Science.gov

Sample records for particle therapy review

  1. Nuclear physics in particle therapy: a review

    NASA Astrophysics Data System (ADS)

    Durante, Marco; Paganetti, Harald

    2016-09-01

    Charged particle therapy has been largely driven and influenced by nuclear physics. The increase in energy deposition density along the ion path in the body allows reducing the dose to normal tissues during radiotherapy compared to photons. Clinical results of particle therapy support the physical rationale for this treatment, but the method remains controversial because of the high cost and of the lack of comparative clinical trials proving the benefit compared to x-rays. Research in applied nuclear physics, including nuclear interactions, dosimetry, image guidance, range verification, novel accelerators and beam delivery technologies, can significantly improve the clinical outcome in particle therapy. Measurements of fragmentation cross-sections, including those for the production of positron-emitting fragments, and attenuation curves are needed for tuning Monte Carlo codes, whose use in clinical environments is rapidly increasing thanks to fast calculation methods. Existing cross sections and codes are indeed not very accurate in the energy and target regions of interest for particle therapy. These measurements are especially urgent for new ions to be used in therapy, such as helium. Furthermore, nuclear physics hardware developments are frequently finding applications in ion therapy due to similar requirements concerning sensors and real-time data processing. In this review we will briefly describe the physics bases, and concentrate on the open issues.

  2. Nuclear physics in particle therapy: a review.

    PubMed

    Durante, Marco; Paganetti, Harald

    2016-09-01

    Charged particle therapy has been largely driven and influenced by nuclear physics. The increase in energy deposition density along the ion path in the body allows reducing the dose to normal tissues during radiotherapy compared to photons. Clinical results of particle therapy support the physical rationale for this treatment, but the method remains controversial because of the high cost and of the lack of comparative clinical trials proving the benefit compared to x-rays. Research in applied nuclear physics, including nuclear interactions, dosimetry, image guidance, range verification, novel accelerators and beam delivery technologies, can significantly improve the clinical outcome in particle therapy. Measurements of fragmentation cross-sections, including those for the production of positron-emitting fragments, and attenuation curves are needed for tuning Monte Carlo codes, whose use in clinical environments is rapidly increasing thanks to fast calculation methods. Existing cross sections and codes are indeed not very accurate in the energy and target regions of interest for particle therapy. These measurements are especially urgent for new ions to be used in therapy, such as helium. Furthermore, nuclear physics hardware developments are frequently finding applications in ion therapy due to similar requirements concerning sensors and real-time data processing. In this review we will briefly describe the physics bases, and concentrate on the open issues. PMID:27540827

  3. 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.

  4. 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

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

    SciTech Connect

    Wang, Zhen; Nabhan, Mohammed; Schild, Steven E.; Stafford, Scott L.; Petersen, Ivy A.; Foote, Robert L.; Murad, M. Hassan

    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.

  6. Nuclear physics and particle therapy

    NASA Astrophysics Data System (ADS)

    Battistoni, G.

    2016-05-01

    The use of charged particles and nuclei in cancer therapy is one of the most successful cases of application of nuclear physics to medicine. The physical advantages in terms of precision and selectivity, combined with the biological properties of densely ionizing radiation, make charged particle approach an elective choice in a number of cases. Hadron therapy is in continuous development and nuclear physicists can give important contributions to this discipline. In this work some of the relevant aspects in nuclear physics will be reviewed, summarizing the most important directions of research and development.

  7. Review of particle properties

    SciTech Connect

    Wohl; Cahn, R.N.; Rittenberg, A.; Trippe, T.G.; Yost, G.P.; Porter, F.; Hernandez, J.J.; Montanet, L.; Hendrick, R.E.; Crawford, R.L.

    1984-04-01

    This review of the properties of leptons, mesons, and baryons is an updating of the Review of Particle Properties, Particle Data Group (Phys. Lett. 111B (1982)). Data are evaluated, listed, averaged, and summarized in tables. Numerous tables, figures, and formulae of interest to particle physicists are also included. A data booklet is available.

  8. Particle therapy for noncancer diseases

    SciTech Connect

    Bert, Christoph; Engenhart-Cabillic, Rita; Durante, Marco

    2012-04-15

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

  9. Particle Radiation Therapy: Requiem or Reveille

    PubMed Central

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

    1979-01-01

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

  10. 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

  11. Basics of particle therapy I: physics

    PubMed Central

    Park, Seo Hyun

    2011-01-01

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

  12. Basics of particle therapy I: physics.

    PubMed

    Park, Seo Hyun; Kang, Jin Oh

    2011-09-01

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

  13. 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.

  14. 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.

  15. Review of Particle Physics

    NASA Astrophysics Data System (ADS)

    Olive, K. A.; Particle Data Group

    2014-08-01

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

  16. Massage therapy research review.

    PubMed

    Field, Tiffany

    2016-08-01

    In this review, massage therapy has been shown to have beneficial effects on varying conditions including prenatal depression, preterm infants, full-term infants, autism, skin conditions, pain syndromes including arthritis and fibromyalgia, hypertension, autoimmune conditions including asthma and multiple sclerosis, immune conditions including HIV and breast cancer and aging problems including Parkinson's and dementia. Although many of the studies have involved comparisons between massage therapy and standard treatment control groups, several have compared different forms of massage (e.g. Swedish versus Thai massage), and different active therapies such as massage versus exercise. Typically, the massage therapy groups have experienced more positive effects than the control or comparison groups. This may relate to the massage therapy providing more stimulation of pressure receptors, in turn enhancing vagal activity and reducing cortisol levels. Some of the researchers have assessed physical, physiological and biochemical effects, although most have relied exclusively on self-report measures. Despite these methodological problems and the dearth of research from the U.S., the massage therapy profession has grown significantly and massage therapy is increasingly practiced in traditional medical settings, highlighting the need for more rigorous research. PMID:27502797

  17. Charged Particle Therapy for Hepatocellular Carcinoma

    PubMed Central

    Skinner, Heath D.; Hong, Theodore S.; Krishnan, Sunil

    2011-01-01

    Historically, the use of external beam radiotherapy for hepatocellular carcinoma (HCC) has been limited by toxicity to the uninvolved liver and surrounding structures. Advances in photon radiotherapy have improved dose conformality to the tumor and facilitated dose escalation, a key contributor to improved HCC radiation treatment outcomes. However, despite these advances in photon radiotherapy, significant volumes of liver still receive low doses of radiation that can preclude dose escalation, particularly in patients with limited functional liver reserves. By capitalizing on the lack of exit dose along the beam path beyond the tumor and higher biological effectiveness, charged particle therapy offers the promise of maximizing tumor control via dose escalation without excessive liver toxicity. In this review we discuss the distinctive biophysical attributes of both proton and carbon ion radiotherapy, particularly as they pertain to treatment of HCC. We also review the available literature regarding clinical outcomes and toxicity of using charged particles for the treatment of HCC. PMID:21939857

  18. 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…

  19. Gantry for medical particle therapy facility

    DOEpatents

    Trbojevic, Dejan

    2012-05-08

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

  20. Gantry for medical particle therapy facility

    SciTech Connect

    Trbojevic, Dejan

    2013-04-23

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

  1. Particle Radiation Therapy for Gastrointestinal Malignancies

    PubMed Central

    Meyer, Jeffrey J.; Willett, Christopher G.

    2007-01-01

    Treatment-related toxicity is common in the radiotherapeutic management of cancers of the gastrointestinal tract. These toxicities can diminish treatment efficacy by necessitating treatment breaks, limiting the radiation dose that can be delivered, and hindering concomitant use of chemotherapy and targeted drug agents. Many efforts have focused on widening the gap between the likelihood of tumor control and the likelihood of toxicities associated with radiation. Use of particles that exhibit a Bragg peak phenomenon in their interactions with tissue, such as protons, heavier ions like carbon ions, and pions, is one means of concentrating radiation dose in tumors and away from normal tissues. Neutron beams have also been used in the treatment of gastrointestinal cancers in an effort to take advantage of their potent biologic effects. This report reviews basic particle radiation physics and biology, as well as the clinical experience with protons, heavier ions, pions, and neutrons in the treatment of various gastrointestinal malignancies. Potential future directions in clinical research with particle therapy are discussed. PMID:19360149

  2. Promise and pitfalls of heavy-particle therapy.

    PubMed

    Mitin, Timur; Zietman, Anthony L

    2014-09-10

    Proton beam therapy, the most common form of heavy-particle radiation therapy, is not a new invention, but it has gained considerable public attention because of the high cost of installing and operating the rapidly increasing number of treatment centers. This article reviews the physical properties of proton beam therapy and focuses on the up-to-date clinical evidence comparing proton beam therapy with the more standard and widely available radiation therapy treatment alternatives. In a cost-conscious era of health care, the hypothetical benefits of proton beam therapy will have to be supported by demonstrable clinical gains. Proton beam therapy represents, through its scale and its cost, a battleground for the policy debate around managing expensive technology in modern medicine. PMID:25113772

  3. Tumor therapy with heavy charged particles

    NASA Astrophysics Data System (ADS)

    Blattmann, Hans

    1999-11-01

    Nuclear science has contributed significantly to the development of tumor therapy with heavy charged particles. Interest evolved for neutron therapies in the forties because of the increased radiobiological effectiveness (RBE) compared to photon irradiation. The development of more powerful proton and heavy ion accelerators with higher energies or higher intensities, made new particles for radiation therapy available. Pions, protons, light ions, from helium up to silicon were studied in view of precision dose delivery and increased RBE. Without the parallel development of new diagnostic techniques such as computer tomography (CT) and positron emission tomography (PET) the rapid development would not have been possible. Heavy-charged particle therapy has now come into a consolidation phase. Hospital-based facilities are built by industry, and research institutes focus on refinements in dose delivery and treatment planning, as well as systems for monitoring dose delivery and for dose distribution verification.

  4. Applications of laser-accelerated particle beams for radiation therapy

    NASA Astrophysics Data System (ADS)

    Ma, C.-M.; Fourkal, E.; Li, J. S.; Veltchev, I.; Luo, W.; Fan, J. J.; Lin, T.; Tafo, A.

    2011-05-01

    Proton beams are more advantageous than high-energy photons and electrons for radiation therapy because of their finite penetrating range and the Bragg peak near the end of their range, which have been utilized to achieve better dose conformity to the treatment target allowing for dose escalation and/or hypofractionation to increase local tumor control, reduce normal tissue complications and/or treatment time/cost. Proton therapy employing conventional particle acceleration techniques is expensive because of the large accelerators and treatment gantries that require excessive space and shielding. Compact proton acceleration systems are being sought to improve the cost-effectiveness for proton therapy. This paper reviews the physics principles of laser-proton acceleration and the development of prototype laserproton therapy systems as a solution for widespread applications of advanced proton therapy. The system design, the major components and the special delivery techniques for energy and intensity modulation are discussed in detail for laser-accelerated proton therapy.

  5. Regenerative photonic therapy: Review

    NASA Astrophysics Data System (ADS)

    Salansky, Natasha; Salansky, Norman

    2012-09-01

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

  6. Basics of particle therapy II: relative biological effectiveness

    PubMed Central

    Choi, Jinhyun

    2012-01-01

    In the previous review, the physical aspect of heavy particles, with a focus on the carbon beam was introduced. Particle beam therapy has many potential advantages for cancer treatment without increasing severe side effects in normal tissue, these kinds of radiation have different biologic characteristics and have advantages over using conventional photon beam radiation during treatment. The relative biological effectiveness (RBE) is used for many biological, clinical endpoints among different radiation types and is the only convenient way to transfer the clinical experience in radiotherapy with photons to another type of radiation therapy. However, the RBE varies dependent on the energy of the beam, the fractionation, cell types, oxygenation status, and the biological endpoint studied. Thus this review describes the concerns about RBE related to particle beam to increase interests of the Korean radiation oncologists' society. PMID:23120738

  7. 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

  8. REVIEW: Review of electron beam therapy physics

    NASA Astrophysics Data System (ADS)

    Hogstrom, Kenneth R.; Almond, Peter R.

    2006-07-01

    For over 50 years, electron beams have been an important modality for providing an accurate dose of radiation to superficial cancers and disease and for limiting the dose to underlying normal tissues and structures. This review looks at many of the important contributions of physics and dosimetry to the development and utilization of electron beam therapy, including electron treatment machines, dose specification and calibration, dose measurement, electron transport calculations, treatment and treatment-planning tools, and clinical utilization, including special procedures. Also, future changes in the practice of electron therapy resulting from challenges to its utilization and from potential future technology are discussed.

  9. Drug therapy reviews: antirheumatic agents.

    PubMed

    Evens, R P

    1979-05-01

    The pathophysiology, symptoms and drug treatment of rheumatic disease are reviewed. Antirheumatic drugs reviewed are salicylates (including aspirin, sodium salicylate, choline salicylate, choline magnesium salicylate, salsalate), phenylpropionic acid derivatives (fenoprofen, ibuprofen, naproxen), indole derivatives (sulindac, tolmetin and indomethacin), pyrazolone derivatives (phenylbutazone, oxyphenbutazone), gold compounds, penicillamine, antimalarials mefenamic acid, corticosteroids and immunosuppressives. Simple analgesic therapy (acetaminophen, aspirin, propoxyphene) is used in the early stage of the disease. As the disease progresses, aspirin remains the drug of choice for antiinflammatory activity but the phenylpropionic acid or indole derivatives may be preferred in patients unable to tolerate salicylates. If such nonsteroidal antiinflammatory agents are not effective, parenteral therapy with gold compounds or oral penicillamine usually is indicated. Indomethacin or phenylbutazone, then antimalarials, are resorted to next. Corticosteroids or immunosuppressives are reserved for patients who are unsuccessfully controlled or who have major side effects with the other drugs. Mefenamic acid occupies a very secondary place in rheumatoid arthritis treatment. PMID:377958

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

    ERIC Educational Resources Information Center

    Haber, David

    2006-01-01

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

  11. 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.

  12. Nanoscale particle therapies for wounds and ulcers.

    PubMed

    Cortivo, Roberta; Vindigni, Vincenzo; Iacobellis, Laura; Abatangelo, Giovanni; Pinton, Paolo; Zavan, Barbara

    2010-06-01

    'Small is beautiful' - this should be the slogan of nanoscientists. Indeed, working with particles less than 100 nm in size, nanotechnology is on the verge of providing a host of new materials and approaches, revolutionizing applied medicine. The obvious potential of nanotechnology has attracted considerable investment from governments and industry hoping to drive its economic development. Several areas of medical care already benefit from the advantages that nanotechnology provides and its application in wound healing will be reviewed in this article. PMID:20528458

  13. [Negative pressure wound therapy - review].

