)

    Janhäll, Sara

    2015-03-01

    Urban vegetation affects air quality through influencing pollutant deposition and dispersion. Both processes are described by many existing models and experiments, on-site and in wind tunnels, focussing e.g. on urban street canyons and crossings or vegetation barriers adjacent to traffic sources. There is an urgent need for well-structured experimental data, including detailed empirical descriptions of parameters that are not the explicit focus of the study. This review revealed that design and choice of urban vegetation is crucial when using vegetation as an ecosystem service for air quality improvements. The reduced mixing in trafficked street canyons on adding large trees increases local air pollution levels, while low vegetation close to sources can improve air quality by increasing deposition. Filtration vegetation barriers have to be dense enough to offer large deposition surface area and porous enough to allow penetration, instead of deflection of the air stream above the barrier. The choice between tall or short and dense or sparse vegetation determines the effect on air pollution from different sources and different particle sizes.

  9. Eslicarbazepine acetate: a review of its use as adjunctive therapy in refractory partial-onset seizures.

    PubMed

    Keating, Gillian M

    2014-07-01

    Eslicarbazepine acetate (Aptiom(®), Zebinix(®)) is approved for the adjunctive treatment of partial-onset seizures in adults aged ?18 years. Adjunctive therapy with oral eslicarbazepine acetate 800 or 1,200 mg once daily was associated with a significantly lower standardized seizure frequency (primary endpoint) than placebo in patients aged ?18 years with refractory partial-onset seizures in three, randomized, double-blind, multinational, phase III trials. In a fourth randomized, double-blind, multinational, phase III trial in patients aged ?16 years with refractory partial-onset seizures, adjunctive eslicarbazepine acetate 1,200 mg once daily, but not 800 mg once daily, was associated with a significantly lower standardized seizure frequency (primary endpoint). Responder rates were significantly higher with eslicarbazepine acetate 1,200 mg once daily than with placebo in these four trials, and with eslicarbazepine acetate 800 mg once daily than with placebo in two trials. The efficacy of eslicarbazepine acetate was maintained in the longer term, according to the results of 1-year extension studies. Adjunctive therapy with oral eslicarbazepine acetate was generally well tolerated in patients with refractory partial-onset seizures, with most adverse events being of mild to moderate severity. In conclusion, eslicarbazepine acetate is a useful option for the adjunctive treatment of patients with refractory partial-onset seizures. PMID:24972948

  10. A review on gold nanoparticles radiosensitization effect in radiation therapy of cancer

    PubMed Central

    Mesbahi, Asghar

    2010-01-01

    In the recent years, application of nanoparticles in diagnosis and treatment of cancer has been the issue of extensive research. Among these studies some have focused on the dose enhancement effect of gold nanoparticles (GNPs) in radiation therapy of cancer. On the other hand, some studies indicated energy dependency of dose enhancement effect, and the others have studied the GNP size effect in association with photon energy. However, in some aspects of GNP-based radiotherapy the results of recent studies do not seem very conclusive in spite of relative agreement on the basic physical interaction of photoelectric between GNPs and low energy photons. The main idea behind the GNP dose enhancement in some studies is not able to explain the results especially in recent investigation on cell lines and animal models radiation therapy using GNPs. In the present article the results of the available reports and articles were analyzed and compared and the final status of the GNP-RT was discussed. PMID:24376946

  11. Ibrutinib, obinutuzumab, idelalisib, and beyond: review of novel and evolving therapies for chronic lymphocytic leukemia.

    PubMed

    Chung, Clement; Lee, Rosetta

    2014-12-01

    Chronic lymphocytic leukemia (CLL) is a neoplasm resulting from the progressive accumulation of functionally incompetent monoclonal B lymphocytes in the blood, bone marrow, lymph nodes, and spleen. It is the most common leukemia in Western countries and typically occurs in elderly patients. Initial treatment of CLL often includes a first-generation anti-CD20 antibody (rituximab) with chemotherapy and is the current standard of treatment for "younger" old adults (< 70 yrs of age) or older, clinically fit patients. However, because disease progression and drug resistance are inevitable, patients typically die from their disease or treatment-related complications. Improved understanding of the B-cell receptor signaling pathway, which is essential for normal B-cell growth and tumorigenesis, has led to the development of targeted therapies, with improved short-term clinical outcomes. Ibrutinib, obinutuzumab, and idelalisib, three novel agents recently approved by the U.S. Food and Administration for CLL, all have the potential to change the treatment paradigm. In this article, we describe the pathogenesis of CLL and some of its prognostic factors. Emphasis is on the pharmacology, dosing, clinical efficacy, safety, and place of therapy of ibrutinib, obinutuzumab, and idelalisib. Investigational agents that target different parts of the CLL pathogenic pathway are also described. PMID:25355689

  12. Narrative Review: Fibrotic Diseases: Cellular and Molecular Mechanisms and Novel Therapies

    NSDL National Science Digital Library

    Sergio A. Jimenez (Thomas Jefferson University)

    2010-02-03

    Physiology in Medicine review article. Abnormal and exaggerated deposition of extracellular matrix is the hallmark of many fibrotic diseases. There are many factors that pose an enormous challenge when treating fibrotic diseases. Basic knowledge about the pathogenesis of the fibrotic process has enabled the development of novel therapeutic agents capable of modifying the deleterious effects of the fibrotic diseases.