    PubMed

    Gudmundsdottir, Ingibjorg; Steingrimsson, Steinn; Valsdottir, Elsa; Gudbjartsson, Tomas

    2014-04-01

    Negative pressure wound therapy (NPWT) is a new therapeutic option in wound healing and was first described in its present form in 1997. A vacuum source is used to create sub-atmospheric pressure in the local wound environment to promote healing. This is achieved by connecting a vacuum pump to a tube that is threaded into a wound gauze or foam filler dressing covered with a drape. This concept in wound treatment has been shown to be useful in treating different wound infections, including diabetic wounds as well as complex infections of the abdomen and thorax. NPWT has been used in Iceland for over a decade and its use is steadily increasing. This review describes the indications and outcome of NPWT and is aimed at a broad group of doctors and nurses where recent Icelandic studies on the subject are covered. PMID:24713539

  14. Anticoagulation Drug Therapy: A Review

    PubMed Central

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

    2015-01-01

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

  15. Value-Free Therapy?: An Empirical Review.

    ERIC Educational Resources Information Center

    Gram, Anita M.

    This paper reviews the literature dealing with therapist neutrality or value-free treatment processes, and proposes that therapist values do play a major role in therapy. Supposed therapist neutrality in psychoanalyses, behavior therapy, and client-centered therapy is explored. The role of therapist values in client selection is discussed, and the…

  16. 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, ⁴He 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

  17. Reducing the uncertainties in particle therapy

    SciTech Connect

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

    2015-02-24

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

  18. Reducing the uncertainties in particle therapy

    NASA Astrophysics Data System (ADS)

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

    2015-02-01

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

  19. Conformal Electromagnetic Particle in Cell: A Review

    SciTech Connect

    Meierbachtol, Collin S.; Greenwood, Andrew D.; Verboncoeur, John P.; Shanker, Balasubramaniam

    2015-10-26

    We review conformal (or body-fitted) electromagnetic particle-in-cell (EM-PIC) numerical solution schemes. Included is a chronological history of relevant particle physics algorithms often employed in these conformal simulations. We also provide brief mathematical descriptions of particle-tracking algorithms and current weighting schemes, along with a brief summary of major time-dependent electromagnetic solution methods. Several research areas are also highlighted for recommended future development of new conformal EM-PIC methods.

  20. A review of particle resuspension

    NASA Astrophysics Data System (ADS)

    Nicholson, K. W.

    Some of the various types of studies on particle resuspension or re-entrainment are summarized along with shortcomings. General experimental aspects have been considered, rather than focusing on the numerical values of results, and research on erosion and resuspension by mechanisms other than wind has been included. It is evident that experiments have been performed in a wide range of environmental conditions but that additional research is required, in many areas, if a quantitative assessment of resuspension is to be achieved.

  1. Molecular Targeted α-Particle Therapy for Oncologic Applications

    PubMed Central

    Wadas, Thaddeus J.; Pandya, Darpan N.; Solingapuram Sai, Kiran Kumar; Mintz, Akiva

    2015-01-01

    OBJECTIVE A significant challenge facing traditional cancer therapies is their propensity to significantly harm normal tissue. The recent clinical success of targeting therapies by attaching them to antibodies that are specific to tumor-restricted biomarkers marks a new era of cancer treatments. CONCLUSION In this article, we highlight the recent developments in α-particle therapy that have enabled investigators to exploit this highly potent form of therapy by targeting tumor-restricted molecular biomarkers. PMID:25055256

  2. [Review of cancer gene therapy].

    PubMed

    Tani, K

    2000-09-01

    Since the first introduction of gene-marking technology to the clinical field in 1989 by Rosenberg et al, more than 4,000 patients have participated gene therapy clinical trials worldwide. Most of those patients had malignancies. Nearly 90% of clinical trials, however, are still in phase I-II stage, and only 3 protocols are in the phase III stage in early 2000. As current clinical gene therapy protocols are intended essentially to examine the safety and feasibility of the new strategy, more careful and steady steps may be required before these clinical trials really produce clinical benefits. Focused on cancer gene therapy, direct and indirect approaches are undertaken. In the direct approach, HSV-TK, HLA-B7, or p53 tumor suppressor gene therapies are the three major approaches historically. In for the indirect approach, cytokine or adhesion molecule gene-transferred tumor cells or immunocompetent cells are considered to be promising to enhance patients' antitumor immunity. In particular, we have concentrated on developing immuno gene therapy using GM-CSF-transduced autologous tumor cells. We have already recruited three patients with stage IV renal cell cancer. In all patients, peripheral blood T cells were mobilized after vaccination with GM-CSF-transduced tumor cells, and two of the three patients showed the persistence of cytotoxic T cells against autologous tumor cells. Clinically, one patient has been followed up with stable disease for more than one year since the start of vaccination. Further clinical studies are required to obtain conclusive results. PMID:11022677

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

    SciTech Connect

    Klein, Jonathan

    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.

  4. The advantages and challenges of superconducting magnets in particle therapy

    NASA Astrophysics Data System (ADS)

    Gerbershagen, Alexander; Calzolaio, Ciro; Meer, David; Sanfilippo, Stéphane; Schippers, Marco

    2016-08-01

    This paper provides an overview of the current developments in superconducting magnets for applications in proton and ion therapy. It summarizes the benefits and challenges regarding the utilization of these magnets in accelerating systems (e.g. superconducting cyclotrons) and gantries. The paper also provides examples of currently used superconducting particle therapy systems and proposed designs.

  5. 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

  6. Scanning systems for particle cancer therapy

    DOEpatents

    Trbojevic, Dejan

    2015-08-04

    A particle beam to treat malignant tissue is delivered to a patient by a gantry. The gantry includes a plurality of small magnets sequentially arranged along a beam tube to transfer the particle beam with strong focusing and a small dispersion function, whereby a beam size is very small, allowing for the small magnet size. Magnets arranged along the beam tube uses combined function magnets where the magnetic field is a combination of a bending dipole field with a focusing or defocusing quadrupole field. A triplet set of combined function magnets defines the beam size at the patient. A scanning system of magnets arranged along the beam tube after the bending system delivers the particle beam in a direction normal to the patient, to minimize healthy skin and tissue exposure to the particle beam.

  7. Ozone therapy: A clinical review

    PubMed Central

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

    2011-01-01

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

  8. Ozone therapy: A clinical review.

    PubMed

    Elvis, A M; Ekta, J S

    2011-01-01

    Ozone (O(3)) gas discovered in the mid-nineteenth century is a molecule consisting of three atoms of oxygen in a dynamically unstable structure due to the presence of mesomeric states. Although O(3) has dangerous effects, yet researchers believe it has many therapeutic effects. Ozone therapy has been utilized and heavily studied for more than a century. Its effects are proven, consistent, safe and with minimal and preventable side effects. Medical O(3) is used to disinfect and treat disease. Mechanism of actions is by inactivation of bacteria, viruses, fungi, yeast and protozoa, stimulation of oxygen metabolism, activation of the immune system. Medication forms in a gaseous state are somewhat unusual, and it is for this reason that special application techniques have had to be developed for the safe use of O(3). In local applications as in the treatment of external wounds, its application in the form of a transcutaneous O(3) gas bath has established itself as being the most practical and useful method, for example at low (sub-atmospheric) pressure in a closed system guaranteeing no escape of O(3) into the surrounding air. Ozonized water, whose use is particularly known in dental medicine, is optimally applied as a spray or compress. Diseases treated are infected wounds, circulatory disorders, geriatric conditions, macular degeneration, viral diseases, rheumatism/arthritis, cancer, SARS and AIDS. PMID:22470237

  9. Spouting of biomass particles: a review.

    PubMed

    Cui, Heping; Grace, John R

    2008-07-01

    Recent research on biomass multiphase flow in spouted beds is reviewed, beginning with fundamental work on hydrodynamic parameters, such as minimum spouting velocity, pressure drop and fountain height. We then consider experimental studies on biomass multiphase flow in such processes as pulp drying, liquid spouting of pulp fibres, drying and coating of agricultural biomass, and bioreactors. Finally, we summarize modelling efforts with respect to spouting of biomass particles. PMID:17570657

  10. Recent developments in family therapy: a review.

    PubMed

    Clarkin, J F; Glick, I D

    1982-07-01

    Since its beginning some 25 years ago, family therapy has become a widely used madality. The field is developing its own theoretical foundations, training institutions, and body of outcome research; the authors review some of the changes, especially those of the last two or three years. One major development is the growing differentiation of family therapy models and techniques; related are increasing attempts to delineate selection criteria and to provide empirical data for special matches of problems and treatments. The field has moved from its early preoccupation with schizophrenia to concern with new target populations, such as families disrupted by divorce. Family therapy is also being used more often in the treatment of hospitalized patients and of substance abusers. The outcome research is growing in extent and sophistication; the positive results indicate a continuing prominent role for this modality. PMID:7106716

  11. 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.

  12. 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

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

    PubMed Central

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

    2013-01-01

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

  14. 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

  15. Treating cancer with sonodynamic therapy: a review.

    PubMed

    Costley, David; Mc Ewan, Conor; Fowley, Colin; McHale, Anthony P; Atchison, Jordan; Nomikou, Nikolitsa; Callan, John F

    2015-03-01

    Sonodynamic therapy (SDT) has emerged as a promising option for the minimally invasive treatment of solid cancerous tumours. SDT requires the combination of three distinct components: a sensitising drug, ultrasound, and molecular oxygen. Individually, these components are non-toxic but when combined together generate cytotoxic reactive oxygen species (ROS). The major advantage of SDT over its close relative photodynamic therapy (PDT), is the increased penetration of ultrasound through mammalian tissue compared to light. As a result, SDT can be used to treat a wider array of deeper and less accessible tumours than PDT. In this article, we critically review the current literature on SDT and discuss strategies that have been developed in combination with SDT to enhance the therapeutic outcome. PMID:25582025

  16. 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…

  17. Range Verification Methods in Particle Therapy: Underlying Physics and Monte Carlo Modeling

    PubMed Central

    Kraan, Aafke Christine

    2015-01-01

    Hadron therapy allows for highly conformal dose distributions and better sparing of organs-at-risk, thanks to the characteristic dose deposition as function of depth. However, the quality of hadron therapy treatments is closely connected with the ability to predict and achieve a given beam range in the patient. Currently, uncertainties in particle range lead to the employment of safety margins, at the expense of treatment quality. Much research in particle therapy is therefore aimed at developing methods to verify the particle range in patients. Non-invasive in vivo monitoring of the particle range can be performed by detecting secondary radiation, emitted from the patient as a result of nuclear interactions of charged hadrons with tissue, including β+ emitters, prompt photons, and charged fragments. The correctness of the dose delivery can be verified by comparing measured and pre-calculated distributions of the secondary particles. The reliability of Monte Carlo (MC) predictions is a key issue. Correctly modeling the production of secondaries is a non-trivial task, because it involves nuclear physics interactions at energies, where no rigorous theories exist to describe them. The goal of this review is to provide a comprehensive overview of various aspects in modeling the physics processes for range verification with secondary particles produced in proton, carbon, and heavier ion irradiation. We discuss electromagnetic and nuclear interactions of charged hadrons in matter, which is followed by a summary of some widely used MC codes in hadron therapy. Then, we describe selected examples of how these codes have been validated and used in three range verification techniques: PET, prompt gamma, and charged particle detection. We include research studies and clinically applied methods. For each of the techniques, we point out advantages and disadvantages, as well as clinical challenges still to be addressed, focusing on MC simulation aspects. PMID:26217586

  18. Measurement of secondary particle production induced by particle therapy ion beams impinging on a PMMA target

    NASA Astrophysics Data System (ADS)

    Toppi, M.; Battistoni, G.; Bellini, F.; Collamati, F.; De Lucia, E.; Durante, M.; Faccini, R.; Frallicciardi, P. M.; Marafini, M.; Mattei, I.; Morganti, S.; Muraro, S.; Paramatti, R.; Patera, V.; Pinci, D.; Piersanti, L.; Rucinski, A.; Russomando, A.; Sarti, A.; Sciubba, A.; Senzacqua, M.; Solfaroli Camillocci, E.; Traini, G.; Voena, C.

    2016-05-01

    Particle therapy is a technique that uses accelerated charged ions for cancer treatment and combines a high irradiation precision with a high biological effectiveness in killing tumor cells [1]. Informations about the secondary particles emitted in the interaction of an ion beam with the patient during a treatment can be of great interest in order to monitor the dose deposition. For this purpose an experiment at the HIT (Heidelberg Ion-Beam Therapy Center) beam facility has been performed in order to measure fluxes and emission profiles of secondary particles produced in the interaction of therapeutic beams with a PMMA target. In this contribution some preliminary results about the emission profiles and the energy spectra of the detected secondaries will be presented.

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

    NASA Astrophysics Data System (ADS)

    Peach, Ken

    2014-05-01

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

  20. Radiation therapy for breast cancer: Literature review.

    PubMed

    Balaji, Karunakaran; Subramanian, Balaji; Yadav, Poonam; Anu Radha, Chandrasekaran; Ramasubramanian, Velayudham

    2016-01-01

    Concave shape with variable size target volume makes treatment planning for the breast/chest wall a challenge. Conventional techniques used for the breast/chest wall cancer treatment provided better sparing of organs at risk (OARs), with poor conformity and uniformity to the target volume. Advanced technologies such as intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) improve the target coverage at the cost of higher low dose volumes to OARs. Novel hybrid techniques present promising results in breast/chest wall irradiation in terms of target coverage as well as OARs sparing. Several published data compared these technologies for the benefit of the breast/chest wall with or without nodal volumes. The aim of this article is to review relevant data and identify the scope for further research in developing optimal treatment plan for breast/chest wall cancer treatment. PMID:27545009

  1. 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

  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. Glycolic acid peel therapy - a current review.

    PubMed

    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

  4. 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...

  5. When sepsis persists: a review of MRSA bacteraemia salvage therapy.

    PubMed

    Kullar, Ravina; Sakoulas, George; Deresinski, Stan; van Hal, Sebastiaan J

    2016-03-01

    MRSA bacteraemia (MRSAB), including infective endocarditis, carries a high mortality rate, with up to 50% of patients failing initial therapy with vancomycin and requiring salvage therapy. Persistent MRSAB can be difficult to successfully eliminate, especially when source control is not possible due to an irremovable focus or the bacteraemia still persists despite surgical intervention. Although vancomycin and daptomycin are the only two antibiotics approved by the US FDA for the treatment of patients with MRSAB as monotherapy, the employment of novel strategies is required to effectively treat patients with persistent MRSAB and these may frequently involve combination drug therapy. Treatment strategies that are reviewed in this manuscript include vancomycin combined with a β-lactam, daptomycin-based therapy, ceftaroline-based therapy, linezolid-based therapy, quinupristin/dalfopristin, telavancin, trimethoprim/sulfamethoxazole-based therapy and fosfomycin-based therapy. We recommend that combination antibiotic therapy be considered for use in MRSAB salvage treatment. PMID:26565015

  6. Spatial mapping of the biologic effectiveness of scanned particle beams: towards biologically optimized particle therapy

    PubMed Central

    Guan, Fada; Bronk, Lawrence; Titt, Uwe; Lin, Steven H.; Mirkovic, Dragan; Kerr, Matthew D.; Zhu, X. Ronald; Dinh, Jeffrey; Sobieski, Mary; Stephan, Clifford; Peeler, Christopher R.; Taleei, Reza; Mohan, Radhe; Grosshans, David R.