  13. Low power laser therapy — an introduction and a review of some biological effects

    PubMed Central

    Thiel, Haymo

    1986-01-01

    This report gives a brief introduction to the characteristics of therapeutic low power laser devices. Absorption, tissue penetration and physiological mechanisms of laser irradiation are discussed. The biological effects of low power laser light are reviewed in the areas of collagen metabolism, woundhealing, inflammation and pain control. Contraindications, precautions and side effects of low power laser irradiation are discussed.

  14. Single-drug therapy or selective decontamination of the digestive tract as antifungal prophylaxis in critically ill patients: a systematic review

    Microsoft Academic Search

    JW Olivier van Till; Oddeke van Ruler; Bas Lamme; Roy JP Weber; Johannes B Reitsma; Marja A Boermeester

    2007-01-01

    INTRODUCTION: The objective of this study was to determine and compare the effectiveness of different prophylactic antifungal therapies in critically ill patients on the incidence of yeast colonisation, infection, candidemia, and hospital mortality. METHODS: A systematic review was conducted of prospective trials including adult non-neutropenic patients, comparing single-drug antifungal prophylaxis (SAP) or selective decontamination of the digestive tract (SDD) with

  15. The Effect of Mindfulness-Based Therapy on Symptoms of Anxiety and Depression in Adult Cancer Patients and Survivors: A Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Piet, Jacob; Wurtzen, Hanne; Zachariae, Robert

    2012-01-01

    Objective: The use of mindfulness-based therapy (MBT) in oncology settings has become increasingly popular, and research in the field has rapidly expanded. The objective was by means of a systematic review and meta-analysis to evaluate the current evidence for the effect of MBT on symptoms of anxiety and depression in adult cancer patients and…

  16. Endogenous testosterone level and testosterone supplementation therapy in chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis

    PubMed Central

    Atlantis, Evan; Fahey, Paul; Cochrane, Belinda; Wittert, Gary; Smith, Sheree

    2013-01-01

    Objective Low testosterone level may be a reversible risk factor for functional disability and deterioration in patients with chronic obstructive pulmonary disease (COPD). We sought to systematically assess the endogenous testosterone levels and effect of testosterone therapy on exercise capacity and health-related quality of life (HRQoL) outcomes in COPD patients, as well as to inform guidelines and practice. Design Systematic review and meta-analysis. Data sources We searched PubMed, Scopus, Cochrane Library, CINAHL, Health Source Nursing and PsychINFO and the reference lists of retrieved articles published before May 2012. Inclusion criteria Observational studies on endogenous testosterone levels in people with chronic lung disease compared with controls, or randomised controlled trials (RCTs) on testosterone therapy for exercise capacity and/or HRQoL outcomes in COPD patients were eligible. Data extraction and analysis Data on the mean difference in endogenous total testosterone (TT) values, and the mean difference in exercise capacity and HRQoL values were extracted and pooled using random effects meta-analysis. Results Nine observational studies in 2918 men with COPD reported consistently lower levels of TT compared with controls (weighted mean difference was –3.21?nmol/L (95% CI ?5.18 to ?1.23)). Six RCTs in 287 participants yielded five studies on peak muscle strength and peak cardiorespiratory fitness outcomes (peak oxygen uptake (VO2) and workload) and three studies on HRQoL outcomes. Testosterone therapies significantly improved peak muscle strength (standardised mean difference (SMD) was 0.31 (95% CI 0.05 to 0.56)) and peak workload (SMD was 0.27 (95% CI 0.01 to 0.52)) compared with control conditions (all but one used placebo), but not peak VO2 (SMD was 0.21 (95% CI ?0.15 to 0.56)) or HRQoL (SMD was –0.03 (95% CI ?0.32 to 0.25)). Conclusions Men with COPD have clinically relevant lower than normal TT levels. Insufficient evidence from short-term studies in predominately male COPD patients suggests that testosterone therapy improves exercise capacity outcomes, namely peak muscle strength and peak workload. PMID:23943774

  17. Transarterial Therapy for Hepatocellular Carcinoma: Which Technique Is More Effective? A Systematic Review of Cohort and Randomized Studies

    SciTech Connect

    Marelli, Laura; Stigliano, Rosa; Triantos, Christos; Senzolo, Marco; Cholongitas, Evangelos [Royal Free Hospital, Liver Transplantation and Hepatobiliary Medicine Unit (United Kingdom); Davies, Neil [Royal Free Hospital, Department of Radiology (United Kingdom); Tibballs, Jonathan; Meyer, Tim [Royal Free Hospital, Department of Oncology (United Kingdom); Patch, David W.; Burroughs, Andrew K. [Royal Free Hospital, Liver Transplantation and Hepatobiliary Medicine Unit (United Kingdom)], E-mail: andrew.burroughs@royalfree.nhs.uk