    2015-01-01

    The physical properties of particles used in radiation therapy, such as protons, have been well characterized, and their dose distributions are superior to photon-based treatments. However, proton therapy may also have inherent biologic advantages that have not been capitalized on. Unlike photon beams, the linear energy transfer (LET) and hence biologic effectiveness of particle beams varies along the beam path. Selective placement of areas of high effectiveness could enhance tumor cell kill and simultaneously spare normal tissues. However, previous methods for mapping spatial variations in biologic effectiveness are time-consuming and often yield inconsistent results with large uncertainties. Thus the data needed to accurately model relative biological effectiveness to guide novel treatment planning approaches are limited. We used Monte Carlo modeling and high-content automated clonogenic survival assays to spatially map the biologic effectiveness of scanned proton beams with high accuracy and throughput while minimizing biological uncertainties. We found that the relationship between cell kill, dose, and LET, is complex and non-unique. Measured biologic effects were substantially greater than in most previous reports, and non-linear surviving fraction response was observed even for the highest LET values. Extension of this approach could generate data needed to optimize proton therapy plans incorporating variable RBE. PMID:25984967

  7. Charged Particle Therapy with Mini-Segmented Beams

    PubMed Central

    Dilmanian, F. Avraham; Eley, John G.; Rusek, Adam; Krishnan, Sunil

    2015-01-01

    One of the fundamental attributes of proton therapy and carbon ion therapy is the ability of these charged particles to spare tissue distal to the targeted tumor. This significantly reduces normal tissue toxicity and has the potential to translate to a wider therapeutic index. Although, in general, particle therapy also reduces dose to the proximal tissues, particularly in the vicinity of the target, dose to the skin and to other very superficial tissues tends to be higher than that of megavoltage x-rays. The methods presented here, namely, “interleaved carbon minibeams” and “radiosurgery with arrays of proton and light ion minibeams,” both utilize beams segmented into arrays of parallel “minibeams” of about 0.3 mm incident-beam size. These minibeam arrays spare tissues, as demonstrated by synchrotron x-ray experiments. An additional feature of particle minibeams is their gradual broadening due to multiple Coulomb scattering as they penetrate tissues. In the case of interleaved carbon minibeams, which do not broaden much, two arrays of planar carbon minibeams that remain parallel at target depth, are aimed at the target from 90° angles and made to “interleave” at the target to produce a solid radiation field within the target. As a result, the surrounding tissues are exposed only to individual carbon minibeam arrays and are therefore spared. The method was used in four-directional geometry at the NASA Space Radiation Laboratory to ablate a 6.5-mm target in a rabbit brain at a single exposure with 40 Gy physical absorbed dose. Contrast-enhanced magnetic resonance imaging and histology 6-month later showed very focal target necrosis with nearly no damage to the surrounding brain. As for minibeams of protons and light ions, for which the minibeam broadening is substantial, measurements at MD Anderson Cancer Center in Houston, TX, USA; and Monte Carlo simulations showed that the broadening minibeams will merge with their neighbors at a certain

  8. 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

  9. Nanodosimetry-Based Plan Optimization for Particle Therapy.

    PubMed

    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

  10. Controversial Therapies: A Review and Critique.

    ERIC Educational Resources Information Center

    Rooney, Karen J.

    1991-01-01

    The article offers guidelines to educators evaluating controversial therapies and applies them to four such therapies: tinted lenses as a cure for dyslexia; orthomolecular treatments for learning disabilities; pharmaceutical intervention for dyslexia; and visual training for children with learning disabilities. (DB)

  11. BOOK REVIEW: Particle Astrophysics (Second Edition)

    NASA Astrophysics Data System (ADS)

    Bell, Nicole

    2009-07-01

    Particle astrophysics, the interface of elementary particle physics with astrophysics and cosmology, is a rapidly evolving field. Perkins' book provides a nice introduction to this field, at a level appropriate for senior undergraduate students. Perkins develops the foundations underlying both the particle and astrophysics areas, and also covers some of the most recent developments in this field. The latter is an appealing feature, as students rarely encounter topics of current research in their undergraduate textbooks. Part 1 of the text introduces the elementary particle content, and interactions, of the standard model of particle physics. Relativity is addressed at the level of special relativistic kinematics, the equivalence principle and the Robertson-Walker metric. Part 2 covers cosmology, starting with the expansion of the Universe and basic thermodynamics. It then moves on to primordial nucleosynthesis, baryogenesis, dark matter, dark energy, structure formation and the cosmic microwave background. Part 3 covers cosmic rays, stellar evolution, and related topics. Cutting edge topics include the use of the cosmological large scale structure power spectrum to constrain neutrino mass, the creation of the baryon asymmetry via leptogenesis, and the equation of state for dark energy. While the treatment of many topics is quite brief, the level of depth is about right for undergraduates who are being exposed to these topics for the first time. The breadth of topics spanned is excellent. Perkins does a good job connecting theory with the experimental underpinnings, and of simplifying the theoretical presentation of complex subjects to a level that senior undergraduate students should find accessible. Each chapter includes a number of exercises. Brief solutions are provided for all the exercises, while fully worked solutions are provided for a smaller subset.

  12. Conflicts of interest and spin in reviews of psychological therapies: a systematic review

    PubMed Central

    Lieb, Klaus; von der Osten-Sacken, Jan; Stoffers-Winterling, Jutta; Reiss, Neele; Barth, Jürgen

    2016-01-01

    Objective To explore conflicts of interest (COI) and their reporting in systematic reviews of psychological therapies, and to evaluate spin in the conclusions of the reviews. Methods MEDLINE and PsycINFO databases were searched for systematic reviews published between 2010 and 2013 that assessed effects of psychological therapies for anxiety, depressive or personality disorders, and included at least one randomised controlled trial. Required COI disclosure by journal, disclosed COI by review authors, and the inclusion of own primary studies by review authors were extracted. Researcher allegiance, that is, that researchers concluded favourably about the interventions they have studied, as well as spin, that is, differences between results and conclusions of the reviews, were rated by 2 independent raters. Results 936 references were retrieved, 95 reviews fulfilled eligibility criteria. 59 compared psychological therapies with other forms of psychological therapies, and 36 psychological therapies with pharmacological interventions. Financial, non-financial, and personal COI were disclosed in 22, 4 and 1 review, respectively. 2 of 86 own primary studies of review authors included in 34 reviews were disclosed by review authors. In 15 of the reviews, authors showed an allegiance effect to the evaluated psychological therapy that was never disclosed. Spin in review conclusions was found in 27 of 95 reviews. Reviews with a conclusion in favour of psychological therapies (vs pharmacological interventions) were at high risk for a spin in conclusions (OR=8.31 (1.41 to 49.05)). Spin was related in trend to the inclusion of own primary studies in the systematic review (OR=2.08 (CI 0.83 to 5.18) p=0.11) and researcher allegiance (OR=2.63 (0.84 to 8.16) p=0.16). Conclusions Non-financial COI, especially the inclusion of own primary studies into reviews and researcher allegiance, are frequently seen in systematic reviews of psychological therapies and need more transparency and

  13. Gene therapy in head and neck cancer: a review

    PubMed Central

    Chisholm, E; Bapat, U; Chisholm, C; Alusi, G; Vassaux, G

    2007-01-01

    Gene therapy for cancer is a rapidly evolving field with head and neck squamous cell cancer being one of the more frequently targeted cancer types. The number of clinical trials in the UK is growing and there is already a commercially available agent in China. Various gene therapy strategies along with delivery mechanisms for targeting head and neck cancer are reviewed. PMID:18057169

  14. Review of progress in magnetic particle inspection

    NASA Astrophysics Data System (ADS)

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

    2014-02-01

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

  15. An Updated Review of the Efficacy of Cupping Therapy

    PubMed Central

    Cao, Huijuan; Li, Xun; Liu, Jianping

    2012-01-01

    Background Since 1950, traditional Chinese medicine (TCM) cupping therapy has been applied as a formal modality in hospitals throughout China and elsewhere in the world. Based on a previous systematic literature review of clinical studies on cupping therapy, this study presents a thorough review of randomized controlled trials (RCTs) to evaluate the therapeutic effect of cupping therapy. Method Six databases were searched for articles published through 2010. RCTs on cupping therapy for various diseases were included. Studies on cupping therapy combined with other TCM treatments versus non-TCM therapies were excluded. Results 135 RCTs published from 1992 through 2010 were identified. The studies were generally of low methodological quality. Diseases for which cupping therapy was commonly applied were herpes zoster, facial paralysis (Bell palsy), cough and dyspnea, acne, lumbar disc herniation, and cervical spondylosis. Wet cupping was used in most trials, followed by retained cupping, moving cupping, and flash cupping. Meta-analysis showed cupping therapy combined with other TCM treatments was significantly superior to other treatments alone in increasing the number of cured patients with herpes zoster, facial paralysis, acne, and cervical spondylosis. No serious adverse effects were reported in the trials. Conclusions Numerous RCTs on cupping therapy have been conducted and published during the past decades. This review showed that cupping has potential effect in the treatment of herpes zoster and other specific conditions. However, further rigorously designed trials on its use for other conditions are warranted. PMID:22389674

  16. A REVIEW OF LOW-INTENSITY ULTRASOUND FOR CANCER THERAPY

    PubMed Central

    WOOD, ANDREW K. W.; SEHGAL, CHANDRA M.

    2015-01-01

    The literature describing the use of low-intensity ultrasound in four major areas of cancer therapy was reviewed - sonodynamic therapy, ultrasound mediated chemotherapy, ultrasound mediated gene delivery and antivascular ultrasound therapy. Each technique consistently resulted in the death of cancer cells and the bioeffects of ultrasound were primarily attributed to thermal actions and inertial cavitation. In each therapeutic modality, theranostic contrast agents composed of microbubbles played a role in both therapy and vascular imaging. The development of these agents is important as it establishes a therapeutic-diagnostic platform which can monitor the success of anti-cancer therapy. Little attention, however, has been given to either the direct assessment of the underlying mechanisms of the observed bioeffects or to the viability of these therapies in naturally occurring cancers in larger mammals; if such investigations provided encouraging data there could be a prompt application of a therapy technique in treating cancer patients. PMID:25728459

  17. Molecular Pathways: Targeted α-Particle Radiation Therapy

    PubMed Central

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

    2012-01-01

    An α-particle, a 4He nucleus, is exquisitely cytotoxic, and indifferent to many limitations associated with conventional chemo- and radiotherapy. The exquisite cytotoxicity of α 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 α-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 α-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 α-emitters such as 225Ac, 211At, 213Bi, 212Pb and 223Ra. PMID:23230321

  18. Development of Clinical Database System Specialized for Heavy Particle Therapy.

    PubMed

    Mukai, Masami; Ando, Yutaka; Yokooka, Yuki; Okuda, Yasuo; Seki, Masayoshi; Kimura, Masahiro; Tsuji, Hiroshi; Kamada, Tadashi

    2015-01-01

    We have developed a data archiving system for study of charged particle therapy. We required a data-relation mechanism between electronic medical record system (EMR) and database system, because it needs to ensure the information consistency. This paper presents the investigation results of these techniques. The standards in the medical informatics field that we focus on are Integrating the Healthcare Enterprise (IHE) and 2) Health Level-7 (HL7) to archive the data. As a main cooperation function, we adapt 2 integration profiles of IHE as follows, 1) Patient Administration Management (PAM) Profile of IHE-ITI domain for patient demographic information reconciliation, 2) Enterprise Schedule Integration(ESI) profile of IHE-Radiation Oncology domain for order management between EMR and treatment management system(TMS). We also use HL7 Ver2.5 messages for exchanging the follow-up data and result of laboratory test. In the future, by implementation of this system cooperation, we will be able to ensure interoperability in the event of the EMR update. PMID:26262235

  19. Technological adjuncts to increase adherence to therapy: a review.

    PubMed

    Clough, Bonnie A; Casey, Leanne M

    2011-07-01

    This paper identified and reviewed technological adjuncts to increase client adherence to therapy. Three areas of adherence were identified, namely treatment dropout and non-attendance, engagement during and between therapy sessions, and aftercare. Database searches were conducted in each of these areas to identify relevant studies published between the years of 1990 and 2010. Adjuncts designed to replace or reduce direct therapist contact, change the medium of communication between the client and therapist, or alter the content or style of the therapy were not included in this review. Adjuncts were reviewed in light of theories of adherence, including Self Determination Theory, the Transtheoretical Model, and the Theory of Planned Behaviour. Adjuncts reviewed included appointment reminders, exercises and monitoring delivered by mobile phone, and exercises and data collection delivered by computer. Limitations and directions for future research were addressed and discussed. PMID:21497153

  20. Combination therapy for erectile dysfunction: an update review

    PubMed Central

    Dhir, Rohit R; Lin, Hao-Cheng; Canfield, Steven E; Wang, Run

    2011-01-01

    The introduction of oral phosphodiesterase-5 inhibitors (PDE5Is) in the late 1990s and early 2000s revolutionized the field of sexual medicine and PDE5Is are currently first-line monotherapy for erectile dysfunction (ED). However, a significant proportion of patients with complex ED will be therapeutic non-responders to PDE5I monotherapy. Combination therapy has recently been adopted for more refractory cases of ED, but a critical evaluation of current combination therapies is lacking. A thorough PubMed and Cochrane Library search was conducted focusing on the effectiveness of combination therapies for ED in therapeutic non-responders to PDE5I therapy. Journal articles spanning the time period between January 1990 and December 2010 were reviewed. Criteria included all pertinent review articles, randomized controlled trials, cohort studies and retrospective analyses. References from retrieved articles were also manually scanned for additional relevant publications. Published combination therapies include PDE5I plus vacuum erectile device (VED), intraurethral medication, intracavernosal injection (ICI), androgen supplement, α-blocker or miscellaneous combinations. Based on this review, some of these combination treatments appeared to be quite effective in preliminary testing. Caution must be advised, however, as the majority of combination therapy articles in the last decade have numerous limitations including study biases and small subject size. Regardless of limitations, present combination therapy research provides a solid foundation for future studies in complex ED management. PMID:21423198

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

    PubMed Central

    Jabbari, Keyvan

    2011-01-01

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

  2. The FLUKA Code: An Accurate Simulation Tool for Particle Therapy

    PubMed Central

    Battistoni, Giuseppe; Bauer, Julia; Boehlen, Till T.; Cerutti, Francesco; Chin, Mary P. W.; Dos Santos Augusto, Ricardo; Ferrari, Alfredo; Ortega, Pablo G.; Kozłowska, Wioletta; Magro, Giuseppe; Mairani, Andrea; Parodi, Katia; Sala, Paola R.; Schoofs, Philippe; Tessonnier, Thomas; Vlachoudis, Vasilis

    2016-01-01

    Monte Carlo (MC) codes are increasingly spreading in the hadrontherapy community due to their detailed description of radiation transport and interaction with matter. The suitability of a MC code for application to hadrontherapy demands accurate and reliable physical models capable of handling all components of the expected radiation field. This becomes extremely important for correctly performing not only physical but also biologically based dose calculations, especially in cases where ions heavier than protons are involved. In addition, accurate prediction of emerging secondary radiation is of utmost importance in innovative areas of research aiming at in vivo treatment verification. This contribution will address the recent developments of the FLUKA MC code and its practical applications in this field. Refinements of the FLUKA nuclear models in the therapeutic energy interval lead to an improved description of the mixed radiation field as shown in the presented benchmarks against experimental data with both 4He and 12C ion beams. Accurate description of ionization energy losses and of particle scattering and interactions lead to the excellent agreement of calculated depth–dose profiles with those measured at leading European hadron therapy centers, both with proton and ion beams. In order to support the application of FLUKA in hospital-based environments, Flair, the FLUKA graphical interface, has been enhanced with the capability of translating CT DICOM images into voxel-based computational phantoms in a fast and well-structured way. The interface is capable of importing also radiotherapy treatment data described in DICOM RT standard. In addition, the interface is equipped with an intuitive PET scanner geometry generator and automatic recording of coincidence events. Clinically, similar cases will be presented both in terms of absorbed dose and biological dose calculations describing the various available features. PMID:27242956

  3. 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.