    2007-02-15

    Background. Chemoembolization (TACE) improves survival in cirrhotic patients with hepatocellular carcinoma (HCC). The optimal schedule, or whether embolization (TAE) alone gives the same survival advantage, is not known. Purpose. To evaluate whether specific patient characteristics and/or radiological transarterial techniques result in better outcomes. Method. A PubMed search was carried out for cohort and randomized trials (n = 175) testing transarterial therapies; meta-analysis was performed where appropriate. Results. Anticancer drugs were used as sole agent in 75% of cases (double 15% and triple 6%): doxorubicin (36%), cisplatin (31%), epirubicin (12%), mitoxantrone (8%), mitomycin (8%), and SMANCS (5%). Embolizing agents used were: gelatin sponge particles (71%), polyvinyl alcohol (PVA) particles (8%), degradable starch microspheres (DSM) (4%), and embospheres (4%). Sessions per patient were 2.5 {+-} 1.5 (interval: 2 months). Objective response was 40 {+-} 20%; survival rates at 1, 2, 3, and 5 years were: 62 {+-} 20%, 42 {+-} 17%, 30 {+-} 15%, and 19 {+-} 16%, respectively, and survival time was 18 {+-} 9.5 months. The post-TACE complications were: acute liver failure, 7.5% (range 0-49%); acute renal failure, 1.8% (0-13%); encephalopathy, 1.8% (0-16%); ascites, 8.3% (0-52%); upper gastrointestinal bleeding; 3% (0-22%); and hepatic or splenic abscess, 1.3% (0-2.5%). Treatment-related mortality was 2.4% (0-9.5%), mainly due to acute liver failure. Our meta-analysis of nine randomized controlled trials (RCTs) confirmed that TACE improves survival; but a meta-analysis of TACE versus TAE alone (3 RCTs, 412 patients) demonstrated no survival difference. Conclusions. No chemotherapeutic agent appears better than any other. There is no evidence for benefit with lipiodol. Gelatin sponge is the most used embolic agent, but PVA particles may be better. TAE appears as effective as TACE. New strategies to reduce the risk of post-TACE complications are required.

  18. Treatment Techniques to Reduce Cardiac Irradiation for Breast Cancer Patients Treated with Breast-Conserving Surgery and Radiation Therapy: A Review

    PubMed Central

    Beck, Robert E.; Kim, Leonard; Yue, Ning J.; Haffty, Bruce G.; Khan, Atif J.; Goyal, Sharad

    2014-01-01

    Thousands of women diagnosed with breast cancer each year receive breast-conserving surgery followed by adjuvant radiation therapy. For women with left-sided breast cancer, there is risk of potential cardiotoxicity from the radiation therapy. As data have become available to quantify the risk of cardiotoxicity from radiation, strategies have also developed to reduce the dose of radiation to the heart without compromising radiation dose to the breast. Several broad categories of techniques to reduce cardiac radiation doses include breath hold techniques, prone positioning, intensity-modulated radiation therapy, and accelerated partial breast irradiation, as well as many small techniques to improve traditional three-dimensional conformal radiation therapy. This review summarizes the published scientific literature on the various techniques to decrease cardiac irradiation in women treated to the left breast for breast cancer after breast-conserving surgery. PMID:25452938

  19. A Review and Empirical Comparison of Three Treatments for Adolescent Males with Conduct and Personality Disorder: Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training

    ERIC Educational Resources Information Center

    Apsche, Jack A.; Bass, Christopher K.

    2006-01-01

    This research study compared the efficacy of three treatment methodologies for adolescent males in residential treatment with conduct disorders and/or personality dysfunctions and documented problems with physical and sexual aggression. The results showed that Mode Deactivation Therapy, an advanced form of cognitive behavioral therapy based on…

  20. Renal effects of molecular targeted therapies in oncology: a review by the Cancer and the Kidney International Network (C-KIN).

    PubMed

    Launay-Vacher, V; Aapro, M; De Castro, G; Cohen, E; Deray, G; Dooley, M; Humphreys, B; Lichtman, S; Rey, J; Scotté, F; Wildiers, H; Sprangers, B

    2015-08-01

    A number of cancer therapy agents are cleared by the kidney and may affect renal function, including cytotoxic chemotherapy agents, molecular targeted therapies, analgesics, antibiotics, radiopharmaceuticals and radiation therapy, and bone-targeted therapies. Many of these agents can be nephrotoxic, including targeted cancer therapies. The incidence, severity, and pattern of renal toxicities may vary according to the respective target of the drug. Here, we review the renal effects associated with a selection of currenty approved targeted cancer therapies, directed to vascular endothelial growth factor or VEGF receptor(s) (VEGF/VEGFR), epidermal growth factor receptor (EGFR), human epidermal growth factor receptor2 (HER2), BRAF, anaplastic lymphoma kinase (ALK), programmed cell death protein-1 or its ligand (PD-1/PDL-1), receptor activator of nuclear factor kappa-B ligand (RANKL), and mammalian target of rapamycin (mTOR). The early diagnosis and prompt treatment of these renal alterations are essential in the daily practice where molecular targeted therapies have a definitive role in the armamentarium used in many cancers. PMID:25735315