  4. The FLUKA Code: An Accurate Simulation Tool for Particle Therapy.

    PubMed

    Battistoni, Giuseppe; Bauer, Julia; Boehlen, Till T; Cerutti, Francesco; Chin, Mary P W; Dos Santos Augusto, Ricardo; Ferrari, Alfredo; Ortega, Pablo G; Kozłowska, Wioletta; Magro, Giuseppe; Mairani, Andrea; Parodi, Katia; Sala, Paola R; Schoofs, Philippe; Tessonnier, Thomas; Vlachoudis, Vasilis

    2016-01-01

    Monte Carlo (MC) codes are increasingly spreading in the hadrontherapy community due to their detailed description of radiation transport and interaction with matter. The suitability of a MC code for application to hadrontherapy demands accurate and reliable physical models capable of handling all components of the expected radiation field. This becomes extremely important for correctly performing not only physical but also biologically based dose calculations, especially in cases where ions heavier than protons are involved. In addition, accurate prediction of emerging secondary radiation is of utmost importance in innovative areas of research aiming at in vivo treatment verification. This contribution will address the recent developments of the FLUKA MC code and its practical applications in this field. Refinements of the FLUKA nuclear models in the therapeutic energy interval lead to an improved description of the mixed radiation field as shown in the presented benchmarks against experimental data with both (4)He and (12)C ion beams. Accurate description of ionization energy losses and of particle scattering and interactions lead to the excellent agreement of calculated depth-dose profiles with those measured at leading European hadron therapy centers, both with proton and ion beams. In order to support the application of FLUKA in hospital-based environments, Flair, the FLUKA graphical interface, has been enhanced with the capability of translating CT DICOM images into voxel-based computational phantoms in a fast and well-structured way. The interface is capable of importing also radiotherapy treatment data described in DICOM RT standard. In addition, the interface is equipped with an intuitive PET scanner geometry generator and automatic recording of coincidence events. Clinically, similar cases will be presented both in terms of absorbed dose and biological dose calculations describing the various available features. PMID:27242956

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

    SciTech Connect

    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.

    2009-06-15

    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.

  6. Proton Radiation Therapy for Head and Neck Cancer: A Review of the Clinical Experience to Date

    SciTech Connect

    Holliday, Emma B.; Frank, Steven J.

    2014-06-01

    Proton beam radiation has been used for cancer treatment since the 1950s, but recent increasing interest in this form of therapy and the construction of hospital-based and clinic-based facilities for its delivery have greatly increased both the number of patients and the variety of tumors being treated with proton therapy. The mass of proton particles and their unique physical properties (ie, the Bragg peak) allow proton therapy to spare normal tissues distal to the tumor target from incidental irradiation. Initial observations show that proton therapy is particularly useful for treating tumors in challenging locations close to nontarget critical structures. Specifically, improvements in local control outcomes for patients with chordoma, chonodrosarcoma, and tumors in the sinonasal regions have been reported in series using proton. Improved local control and survival outcomes for patients with cancer of the head and neck region have also been seen with the advent of improvements in better imaging and multimodality therapy comprising surgery, radiation therapy, and chemotherapy. However, aggressive local therapy in the proximity of critical normal structures to tumors in the head and neck region may produce debilitating early and late toxic effects. Great interest has been expressed in evaluating whether proton therapy can improve outcomes, especially early and late toxicity, when used in the treatment of head and neck malignancies. This review summarizes the progress made to date in addressing this question.

  7. Percutaneous ablation therapies of inoperable pancreatic cancer: a systematic review

    PubMed Central

    Ierardi, Anna Maria; Lucchina, Natalie; Bacuzzi, Alessandro; Marco, De Chiara; Bracchi, Elena; Cocozza, Eugenio; Dionigi, Gianlorenzo; Tsetis, Dimitrios; Floridi, Chiara; Carrafiello, Gianpaolo

    2015-01-01

    Initial studies about ablation therapies of the pancreas were associated with significant morbidity and mortality, which limited widespread adoption. Development of techniques with high quality imaging used as guidance improve outcomes reducing complications. Moreover, only few experiences of percutaneous pancreatic ablations are reported. They are performed by very skilled operators in highly specialized centers. This review presents the current status of percutaneous local ablative therapies in the treatment of advanced pancreatic cancer. PMID:26424487

  8. Drug therapy in cardiac arrest: a review of the literature.

    PubMed

    Lundin, Andreas; Djärv, Therese; Engdahl, Johan; Hollenberg, Jacob; Nordberg, Per; Ravn-Fischer, Annika; Ringh, Mattias; Rysz, Susanne; Svensson, Leif; Herlitz, Johan; Lundgren, Peter

    2016-01-01

    The aim of this study was to review the literature on human studies of drug therapy in cardiac arrest during the last 25 years. In May 2015, a systematic literature search was performed in PubMed, Embase, the Cochrane Library, and CRD databases. Prospective interventional and observational studies evaluating a specified drug therapy in human cardiac arrest reporting a clinical endpoint [i.e. return of spontaneous circulation (ROSC) or survival] and published in English 1990 or later were included, whereas animal studies, case series and reports, studies of drug administration, drug pharmacology, non-specified drug therapies, preventive drug therapy, drug administration after ROSC, studies with primarily physiological endpoints, and studies of traumatic cardiac arrest were excluded. The literature search identified a total of 8936 articles. Eighty-eight articles met our inclusion criteria and were included in the review. We identified no human study in which drug therapy, compared with placebo, improved long-term survival. Regarding adrenaline and amiodarone, the drugs currently recommended in cardiac arrest, two prospective randomized placebo-controlled trials, were identified for adrenaline, and one for amiodarone, but they were all underpowered to detect differences in survival to hospital discharge. Of all reviewed studies, only one recent prospective study demonstrated improved neurological outcome with one therapy over another using a combination of vasopressin, steroids, and adrenaline as the intervention compared with standard adrenaline administration. The evidence base for drug therapy in cardiac arrest is scarce. However, many human studies on drug therapy in cardiac arrest have not been powered to identify differences in important clinical outcomes such as survival to hospital discharge and favourable neurological outcome. Efforts are needed to initiate large multicentre prospective randomized clinical trials to evaluate both currently recommended and

  9. [Music therapy in oncology--concepts and review].

    PubMed

    Rose, Jens-Peter; Brandt, Kerstin; Weis, Joachim

    2004-12-01

    The following article is addresses the applications and functions of music therapy in the acute and rehabilitative phases of treatment of adult cancer patients. It is based on a literature review with a focus on the state of empirical research in the oncology sector of music therapy and consequences for the concepts of music therapy. First the basic aspects of music therapy treatment are explained to clarify the different research methods and to examine the special demands of oncology patients. Furthermore, a brief summary of the approaches of music therapy research in the most renowned educational institutions in Germany are outlined. The results of the studies and case histories are summarized and evaluated and provide the basis for the conclusions and recommendations for the music therapeutic practice in oncology. PMID:15551190

  10. The Role of Nuclear Fragmentation in Particle Therapy and Space Radiation Protection.

    PubMed

    Zeitlin, Cary; La Tessa, Chiara

    2016-01-01

    The transport of the so-called HZE particles (those having high charge, Z, and energy, E) through matter is crucially important both in space radiation protection and in the clinical setting where heavy ions are used for cancer treatment. HZE particles are usually considered those having Z > 1, though sometimes Z > 2 is meant. Transport physics is governed by two types of interactions, electromagnetic (ionization energy loss) and nuclear. Models of transport, such as those used in treatment planning and space mission planning must account for both effects in detail. The theory of electromagnetic interactions is well developed, but nucleus-nucleus collisions are so complex that no fundamental physical theory currently describes them. Instead, interaction models are generally anchored to experimental data, which in some areas are far from complete. The lack of fundamental physics knowledge introduces uncertainties in the calculations of exposures and their associated risks. These uncertainties are greatly compounded by the much larger uncertainties in biological response to HZE particles. In this article, we discuss the role of nucleus-nucleus interactions in heavy charged particle therapy and in deep space, where astronauts will receive a chronic low dose from galactic cosmic rays (GCRs) and potentially higher short-term doses from sporadic, unpredictable solar energetic particles (SEPs). GCRs include HZE particles; SEPs typically do not and we, therefore, exclude them from consideration in this article. Nucleus-nucleus collisions can result in the breakup of heavy ions into lighter ions. In space, this is generally beneficial because dose and dose equivalent are, on the whole, reduced in the process. The GCRs can be considered a radiation field with a significant high-LET component; when they pass through matter, the high-LET component is attenuated, at the cost of a slight increase in the low-LET component. Not only are the standard measures of risk

  11. The Role of Nuclear Fragmentation in Particle Therapy and Space Radiation Protection

    PubMed Central

    Zeitlin, Cary; La Tessa, Chiara

    2016-01-01

    The transport of the so-called HZE particles (those having high charge, Z, and energy, E) through matter is crucially important both in space radiation protection and in the clinical setting where heavy ions are used for cancer treatment. HZE particles are usually considered those having Z > 1, though sometimes Z > 2 is meant. Transport physics is governed by two types of interactions, electromagnetic (ionization energy loss) and nuclear. Models of transport, such as those used in treatment planning and space mission planning must account for both effects in detail. The theory of electromagnetic interactions is well developed, but nucleus–nucleus collisions are so complex that no fundamental physical theory currently describes them. Instead, interaction models are generally anchored to experimental data, which in some areas are far from complete. The lack of fundamental physics knowledge introduces uncertainties in the calculations of exposures and their associated risks. These uncertainties are greatly compounded by the much larger uncertainties in biological response to HZE particles. In this article, we discuss the role of nucleus–nucleus interactions in heavy charged particle therapy and in deep space, where astronauts will receive a chronic low dose from galactic cosmic rays (GCRs) and potentially higher short-term doses from sporadic, unpredictable solar energetic particles (SEPs). GCRs include HZE particles; SEPs typically do not and we, therefore, exclude them from consideration in this article. Nucleus–nucleus collisions can result in the breakup of heavy ions into lighter ions. In space, this is generally beneficial because dose and dose equivalent are, on the whole, reduced in the process. The GCRs can be considered a radiation field with a significant high-LET component; when they pass through matter, the high-LET component is attenuated, at the cost of a slight increase in the low-LET component. Not only are the standard measures of risk

  12. Particle filter-based prognostics: Review, discussion and perspectives

    NASA Astrophysics Data System (ADS)

    Jouin, Marine; Gouriveau, Rafael; Hissel, Daniel; Péra, Marie-Cécile; Zerhouni, Noureddine

    2016-05-01

    Particle filters are of great concern in a large variety of engineering fields such as robotics, statistics or automatics. Recently, it has developed among Prognostics and Health Management (PHM) applications for diagnostics and prognostics. According to some authors, it has ever become a state-of-the-art technique for prognostics. Nowadays, around 50 papers dealing with prognostics based on particle filters can be found in the literature. However, no comprehensive review has been proposed on the subject until now. This paper aims at analyzing the way particle filters are used in that context. The development of the tool in the prognostics' field is discussed before entering the details of its practical use and implementation. Current issues are identified, analyzed and some solutions or work trails are proposed. All this aims at highlighting future perspectives as well as helping new users to start with particle filters in the goal of prognostics.

  13. Review-Epigenetic therapy for cancer.

    PubMed

    Saleem, Mohammad; Abbas, Khizar; Manan, Maria; Ijaz, Hira; Ahmed, Bilal; Ali, Muhammad; Hanif, Muhammad; Farooqi, Ammad Ahmad; Qadir, Muhammad Imran

    2015-05-01

    Epigenetics means the study of alterations in the genetic material that affect the phenotype but does not affect the genotype. Epigenetics cause alterations in cell properties, which are inherited; but it does not cause alterations in DNA sequence. Epigenetic mediated silencing of gene is of four types, which are DNA methylation, histone deacetylation, RNA associated silencing and Genomic imprinting. Other factors (environmental and xenobiotics) can also cause gene silencing but DNA methytlation and changes in histones of chromatin are two important changes, which are responsible for malignant diseases. Two groups of drugs are under development, which corrects the epigenetic alterations. These are histone deacetylation (HDAC) inhibitors and DNA methytransferase (DNMT) inhibitors. These drugs may be used in cancer because in cancer, hypermethylation of cancer suppressor gene causes gene silencing. Epigenetic therapy scope is likely to increase in future. PMID:26004710

  14. [Review of symptoms and therapy of paraphylias].

    PubMed

    Kórász, Krisztián; Koras, Réka; Simon, Lajos

    2007-01-01

    The authors review the historical main milestones in the legislative aspects of sexual deviances, from ancient times through age of enlightenment to present times, including the factors affecting the Hungarian public attitudes towards it. The evolution of nomenclature of sexual orientation disorders is also evaluated thoroughly, detailing the DSM-IV-TR classification and the attempts and difficulties to further develop the present classification system. The authors also review the difficulties of epidemiological studies and sum up the pioneer work of Alfred Kinsey. The etiology of paraphylias is summed up based on biological, psychodynamic and learning theory approaches. Finally, the pharmacological and psychotherapeutic interventions are evaluated considering also comorbidity, outer control and forensic psychiatric aspects. PMID:18445868

  15. Triple therapy for the management of COPD: a review.

    PubMed

    Gaebel, Kathryn; McIvor, R Andrew; Xie, Feng; Blackhouse, Gord; Robertson, Diana; Assasi, Nazila; Hernandez, Paul; Goeree, Ron

    2011-06-01

    Triple therapy for COPD consists of a long-acting anti-cholinergic bronchodilator, a long-acting beta-agonist bronchodilator, and an inhaled corticosteroid. Guidelines from the Canadian Thoracic Society advocate triple therapy for some patients with moderate-to-severe COPD. The objective of this review was to evaluate the evidence based clinical efficacy of triple therapy compared to dual bronchodilator therapy (long-acting anti-cholinergic bronchodilator + beta-agonist bronchodilator) or long-acting anti-cholinergic bronchodilator monotherapy for managing COPD. A systematic literature search was conducted to identify relevant clinical evaluations of triple therapy in the management of moderate to severe COPD. Databases searched included: Medline; EMBASE; CINAHL and PubMed (non-Medline records only). Of 2,314 publications, 4 articles evaluated triple therapy for the management of COPD. Hospitalization rates for COPD exacerbations, reported in 2 trials, were significantly reduced with triple therapy compared to long-acting anti-cholinergic bronchodilator monotherapy, with reported relative risks of 0.53 (95% CI: 0.33, 0.86, p = 0.01) and 0.35 (95% CI: 0.16-0.78, p = 0.011). Exacerbation data is inconsistent between the two trials reporting this outcome. Lung function, dyspnea and quality of life data show statistical significant changes with triple therapy compared to long-acting anti-cholinergic bronchodilator monotherapy but the changes do not reach clinical importance. Triple therapy does decrease the number of hospitalizations for severe/acute COPD exacerbations compared with long-acting anti-cholinergic bronchodilator monotherapy. There is insufficient evidence to determine if triple therapy is superior to dual bronchodilator therapy. PMID:21513437

  16. Spiritually Modified Cognitive Therapy: A Review of the Literature

    ERIC Educational Resources Information Center

    Hodge, David R.

    2006-01-01

    A paucity of research exists on the effectiveness of spiritual interventions, despite their wide use by practitioners and the acknowledged importance of evidence-based practice. To assist practitioners in their selection of spiritual interventions, the author reviewed research on the effectiveness of spiritually modified cognitive therapy. The…

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

    PubMed Central

    Schulte, Reinhard W.; Wroe, Andrew J.

    2014-01-01

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

  18. Practice Update: Review of Anticonvulsant Therapy.

    PubMed

    Chong, Derek J; Lerman, Andrew M

    2016-04-01

    Since 2010, the Food and Drug Administration has approved the use of four new anti-epilepsy drugs (AEDs) for the treatment of epilepsy in the USA: clobazam (Onfi), ezogabine (Potiga), perampanel (Fycompa), and eslicarbazepine (Aptiom) as well as two extended release formulations, topiramate ER (Qudexy XR and Trokendi) and oxcarbazepine ER (Oxtellar). This not only provides practitioners ample choice to match medication profiles to their patients' preferences and co-morbidities better, but also challenges us to be proficient in the use of all. In addition to providing a brief overview of these new medications and of the current medical management of epilepsy, this review discusses new data regarding vitamin D and AED-related osteoporosis, pregnancy registries, suicidality, marijuana-related compounds for epilepsy, and the recently published guidelines on the approach and management of a first unprovoked seizure in adults and guidelines for when to stop AEDs. PMID:26984292

  19. Zinc therapy in dermatology: a review.

    PubMed

    Gupta, Mrinal; 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

  20. 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

  1. A review of low-intensity ultrasound for cancer therapy.

    PubMed

    Wood, Andrew K W; Sehgal, Chandra M

    2015-04-01

    The literature describing the use of low-intensity ultrasound in four major areas of cancer therapy-sonodynamic therapy, ultrasound-mediated chemotherapy, ultrasound-mediated gene delivery and anti-vascular ultrasound therapy-was reviewed. Each technique consistently resulted in the death of cancer cells, and the bio-effects of ultrasound were attributed primarily to thermal actions and inertial cavitation. In each therapeutic modality, theranostic contrast agents composed of microbubbles played a role in both therapy and vascular imaging. The development of these agents is important as it establishes a therapeutic-diagnostic platform that can monitor the success of anti-cancer therapy. Little attention, however, has been given either to the direct assessment of the mechanisms underlying the observed bio-effects or to the viability of these therapies in naturally occurring cancers in larger mammals; if such investigations provided encouraging data, there could be prompt application of a therapy technique in the treatment of cancer patients. PMID:25728459

  2. Complementary Spiritist Therapy: Systematic Review of Scientific Evidence

    PubMed Central

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

    2011-01-01

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

  3. 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

  4. Recent advances in massage therapy--a review.

    PubMed

    Liu, S-L; Qi, W; Li, H; Wang, Y-F; Yang, X-F; Li, Z-M; Lu, Q; Cong, D-Y

    2015-10-01

    Massage therapy is one of the most widely accepted alternative form of medicine helping patients suffering from varied pathological states including arthritis, anxiety, sleep problems, pain management and injury repair. Besides this, it is one of the safest forms of alternative medicine and has become favorite among various health care professionals. However, there is still a lot of debate is going in medical world pertaining to its certain use in modern medicine. So, the present review shall enlighten all the latest aspects of massage therapy in current medicine. PMID:26531268

  5. Antimicrobial therapy of acute diarrhoea: a clinical review.

    PubMed

    Lübbert, Christoph

    2016-01-01

    Diarrhoea is one of the most commonly occurring diseases. This article presents a review of the current state of the treatment of acute infectious diarrhoea, as well as of the most important pathogens. The general principles of the therapy of diarrhoea are exemplified, followed by a description of the targeted antimicrobial therapy of the most important bacterial gastrointestinal infections, including salmonellosis, shigellosis and Campylobacter infections, as well as infections with pathogenic Escherichia coli strains, yersiniosis and cholera. Diarrhoea caused by toxigenic Clostridium difficile strains has increased in incidence and in severity. These infections will therefore be described in detail, including important new aspects of treatment. Symptomatic therapy is still the most important component of the treatment of infectious diarrhoea. However, empirical antibiotic therapy should be considered for severely ill patients with a high frequency of stools, fever, bloody diarrhoea, underlying immune deficiency, advanced age or significant comorbidities. Increasing resistance, in particular against fluoroquinolones, must be taken into consideration. Therapy with motility inhibitors is not recommended for Shiga toxin-producing Escherichia coli (STEC) infections, Clostridium difficile infections (CDI), and severe colitis. The macrocyclic antibiotic fidaxomicin can reduce the rate of recurrent disease in CDI. Furthermore, evidence for the benefits of faecal microbiota transplantation as a treatment option for multiple recurrences of CDI is increasing. In conclusion, the treatment of acute diarrhoea is still primarily supportive. General empirical antibiotic therapy for acute diarrhoea is not evidence-based. PMID:26641310

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    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

  8. A review of monoclonal antibody therapies in lymphoma.

    PubMed

    Teo, Esmeralda Chi-yuan; Chew, Yveline; Phipps, Colin

    2016-01-01

    Monoclonal antibodies (moAb) represent a novel way of delivering therapy through specific target antigens expressed on lymphoma cells and minimizes the collateral damage that is common with conventional chemotherapy. The paradigm of this approach is the targeting of CD20 by rituximab. Since its FDA approval in 1997, rituximab has become the standard of care in almost every line of therapy in most B-cell lymphomas. This review will briefly highlight some of the key rituximab trials while looking more closely at the evidence that is bringing other antibodies, including next generation anti-CD20 moAbs, and anti-CD30 moAbs, among others to the forefront of lymphoma therapy. PMID:26318093

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

    PubMed Central

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

    2011-01-01

    Ionizing radiation causes many types of DNA damage, including base damage and single- and double-strand breaks. Photons, including X-rays and γ-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

  10. 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 γ-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

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

    PubMed Central

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

    2013-01-01

    Objective: Standard cancer therapy prolongs survival, but can be detrimental to the quality of life, compromise the immune system, and leave residual disease that can cause recurrence years or decades in the future. Tumor dormancy therapy is a novel therapeutic approach that may improve these shortcomings, promote quality of life, and prolong survival. The aim of this study was to analyze studies on dormancy therapy, especially studies using traditional Oriental herbal medicine, so as to evaluate the efficacy of dormancy therapy with traditional oriental herbal medicine. Methods: We conducted a systematic literature review using Scientific and Technical Information Integration Services (NDSL), PubMed, and RISS. We searched for clinical reports, papers, and books related to tumor metastasis, recurrence, immunotherapy, tumor dormancy, and traditional oriental herbal medicine with anticancer effects. Seventy-nine (79) experimental and clinical articles in both Korean and English were reviewed. This study was conducted from March 1, 2012 to May 31, 2012. Results: This approach, Tumor dormancy therapy, rather than seeking to remove the tumor, includes combination of low-dose chemotherapy, immunotherapy, immunosurveillance, and other methods to stabilize tumor growth and to enhance the host is immunity against disseminated tumor cells and thus to manage cancer as a chronic disease while maintaining quality of life. In particular, integrative use of Oriental herbal medicine has been shown to induce or maintain tumor dormancy, increase the effectiveness of conventional chemotherapy, improve quality of life, and prolong survival. Conclusion: Tumor dormancy therapy is a promising novel therapeutic approach that may be especially effective with Oriental herbal medicine. Further research is needed to determine its potential mechanisms and therapeutic applications. PMID:25780657

  12. An integrative review of Reiki touch therapy research.

    PubMed

    Vitale, Anne

    2007-01-01

    Reiki touch therapy is a complementary biofield energy therapy that involves the use of hands to help strengthen the body's ability to heal. There is growing interest among nurses to use Reiki in patient care and as a self-care treatment, however, with little supportive empirical research and evidence to substantiate these practices. The purpose of this integrative review is to begin the systematic process of evaluating the findings of published Reiki research. Selected investigations using Reiki for effects on stress, relaxation, depression, pain, and wound healing management, among others is reviewed and summarized. A summary of Reiki studies table illustrates the study descriptions and Reiki treatment protocols specified in the investigations. Synthesis of findings for clinical practice and implications for future research are explored. PMID:17627194

  13. Streptokinase-A Drug for Thrombolytic Therapy: A Patent Review.

    PubMed

    Kunamneni, Adinarayana; Durvasula, Ravi

    2014-01-01

    Accumulation of fibrin in blood vessels significantly increases thrombosis, leading to myocardial infraction and other cardiovascular diseases. Microbial enzymes are one option for curing this pathological condition. Fibrinolytic enzymes such as urokinase (UK), tissue type plasminogen activator (t-PA) and streptokinase (SK) attracted much attention for thrombolytic therapy. Among them SK is preferable in low-resource settings because it is cost-effective. Therefore, the purpose of this review is to summarize recent patents related to the occurrence, mechanism of action, physico-chemical properties, cloning and expression, production, structure, immunogenicity, chemical modification, in vivo application and clinical trials of SK. This patent review considers the properties and characteristics of SK that make it a preferred agent for thrombolytic therapy. PMID:26497671

  14. A Review of Probiotic Therapy in Preventive Dental Practice.

    PubMed

    Cannon, Mark L

    2011-06-01

    Probiotics have been widely publicized in the general press and the consumer media. Knowledge of the existence of "probiotics" is commonplace, and the effectiveness of probiotic therapy has been well reported in the medical literature. However, even though most published dental studies have reported positive results, the dental profession has not yet accepted the use of probiotic therapy as an adjunct for preventive dental care. This review article discusses published and current research into the applications of probiotics along with diagnostic testing of the oral biofilm. Probiotic therapy appears to be generally safe and effective in modifying with beneficial bacteria the oral biofilm and thereby reducing the effects of pathogenic oral bacteria. In this review, some examples of current oral probiotic research are discussed along with reference to the potential application of diagnostic testing of the oral biofilm for the presence of oral pathogens as a precursor to initiation of specific probiotic therapy. Dental professionals should be actively investigating this potentially very useful therapeutic measure for the benefit of their patients. PMID:26781571

  15. [Genetics and present therapy options in Parkinson's disease: a review].

    PubMed

    Bereznai, Benjamin; Molnar, Mária Judit

    2009-05-30

    In the past years, six monogenic forms of Parkinson disease have clearly been associated with this movement disorder. The most frequent forms are LRRK2- and Parkin-associated Parkinson disease. Currently, a genetic diagnosis does not change the therapy, the genes involved in genetic Parkinson disease help to understand the underlying pathophysiologic mechanisms of Parkinson disease. Beside the overview of the molecular-genetic basis, we give a review about genetic testing, pharmacological and other multidisciplinary treatment options. PMID:19579663

  16. Charged Particle Therapy Steps Into the Clinical Environment

    NASA Astrophysics Data System (ADS)

    Haberer, Th.

    Beams of heavy charged particles like protons or carbon ions represent the ideal tool for the treatment of deep-seated, inoperable and radioresistant tumors. For more than 4 decades research with beams of charged particles has been performed. In total more than 40000 patients have been treated, mostly using protons being delivered by accelerators that were designed for basic research centers. In Berkeley, USA heavier particles like helium or neon ions were used to conduct clinical trials until 1992. Based on that somewhat limited technological standard and triggered by the promising results from Berkeley the first dedicated charged particle facilities were constructed. In order to maximally exploit the advantageous physical and radiobiological characteristics of these beams enormous effort was put into developing dynamic beam delivery techniques and tailoring the capabilities of the accelerators, the planning systems and the quality assurance procedures and equipment to the requirements resulting from these new treatment modalities. Active beam delivery systems integrated in rotating gantries, if necessary, will allow the production of superior dose distributions that precisely follow the medical prescription. The technological progress being made during the last 10 years defines the state of the art of the upcoming next-generation facilities for the clinical environment in Europe and Japan.

  17. Stem cells therapy in cerebral palsy: A systematic review.

    PubMed

    Kułak-Bejda, Agnieszka; Kułak, Piotr; Bejda, Grzegorz; Krajewska-Kułak, Elżbieta; Kułak, Wojciech

    2016-09-01

    The aim of this study was to systematically present the best available stem cell therapies for children with cerebral palsy (CP). The databases Medline, PubMed, EMBASE, and the Cochrane Controlled Trials Register for RCTs were searched for studies published from 1967 to August 2015. Systematic reviews, randomised controlled trials (RCTs), controlled trials, uncontrolled trials, cohort studies, open-label studies, and a meta-analysis were analysed. Of 360 articles, seven fulfilled the inclusion criteria: one RCT and six were open-label trials. In these studies, one application of stem cells for children with CP was typical, and the total number of cells administered to patients ranged from 10(6) to 10(8)/kg. Different routes of cell delivery were used, though in most studies motor development was applied as an indicator of primary outcomes. In three articles, neuroimaging studies were also implemented to confirm the efficacy of the therapies. Observation periods varied from 3months to 5years, and patients' tolerance of the therapy was generally good. Stem cell therapy may improve some symptoms in patients with CP, though larger studies are needed to examine the impact of stem cell therapy upon CP. PMID:27004672

  18. SYSTEMATIC REVIEW OF HYPOFRACTIONATED RADIATION THERAPY FOR PROSTATE CANCER

    PubMed Central

    Zaorsky, Nicholas G; Ohri, Nitin; Showalter, Timothy N; Dicker, Adam P; Den, Robert B

    2013-01-01

    Prostate cancer is the second most prevalent solid tumor diagnosed in men in the United States and Western Europe. Conventionally fractionated external beam radiation therapy (1.8-2.0 Gy/fraction) is an established treatment modality for men in all disease risk groups. Emerging evidence from experimental and clinical studies suggests that the α/β ratio for prostate cancer may be as low as 1.5 Gy, which has prompted investigators around the world to explore moderately hypofractionated radiation therapy (2.1-3.5 Gy/fraction). We review the impetus behind moderate hypofractionation and the current clinical evidence supporting moderate hypofractionated radiation therapy for prostate cancer. Although hypofractionated radiation therapy has many theoretical advantages, there is no clear evidence from prospective, randomized, controlled trials showing that hypofractionated schedules have improved outcomes or lower toxicity than conventionally fractionated regimens. Currently, hypofractionated schedules should only be used in the context of clinical trials. High dose rate brachytherapy and stereotactic body radiation therapy (fraction size 3.5 Gy and greater) are alternative approaches to hypofractionation, but are beyond the scope of this report. PMID:23453861

  19. Magnetic particle hyperthermia—biophysical limitations of a visionary tumour therapy

    NASA Astrophysics Data System (ADS)

    Hergt, Rudolf; Dutz, Silvio

    2007-04-01

    Loss processes being relevant for magnetic particle hyperthermia are analysed with respect to specific loss power under the condition of a limitation of the alternating magnetic field amplitude and frequency. Extrapolations to the maximum specific loss power of magnetic nanoparticles are discussed and conclusions are drawn with respect to the minimum particle concentration being necessary for hyperthermia or thermoablation under intra-tumoural or systemic particle supply. As a result, much efforts are necessary to render magnetic particle hyperthermia a valuable tumour therapy keeping at least part of the promises found in literature.

  20. Review of lattice results concerning low-energy particle physics

    SciTech Connect

    Aoki, S.; Aoki, Y.; Bernard, C.; Blum, T.; Colangelo, G.; Della Morte, M.; Dürr, S.; El-Khadra, A. X.; Fukaya, H.; Horsley, R.; Jüttner, A.; Kaneko, T.; Laiho, J.; Lellouch, L.; Leutwyler, H.; Lubicz, V.; Lunghi, E.; Necco, S.; Onogi, T.; Pena, C.; Sachrajda, C. T.; Sharpe, S. R.; Simula, S.; Sommer, R.; Van de Water, R. S.; Vladikas, A.; Wenger, U.; Wittig, H.

    2014-09-01

    We review lattice results related to pion, kaon, D- and B-meson physics with the aim of making them easily accessible to the particle physics community. More specifically, we report on the determination of the light-quark masses, the form factor f+(0), arising in semileptonic K -> pi transition at zero momentum transfer, as well as the decay constant ratio fK/fpi of decay constants and its consequences for the CKM matrix elements Vus and Vud. Furthermore, we describe the results obtained on the lattice for some of the low-energy constants of SU(2)LxSU(2)R and SU(3)LxSU(3)R Chiral Perturbation Theory and review the determination of the BK parameter of neutral kaon mixing. The inclusion of heavy-quark quantities significantly expands the FLAG scope with respect to the previous review. Therefore, for this review, we focus on D- and B-meson decay constants, form factors, and mixing parameters, since these are most relevant for the determination of CKM matrix elements and the global CKM unitarity-triangle fit. In addition we review the status of lattice determinations of the strong coupling constant alpha_s.

  1. Review of lattice results concerning low-energy particle physics

    DOE PAGESBeta

    Aoki, S.; Aoki, Y.; Bernard, C.; Blum, T.; Colangelo, G.; Della Morte, M.; Dürr, S.; El-Khadra, A. X.; Fukaya, H.; Horsley, R.; et al

    2014-09-01

    We review lattice results related to pion, kaon, D- and B-meson physics with the aim of making them easily accessible to the particle physics community. More specifically, we report on the determination of the light-quark masses, the form factor f+(0), arising in semileptonic K -> pi transition at zero momentum transfer, as well as the decay constant ratio fK/fpi of decay constants and its consequences for the CKM matrix elements Vus and Vud. Furthermore, we describe the results obtained on the lattice for some of the low-energy constants of SU(2)LxSU(2)R and SU(3)LxSU(3)R Chiral Perturbation Theory and review the determination ofmore » the BK parameter of neutral kaon mixing. The inclusion of heavy-quark quantities significantly expands the FLAG scope with respect to the previous review. Therefore, for this review, we focus on D- and B-meson decay constants, form factors, and mixing parameters, since these are most relevant for the determination of CKM matrix elements and the global CKM unitarity-triangle fit. In addition we review the status of lattice determinations of the strong coupling constant alpha_s.« less

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

    SciTech Connect

    Redondo, Antonio

    2010-01-01

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

  3. Accelerators for heavy-charged-particle radiation therapy.

    PubMed

    Coutrakon, George B

    2007-08-01

    This paper focuses on current and future designs of medical hadron accelerators for treating cancers and other diseases. Presently, five vendors and several national laboratories have produced heavy-particle medical accelerators for accelerating nuclei from hydrogen (protons) up through carbon and oxygen. Particle energies are varied to control the beam penetration depth in the patient. As of the end of 2006, four hospitals and one clinic in the United States offer proton treatments; there are five more such facilities in Japan. In most cases, these facilities use accelerators designed explicitly for cancer treatments. The accelerator types are a combination of synchrotrons, cyclotrons, and linear accelerators; some carry advanced features such as respiration gating, intensity modulation, and rapid energy changes, which contribute to better dose conformity on the tumor when using heavy charged particles. Recent interest in carbon nuclei for cancer treatment has led some vendors to offer carbon-ion and proton capability in their accelerator systems, so that either ion can be used. These features are now being incorporated for medical accelerators in new facilities. PMID:17668952

  4. 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

  5. Brief review of uncertainty quantification for particle image velocimetry

    NASA Astrophysics Data System (ADS)

    Farias, M. H.; Teixeira, R. S.; Koiller, J.; Santos, A. M.

    2016-07-01

    Metrological studies for particle image velocimetry (PIV) are recent in literature. An attempt to evaluate the uncertainty quantifications (UQ) of the PIV velocity field are in evidence. Therefore, a short review on main sources of uncertainty in PIV and available methodologies for its quantification are presented. In addition, the potential of some mathematical techniques, coming from the area of geometric mechanics and control, that could interest the fluids UQ community are highlighted as good possibilities. “We must measure what is measurable and make measurable what cannot be measured” (Galileo)

  6. 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.

  7. 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.

  8. 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.

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

    SciTech Connect

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

    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.

  10. Advances in nutritional therapy in inflammatory bowel diseases: Review

    PubMed Central

    Wędrychowicz, Andrzej; Zając, Andrzej; Tomasik, Przemysław

    2016-01-01

    Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn’s disease are chronic, life-long, and relapsing diseases of the gastrointestinal tract. Currently, there are no complete cure possibilities, but combined pharmacological and nutritional therapy may induce remission of the disease. Malnutrition and specific nutritional deficiencies are frequent among IBD patients, so the majority of them need nutritional treatment, which not only improves the state of nutrition of the patients but has strong anti-inflammatory activity as well. Moreover, some nutrients, from early stages of life are suspected as triggering factors in the etiopathogenesis of IBD. Both parenteral and enteral nutrition is used in IBD therapy, but their practical utility in different populations and in different countries is not clearly established, and there are sometimes conflicting theories concerning the role of nutrition in IBD. This review presents the actual data from research studies on the influence of nutrition on the etiopathogenesis of IBD and the latest findings regarding its mechanisms of action. The use of both parenteral and enteral nutrition as therapeutic methods in induction and maintenance therapy in IBD treatment is also extensively discussed. Comparison of the latest research data, scientific theories concerning the role of nutrition in IBD, and different opinions about them are also presented and discussed. Additionally, some potential future perspectives for nutritional therapy are highlighted. PMID:26811646

  11. Advances in nutritional therapy in inflammatory bowel diseases: Review.

    PubMed

    Wędrychowicz, Andrzej; Zając, Andrzej; Tomasik, Przemysław

    2016-01-21

    Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn's disease are chronic, life-long, and relapsing diseases of the gastrointestinal tract. Currently, there are no complete cure possibilities, but combined pharmacological and nutritional therapy may induce remission of the disease. Malnutrition and specific nutritional deficiencies are frequent among IBD patients, so the majority of them need nutritional treatment, which not only improves the state of nutrition of the patients but has strong anti-inflammatory activity as well. Moreover, some nutrients, from early stages of life are suspected as triggering factors in the etiopathogenesis of IBD. Both parenteral and enteral nutrition is used in IBD therapy, but their practical utility in different populations and in different countries is not clearly established, and there are sometimes conflicting theories concerning the role of nutrition in IBD. This review presents the actual data from research studies on the influence of nutrition on the etiopathogenesis of IBD and the latest findings regarding its mechanisms of action. The use of both parenteral and enteral nutrition as therapeutic methods in induction and maintenance therapy in IBD treatment is also extensively discussed. Comparison of the latest research data, scientific theories concerning the role of nutrition in IBD, and different opinions about them are also presented and discussed. Additionally, some potential future perspectives for nutritional therapy are highlighted. PMID:26811646

  12. Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review

    PubMed Central

    Cooper, Katy; Martyn-St James, Marrissa; Kaltenthaler, Eva; Dickinson, Kath; Cantrell, Anna; Wylie, Kevan; Frodsham, Leila; Hood, Catherine

    2015-01-01

    Introduction Premature ejaculation (PE) is defined by short ejaculatory latency and inability to delay ejaculation causing distress. Management may involve behavioral and/or pharmacological approaches. Aim To systematically review the randomized controlled trial (RCT) evidence for behavioral therapies in the management of PE. Methods Nine databases including MEDLINE were searched up to August 2014. Included RCTs compared behavioral therapy against waitlist control or another therapy, or behavioral plus drug therapy against drug treatment alone. [Correction added on 10 September 2015, after first online publication: Search period has been amended from August 2013 to August 2014.] Main Outcome Measure Intravaginal ejaculatory latency time (IELT), sexual satisfaction, ejaculatory control, and anxiety and adverse effects. Results Ten RCTs (521 participants) were included. Overall risk of bias was unclear. All studies assessed physical techniques, including squeeze and stop-start, sensate focus, stimulation device, and pelvic floor rehabilitation. Only one RCT included a psychotherapeutic approach (combined with stop-start and drug treatment). Four trials compared behavioral therapies against waitlist control, of which two (involving squeeze, stop-start, and sensate focus) reported IELT differences of 7–9 minutes, whereas two (web-based sensate focus, stimulation device) reported no difference in ejaculatory latency posttreatment. For other outcomes (sexual satisfaction, desire, and self-confidence), some waitlist comparisons significantly favored behavioral therapy, whereas others were not significant. Three trials favored combined behavioral and drug treatment over drug treatment alone, with small but significant differences in IELT (0.5–1 minute) and significantly better results on other outcomes (sexual satisfaction, ejaculatory control, and anxiety). Direct comparisons of behavioral therapy vs. drug treatment gave mixed results, mostly either favoring drug

  13. A critical review on the translational journey of cardioprotective therapies!

    PubMed

    Rossello, Xavier; Yellon, Derek M

    2016-10-01

    The failure to translate novel cardioprotective therapies tested in pre-clinical studies into the clinical setting for patient benefit can be attributed to a number of factors at different stages of the research process. This review focuses on the evidences and the gaps with regard to the translational journey of cardioprotective interventions. Gaps are classified into 3 main groups: 1) those related to pre-clinical studies, 2) those associated with the validation of infarct size as a good surrogate and 3) those based on design and interpretation of randomized clinical trials on cardioprotection. Addressing these gaps might increase the chances to successfully translate cardioprotective therapies into improving both post-STEMI heart failure and cardiovascular death rates. PMID:27379920

  14. 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

  15. Using antimicrobial adjuvant therapy in cancer treatment: a review

    PubMed Central

    2012-01-01

    Recent clinical and pre-clinical data demonstrate that adjuvant antimicrobial therapy is beneficial in cancer treatment. There could be several reasons for this effect, which include treating cancer associated bacteria and viruses, prophylaxis of post-chemotherapy infections due to immunosuppression, and antiproliferative effect of certain antimicrobials. Targeting cancer associated viruses and bacteria with antimicrobial agents is currently used for gastric, cervical, hematopoietic, liver and brain cancer. However this treatment is effective only in combination with conventional therapies. Antimicrobials can also have a direct antiproliferative and cytotoxic effect, and can cause apoptosis. Moreover, some antimicrobials are known to be helpful in overcoming side effects of drugs commonly used in cancer treatment. Chemotherapy related bacteremia and neutropenia can be overcome by the appropriately timed use of antimicrobials. This review summarizes the data on the effects of antivirals and antibiotics on cancer treatment and describes their mechanisms. PMID:23164412

  16. Distal humerus fractures: a review of current therapy concepts.

    PubMed

    Amir, Steinitz; Jannis, Sailer; Daniel, Rikli

    2016-06-01

    Fractures of the distal humerus in the adult comprise approximately one third of all humeral fractures. Successful management of distal humerus fractures depends on correct reduction of the fracture, reconstruction of the articular surface if needed, stability and rigidity of the fixation, and appropriate rehabilitation. In this review, we evaluated the available literature and highlighted current therapy concepts. We assessed the evolution of internal fixation and elbow arthroplasty focusing on the established surgical approaches against the background of a growing incidence of distal humeral fractures in an aging patient population. Therefore evaluating the aspect and influence of age-dependent comorbidities like osteoporosis on successful treatment. PMID:27039395

  17. Particle beam radiation therapy in prostate cancer: is there an advantage?

    PubMed

    Rossi, C J; Slater, J D; Reyes-Molyneux, N; Yonemoto, L T; Archambeau, J O; Coutrakon, G; Slater, J M

    1998-04-01

    Hadron therapy uses heavy particles to deliver therapeutic ionizing energy. Each particle's inherent attributes determine the pattern of energy deposited by its beam, expressed in macro (conformability to a three-dimensional target volume) and micro (radiobiologic properties) distributions. Mass and charge regulate the inherent properties; beam energy provides a controllable, variable characteristic. Generally, heavy charged particles provide superior macrodosimetric properties; heavy particles (charged or not) have microdosimetric characteristics that produce high linear energy transfer (LET). Neutron macrodosimetry is similar to that of photons. Protons and helium ions possess superior macrodosimetric properties, plus microdosimetric characteristics resulting in low LET, yielding beam characteristics that approach the ideal for clinical radiotherapy. Hadron therapy for prostate cancer has been limited by the availability of appropriate treatment facilities. Nonetheless, encouraging results have been obtained. Neutron therapy demonstrated improved overall survival in a multi-institutional randomized trial, and improved local disease control in a subsequent trial. Proton radiation forms the boost component of several conformal dose-escalation studies. A Loma Linda University study demonstrated low treatment-related morbidity despite a prostate dose of 75 CGE; late-morbidity data were superior to published reports from multi-field, conformal photon therapy. A Phase III dose-escalation study of protons for early prostate cancer is proceeding. PMID:9516592

  18. 21 CFR 892.5050 - Medical charged-particle radiation therapy system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical charged-particle radiation therapy system. 892.5050 Section 892.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5050 Medical...

  19. 21 CFR 892.5050 - Medical charged-particle radiation therapy system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Medical charged-particle radiation therapy system. 892.5050 Section 892.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5050 Medical...

  20. 21 CFR 892.5050 - Medical charged-particle radiation therapy system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Medical charged-particle radiation therapy system. 892.5050 Section 892.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5050 Medical...

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

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Medical charged-particle radiation therapy system. 892.5050 Section 892.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5050 Medical...

  2. 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…

  3. Microscopic Gold Particle-Based Fiducial Markers for Proton Therapy of Prostate Cancer

    SciTech Connect

    Lim, Young Kyung; Kwak, Jungwon; Kim, Dong Wook; Shin, Dongho; Yoon, Myonggeun; Park, Soah; Kim, Jin Sung; Ahn, Sung Hwan; Shin, Jungwook; Lee, Se Byeong Park, Sung Yong; Pyo, Hong Ryeol; Kim, Dae Yong M.D.; Cho, Kwan Ho

    2009-08-01

    Purpose: We examined the feasibility of using fiducial markers composed of microscopic gold particles and human-compatible polymers as a means to overcome current problems with conventional macroscopic gold fiducial markers, such as dose reduction and artifact generation, in proton therapy for prostate cancer. Methods and Materials: We examined two types of gold particle fiducial marker interactions: that with diagnostic X-rays and with a therapeutic proton beam. That is, we qualitatively and quantitatively compared the radiographic visibility of conventional gold and gold particle fiducial markers and the CT artifacts and dose reduction associated with their use. Results: The gold particle fiducials could be easily distinguished from high-density structures, such as the pelvic bone, in diagnostic X-rays but were nearly transparent to a proton beam. The proton dose distribution was distorted <5% by the gold particle fiducials with a 4.9% normalized gold density; this was the case even in the worst configuration (i.e., parallel alignment with a single-direction proton beam). In addition, CT artifacts were dramatically reduced for the gold particle mixture. Conclusion: Mixtures of microscopic gold particles and human-compatible polymers have excellent potential as fiducial markers for proton therapy for prostate cancer. These include good radiographic visibility, low distortion of the depth-dose distribution, and few CT artifacts.

  4. Kill-painting of hypoxic tumours in charged particle therapy

    PubMed Central

    Tinganelli, Walter; Durante, Marco; Hirayama, Ryoichi; Krämer, Michael; Maier, Andreas; Kraft-Weyrather, Wilma; Furusawa, Yoshiya; Friedrich, Thomas; Scifoni, Emanuele

    2015-01-01

    Solid tumours often present regions with severe oxygen deprivation (hypoxia), which are resistant to both chemotherapy and radiotherapy. Increased radiosensitivity as a function of the oxygen concentration is well described for X-rays. It has also been demonstrated that radioresistance in anoxia is reduced using high-LET radiation rather than conventional X-rays. However, the dependence of the oxygen enhancement ratio (OER) on radiation quality in the regions of intermediate oxygen concentrations, those normally found in tumours, had never been measured and biophysical models were based on extrapolations. Here we present a complete survival dataset of mammalian cells exposed to different ions in oxygen concentration ranging from normoxia (21%) to anoxia (0%). The data were used to generate a model of the dependence of the OER on oxygen concentration and particle energy. The model was implemented in the ion beam treatment planning system to prescribe uniform cell killing across volumes with heterogeneous radiosensitivity. The adaptive treatment plans have been validated in two different accelerator facilities, using a biological phantom where cells can be irradiated simultaneously at three different oxygen concentrations. We thus realized a hypoxia-adapted treatment plan, which will be used for painting by voxel of hypoxic tumours visualized by functional imaging. PMID:26596243

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

    ERIC Educational Resources Information Center

    Yeaw, John David Andrew

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

  6. Chronic Pain and Cognitive Behavioral Therapy: An Integrative Review.

    PubMed

    Knoerl, Robert; Lavoie Smith, Ellen M; Weisberg, James

    2016-05-01

    Cognitive behavioral therapy (CBT) is often used to treat chronic pain; however, more information is needed about what are the most efficacious dose and delivery methods. The aims of this review were to determine (a) which CBT doses, delivery methods, strategies, and follow-up periods have been explored in recent intervention studies of individuals with chronic pain and (b) whether the outcomes described in the selected studies were consistent with recommendations by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials. The CINAHL, EMBASE, PubMed, PsycInfo, and SCOPUS databases were searched for randomized controlled trials published from 2009 to 2015 testing CBT for adults with chronic pain. Thirty-five studies were included in this review. Results revealed that CBT reduced pain intensity in 43% of trials, the efficacy of online and in-person formats were comparable, and military veterans and individuals with cancer-related chronic pain were understudied. PMID:26604219

  7. A review of photodynamic therapy in cutaneous leishmaniasis.

    PubMed

    van der Snoek, E M; Robinson, D J; van Hellemond, J J; Neumann, H A M

    2008-08-01

    We present a review of six clinical studies investigating the use of photodynamic therapy (PDT) using porphyrin precursors for the treatment of Old World cutaneous leishmaniasis (CL). Thirty-nine patients with a total of 77 lesions received PDT using a range of treatment schedules following topical application of aminolevulinic acid (ALA) or methyl-aminolevulinate (MAL). The tissue response to PDT is accompanied by a mild burning sensation, erythema and reversible hypo- and hyperpigmentation. Few mechanistic studies have addressed the principles underlying the use of PDT for CL. All six reviewed papers suggest that PDT with porphyrin precursors is relatively effective in treating CL. Data are still limited, and PDT cannot at this point be recommended in routine clinical practice. The mechanism of action of this promising therapeutic modality needs to investigated further and additional controlled trials need to be performed. PMID:18624853

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

    PubMed Central

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

    2014-01-01

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

  9. Acute oxygen therapy: a review of prescribing and delivery practices

    PubMed Central

    Cousins, Joyce L; Wark, Peter AB; McDonald, Vanessa M

    2016-01-01

    Oxygen is a commonly used drug in the clinical setting and like other drugs its use must be considered carefully. This is particularly true for those patients who are at risk of type II respiratory failure in whom the risk of hypercapnia is well established. In recent times, several international bodies have advocated for the prescription of oxygen therapy in an attempt to reduce this risk in vulnerable patient groups. Despite this guidance, published data have demonstrated that there has been poor uptake of these recommendations. Multiple interventions have been tested to improve concordance, and while some of these interventions show promise, the sustainability of these interventions are less convincing. In this review, we summarize data that have been published on the prevalence of oxygen prescription and the accurate and appropriate administration of this drug therapy. We also identify strategies that have shown promise in facilitating changes to oxygen prescription and delivery practice. There is a clear need to investigate the barriers, facilitators, and attitudes of clinicians in relation to the prescription of oxygen therapy in acute care. Interventions based on these findings then need to be designed and tested to facilitate the application of evidence-based guidelines to support sustained changes in practice, and ultimately improve patient care. PMID:27307722

  10. Role of radiation therapy in lung cancer management - a review.

    PubMed

    Shi, J-G; Shao, H-J; Jiang, F-E; Huang, Y-D

    2016-07-01

    Lung cancer is the leading cause of cancer death worldwide. Furthermore, more than 50% of lung cancer patients are found affected by distant metastases at the time of diagnosis. On the other hand, 20% of these patients are without regional spread and are good candidates for surgical operation. The remaining 30% represent an intermediate group whose tumors have metastasized up to regional lymph nodes. These remain 30% are the most appropriate candidates for radiation therapy. These patients are also called as "locally advanced lung cancer" or stage III lung cancer patients. In these patients strategy of combination therapy viz. radiation therapy in combination with chemotherapy is also tried by various groups in the recent past for this better management. However, long-term survival is still poor with a 5-year survival in 5-25% of patients. During the last decades, there has been a development in radiation strategies. The present review article focuses on different approaches to optimize radiotherapy for these patients. PMID:27466995

  11. Vagus nerve stimulation therapy in partial epilepsy: a review.

    PubMed

    Panebianco, Mariangela; Zavanone, Chiara; Dupont, Sophie; Restivo, Domenico A; Pavone, Antonino

    2016-09-01

    Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked epileptic seizures. The majority of people given a diagnosis of epilepsy have a good prognosis, but 20-30 % will develop drug-resistant epilepsy. Vagus nerve stimulation (VNS) is a neuromodulatory treatment that is used as an adjunctive therapy for treating people with medically refractory epilepsy. It consists of chronic intermittent electrical stimulation of the vagus nerve, delivered by a programmable pulse generator (Neuro-Cybernetic Prosthesis). In 1997, the Food and Drug Administration approved VNS as adjunctive treatment for medically refractory partial-onset seizures in adults and adolescents. This article reviews the literature from 1988 to nowadays. We discuss thoroughly the anatomy and physiology of vagus nerve and the potential mechanisms of actions and clinical applications involved in VNS therapy, as well as the management, safety, tolerability and effectiveness of VNS therapy. VNS for partial seizures appears to be an effective and well tolerated treatment in adult and pediatric patients. People noted improvements in feelings of well-being, alertness, memory and thinking skills, as well as mood. The adverse effect profile is substantially different from the adverse effect profile associated with antiepileptic drugs, making VNS a potential alternative for patients with difficulty tolerating antiepileptic drug adverse effects. Despite the passing years and the advent of promising neuromodulation technologies, VNS remains an efficacy treatment for people with medically refractory epilepsy. Past and ongoing investigations in other indications have provided signals of the therapeutic potential in a wide variety of conditions. PMID:26908034

  12. Acute oxygen therapy: a review of prescribing and delivery practices.

    PubMed

    Cousins, Joyce L; Wark, Peter A B; McDonald, Vanessa M

    2016-01-01

    Oxygen is a commonly used drug in the clinical setting and like other drugs its use must be considered carefully. This is particularly true for those patients who are at risk of type II respiratory failure in whom the risk of hypercapnia is well established. In recent times, several international bodies have advocated for the prescription of oxygen therapy in an attempt to reduce this risk in vulnerable patient groups. Despite this guidance, published data have demonstrated that there has been poor uptake of these recommendations. Multiple interventions have been tested to improve concordance, and while some of these interventions show promise, the sustainability of these interventions are less convincing. In this review, we summarize data that have been published on the prevalence of oxygen prescription and the accurate and appropriate administration of this drug therapy. We also identify strategies that have shown promise in facilitating changes to oxygen prescription and delivery practice. There is a clear need to investigate the barriers, facilitators, and attitudes of clinicians in relation to the prescription of oxygen therapy in acute care. Interventions based on these findings then need to be designed and tested to facilitate the application of evidence-based guidelines to support sustained changes in practice, and ultimately improve patient care. PMID:27307722

  13. Advances in stem cell therapy for cardiovascular disease (Review)

    PubMed Central

    SUN, RONGRONG; LI, XIANCHI; LIU, MIN; ZENG, YI; CHEN, SHUANG; ZHANG, PEYING

    2016-01-01

    Cardiovascular disease constitutes the primary cause of mortality and morbidity worldwide, and represents a group of disorders associated with the loss of cardiac function. Despite considerable advances in the understanding of the pathologic mechanisms of the disease, the majority of the currently available therapies remain at best palliative, since the problem of cardiac tissue loss has not yet been addressed. Indeed, few therapeutic approaches offer direct tissue repair and regeneration, whereas the majority of treatment options aim to limit scar formation and adverse remodeling, while improving myocardial function. Of all the existing therapeutic approaches, the problem of cardiac tissue loss is addressed uniquely by heart transplantation. Nevertheless, alternative options, particularly stem cell therapy, has emerged as a novel and promising approach. This approach involves the transplantation of healthy and functional cells to promote the renewal of damaged cells and repair injured tissue. Bone marrow precursor cells were the first cell type used in clinical studies, and subsequently, preclinical and clinical investigations have been extended to the use of various populations of stem cells. This review addresses the present state of research as regards stem cell therapy for cardiovascular disease. PMID:27220939

  14. Digital particle image thermometry/velocimetry: a review

    NASA Astrophysics Data System (ADS)

    Dabiri, Dana

    2009-02-01

    Digital particle image thermometry/velocimetry (DPIT/V) is a relatively new methodology that allows for measurements of simultaneous temperature and velocity within a two-dimensional domain, using thermochromic liquid crystal tracer particles as the temperature and velocity sensors. Extensive research has been carried out over recent years that have allowed the methodology and its implementation to grow and evolve. While there have been several reviews on the topic of liquid crystal thermometry (Moffat in Exp Therm Fluid Sci 3:14-32, 1990; Baughn in Int J Heat Fluid Flow 16:365-375, 1995; Roberts and East in J Spacecr Rockets 33:761-768, 1996; Wozniak et al. in Appl Sci Res 56:145-156, 1996; Behle et al. in Appl Sci Res 56:113-143, 1996; Stasiek in Heat Mass Transf 33:27-39, 1997; Stasiek and Kowalewski in Opto Electron Rev 10:1-10, 2002; Stasiek et al. in Opt Laser Technol 38:243-256, 2006; Smith et al. in Exp Fluids 30:190-201, 2001; Kowalewski et al. in Springer handbook of experimental fluid mechanics, 1st edn. Springer, Berlin, pp 487-561, 2007), the focus of the present review is to provide a relevant discussion of liquid crystals pertinent to DPIT/V. This includes a background on liquid crystals and color theory, a discussion of experimental setup parameters, a description of the methodology’s most recent advances and processing methods affecting temperature measurements, and finally an explanation of its various implementations and applications.

  15. Implant survival rate after oral cancer therapy: a review.

    PubMed

    Javed, Fawad; Al-Hezaimi, Khalid; Al-Rasheed, Abdulaziz; Almas, Khalid; Romanos, George E

    2010-12-01

    The overall impression regarding the success of dental implants (DI) in patients having undergone oral cancer therapy remains unclear. The aim of the present review study was to assess the implant survival rate after oral cancer therapy. Databases were explored from 1986 up to and including September 2010 using the following keywords in various combinations: "cancer", "chemotherapy", "dental implant", "oral", "osseointegration", "radiotherapy", "surgery" and "treatment". The eligibility criteria were: (1) original research articles; (2) clinical studies; (3) reference list of pertinent original and review studies; (4) intervention: patients having undergone radio- and chemotherapy following oral cancer surgery; and (5) articles published only in English. Twenty-one clinical studies were included. Results from 16 studies reported that DI can osseointegrate and remain functionally stable in patients having undergone radiotherapy following oral cancer surgery; whereas three studies showed irradiation to have negative effects on the survival of DI. Two studies reported that DI can osseointegrate and remain functionally stable in patients having undergone chemotherapy. It is concluded that DI can osseointegrate and remain functionally stable in patients having undergone oral cancer treatment. PMID:21055997

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

    SciTech Connect

    Phillips, Jonathan; Luhrs, Claudia C; Richard, Monique

    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.

  17. 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

  18. 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

  19. Charged particle therapy for cancer: the inheritance of the Cavendish scientists?

    PubMed

    Jones, Bleddyn; Dale, Roger G; Cárabe-Fernández, Alejandro

    2009-03-01

    The history of developments in atomic physics and its applications follows the decisive input provided by Maxwell and subsequent discoveries by his successors at the Cavendish Laboratory. In medicine the potential applications of particle physics (with the notable exception of the electron) were unfortunately delayed by the disappointing experiences with neutron therapy, which produced long-term scepticism. Neutrons are not appropriate for cancer therapy because not only their physical dose distributions offer no advantages over X-rays, but also their biological dose distributions are worse. The much improved dose distributions achieved with charged particles offer real prospects for better treatment outcomes because of the large reduction in the volume of unnecessarily irradiated tissue in many situations. Charged particle therapy is relatively new and can be applied with increasing confidence due to advances in radiology and computing, but at present there are insufficient numbers of treatment facilities to produce statistically powerful studies to compare treatment outcomes with those of X-rays. Considerable progress has been achieved in Japan and Germany with pilot studies of carbon ions but their efficacy compared with protons needs to be tested: in theory carbon should be better for intrinsically radio-resistant and for the most hypoxic tumours. The optimisation of proton and ion beam therapy in clinical practice remains to be achieved, but there are good scientific reasons why these modalities will be preferred by patients and their physicians in the future. Regrettably, despite hosting many of the momentous discoveries that enabled the development of charged particle therapy, the UK is slow to adopt and implement this very important form of cancer treatment. PMID:18693025

  20. Range assessment in particle therapy based on prompt γ-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.

  1. Nonadherence to Medication Therapy in Haemodialysis Patients: A Systematic Review

    PubMed Central

    Ghimire, Saurav; Castelino, Ronald L.; Lioufas, Nicole M.; Peterson, Gregory M.; Zaidi, Syed Tabish R.

    2015-01-01

    Background End-stage kidney disease (ESKD) patients are often prescribed multiple medications. Together with a demanding weekly schedule of dialysis sessions, increased number of medicines and associated regimen complexity pre-dispose them at high risk of medication nonadherence. This review summarizes existing literature on nonadherence and identifies factors associated with nonadherence to medication therapy in patients undergoing haemodialysis. Methods A comprehensive search of PubMed, Embase, CINAHL, PsycInfo, and Cochrane Database of Systematic Reviews covering the period from 1970 through November 2014 was performed following a predefined inclusion and exclusion criteria. Reference lists from relevant materials were reviewed. Data on study characteristics, measures of nonadherence, prevalence rates and factors associated with nonadherence were collected. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was followed in conducting this systematic review. Results Of 920 relevant publications, 44 were included. The prevalence of medication nonadherence varied from 12.5% to 98.6%, with widespread heterogeneity in measures and definitions employed. Most common patient-related factors significantly associated with nonadherence were younger age, non-Caucasian ethnicity, illness interfering family life, being a smoker, and living single and being divorced or widowed. Similarly, disease-related factors include longevity of haemodialysis, recurrent hospitalization, depressive symptoms and having concomitant illness like diabetes and hypertension. Medication-related factors such as daily tablet count, total pill burden, number of phosphate binders prescribed and complexity of medication regimen were also associated with poor adherence. Conclusions A number of patient-, disease-, and medication-related factors are associated with medication nonadherence in haemodialysis patients. Clinicians should be aware of such factors so that

  2. Laser therapy and photosensitive medication: a review of the evidence.

    PubMed

    Kerstein, Ryan L; Lister, Tom; Cole, Richard

    2014-07-01

    In the 2009 guidelines from the BMLA, the use of non-essential aesthetic lasers was contraindicated in patients receiving medication that causes whole-body photosensitisation as well as those causing local light sensitisation. Following this and anecdotal advice, many laser centres refuse to treat patients who are on known photosensitive medication. Therefore, specific patient cohorts that would benefit from laser therapy are being denied because of medications, such as long-term antibiotics for chronic facial acne. This article reviews the published literature on lasers and photosensitive medications, the mechanisms of photosensitivity and the role of laser in its production. The aim is to analyse the available evidence regarding adverse reactions to laser treatment related to photosensitive medication. A PubMed review of published article titles and abstracts was performed using the search term Laser with each of the following terms individually: photosensitive, photosensitiser, photosensitizer, phototoxicity, photoallergy, complications, case-report, tetracycline, minocycline, amiodarone, nitrofurantoin and medication. Four publications were identified, none of which reported any complication in the use of laser in patients taking photosensitising medication. As there are no published accounts of adverse effects of laser in patients with photosensitive medication, we performed a review of the mechanism of photosensitivity by compiling a list of photosensitive medication and the peak wavelength of radiation required to activate the drug. We recommend a national database of drugs and the wavelengths causing photosensitive reactions of each which a laser department can access prior to treatment. PMID:24590242

  3. Targeted alpha therapy using short-lived alpha-particles and the promise of nanobodies as targeting vehicle

    PubMed Central

    Dekempeneer, Yana; Keyaerts, Marleen; Krasniqi, Ahmet; Puttemans, Janik; Muyldermans, Serge; Lahoutte, Tony; D’huyvetter, Matthias; Devoogdt, Nick

    2016-01-01

    ABSTRACT Introduction: The combination of a targeted biomolecule that specifically defines the target and a radionuclide that delivers a cytotoxic payload offers a specific way to destroy cancer cells. Targeted radionuclide therapy (TRNT) aims to deliver cytotoxic radiation to cancer cells and causes minimal toxicity to surrounding healthy tissues. Recent advances using α-particle radiation emphasizes their potential to generate radiation in a highly localized and toxic manner because of their high level of ionization and short range in tissue. Areas covered: We review the importance of targeted alpha therapy (TAT) and focus on nanobodies as potential beneficial vehicles. In recent years, nanobodies have been evaluated intensively as unique antigen-specific vehicles for molecular imaging and TRNT. Expert opinion: We expect that the efficient targeting capacity and fast clearance of nanobodies offer a high potential for TAT. More particularly, we argue that the nanobodies’ pharmacokinetic properties match perfectly with the interesting decay properties of the short-lived α-particle emitting radionuclides Astatine-211 and Bismuth-213 and offer an interesting treatment option particularly for micrometastatic cancer and residual disease. PMID:27145158

  4. 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

  5. Corneal Neovascularization: An Anti-VEGF Therapy Review

    PubMed Central

    Chang, Jin-Hong; Garg, Nitin K.; Lunde, Elisa; Han, Kyu-Yeon; Jain, Sandeep; Azar, Dimitri T.

    2013-01-01

    Corneal neovascularization is a serious condition that can lead to a profound decline in vision. The abnormal vessels block light, cause corneal scarring, compromise visual acuity, and may lead to inflammation and edema. Corneal neovascularization occurs when the balance between angiogenic and antiangiogenic factors is tipped toward angiogenic molecules. Vascular endothelial growth factor (VEGF), one of the most important mediators of angiogenesis, is upregulated during neovascularization. In fact, anti-VEGF agents have efficacy in the treatment of neovascular age-related macular degeneration, diabetic retinopathy, macular edema, neovascular glaucoma, and other neovascular diseases. These same agents have great potential for the treatment of corneal neovascularization. We review some of the most promising anti-VEGF therapies, including bevacizumab, VEGF trap, siRNA, and tyrosine kinase inhibitors. PMID:22898649

  6. 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

  7. Mini-review: bmx kinase inhibitors for cancer therapy.

    PubMed

    Jarboe, John S; Dutta, Shilpa; Velu, Sadanandan E; Willey, Christopher D

    2013-09-01

    Kinase inhibitors are among the fastest growing class of anti-cancer therapies. One family of kinases that has recently gained attention as a target for treating malignant disorders is the Tec kinase family. Evidence has been published that one member of this family; the Bmx kinase, may play a role in the pathogenesis of glioblastoma, prostate, breast and lung cancer. Bmx has also shown potential as an anti-vascular therapy in combination with radiation or as a sensitizer to chemotherapeutic agents. Therefore, several companies such as Pharmacyclics, Avila Therapeutics, Merck and Co., Metaproteomics, IRM, and Moerae Matrix have developed compounds or peptides that function as Bmx kinase inhibitors. These companies have subsequently been issued patents for these inhibitors. Additionally, it has been shown that current clinical stage EGFR inhibitors can irreversibly inhibit Bmx, suggesting these compounds might be rapidly moved to clinical trials for other malignancies. This review will discuss current patents issued since 2009 that contain data specifically on inhibition of the Bmx kinase, and will also discuss the scientific literature that suggests their potential application as therapeutics in the treatment of the aforementioned malignancies. PMID:23198769

  8. [LOCAL ANTIBIOTIC THERAPY OF OSTEOMYELITIS USING NONABSORBABLE IMPLANT (REVIEW)].

    PubMed

    Tuleubaev, B; Saginova, D; Abiyev, T; Davletbaev, M; Koshanova, A

    2016-06-01

    Despite the variety of treatments available, including surgical procedures and antimicrobial therapy, bone infections is still a medical problem, because they are difficult to treat. Optimal treatment should stabilize the bone, promote the biological recovery of bone defects and destroy bacterial infection. Systemic antibiotics are part of the standard therapy after surgical treatment of infected bone, but their effectiveness is limited due to malnutrition and low absorption at the site of infection. Moreover, long-term treatment and higher doses are associated with serious side effects. In contrast, the antibiotic impregnated bone cements or fillers can act as a local anti-infective drug delivery system, which not only fills the dead space after debridement, but also provide high concentrations of antibiotics in a potential site of infection, no increase levels of antibiotics in serum. The review analyzed the use of antibiotic-impregnated cement as local delivery of antibiotics systems. Gentamycin impregnated polymethylmethacrylate (PMMA) beads, for the topical treatment of orthopedic infections clinically used for over 30 years. Application of antibiotic delivery systems using cement in the infected region is common method of treatment that continues to improve. On the downside of PMMA is that the material does not biodegradable requires subsequent invasive procedures necessary to remove the implant. PMID:27441531

  9. Testosterone Replacement Therapy and Cardiovascular Risk: A Review

    PubMed Central

    Corona G, Giovanni; Rastrelli, Giulia; Maseroli, Elisa; Sforza, Alessandra

    2015-01-01

    Recent reports in the scientific and lay press have suggested that testosterone (T) replacement therapy (TRT) is likely to increase cardiovascular (CV) risk. In a final report released in 2015, the Food and Drug Administration (FDA) cautioned that prescribing T products is approved only for men who have low T levels due to primary or secondary hypogonadism resulting from problems within the testis, pituitary, or hypothalamus (e.g., genetic problems or damage from surgery, chemotherapy, or infection). In this report, the FDA emphasized that the benefits and safety of T medications have not been established for the treatment of low T levels due to aging, even if a man's symptoms seem to be related to low T. In this paper, we reviewed the available evidence on the association between TRT and CV risk. In particular, data from randomized controlled studies and information derived from observational and pharmacoepidemiological investigations were scrutinized. The data meta-analyzed here do not support any causal role between TRT and adverse CV events. This is especially true when hypogonadism is properly diagnosed and replacement therapy is correctly performed. Elevated hematocrit represents the most common adverse event related to TRT. Hence, it is important to monitor hematocrit at regular intervals in T-treated subjects in order to avoid potentially serious adverse events. PMID:26770933

  10. Immunotherapeutic approaches for cancer therapy: An updated review.

    PubMed

    Kazemi, Tohid; Younesi, Vahid; Jadidi-Niaragh, Farhad; Yousefi, Mehdi

    2016-05-01

    In spite of specific immune effector mechanisms raised against tumor cells, there are mechanisms employed by the tumor cells to keep them away from immune recognition and elimination; some of these mechanisms have been identified, while others are still poorly understood. Manipulation or augmentation of specific antitumor immune responses are now the preferred approaches for treatment of malignancies, and traditional therapeutic approaches are being replaced by the use of agents which potentiate immune effector mechanisms, broadly called "immunotherapy". Cancer immunotherapy is generally classified into two main classes including active and passive methods. Interventions to augment the immune system of the patient, for example, vaccination or adjuvant therapy, actively promote antitumor effector mechanisms to improve cancer elimination. On the other hand, administration of specific monoclonal antibodies (mAbs) against different tumor antigens and adoptive transfer of genetically-modified specific T cells are currently the most rapidly developing approaches for cancer targeted therapy. In this review, we will discuss the different modalities for active and passive immunotherapy for cancer. PMID:25801036

  11. Beta-blocking agents during electroconvulsive therapy: a review.

    PubMed

    Boere, E; Birkenhäger, T K; Groenland, T H N; van den Broek, W W

    2014-07-01

    Electroconvulsive therapy (ECT) is associated with at least transient episodes of hypertension and tachycardia. Beta-blocking agents may be indicated to prevent cardiovascular complications and may shorten seizure duration. This review evaluates studies that used beta-blocking agents during ECT to determine which agent has the most favourable outcomes on cardiovascular variables and seizure duration. A Medline database search was made using the combined keywords 'adrenergic beta-antagonists' and 'electroconvulsive therapy'. The search was restricted to double-blind randomized controlled trials and yielded 29 original studies. With the use of esmolol, significant attenuating effects were found on cardiovascular parameters in the first 5 min after stimulation; its shortening effects on seizure duration may be dose-related. With the use of labetalol, findings on cardiovascular effects were inconsistent during the first minutes after stimulation but were significant after 5 min and thereafter; seizure duration was scarcely studied. Landiolol attenuates heart rate but with inconsistent findings regarding arterial pressure (AP); seizure duration was mostly unaffected. Esmolol appears to be effective in reducing the cardiovascular response, although seizure duration may be affected with higher dosages. Landiolol can be considered a suitable alternative, but effects on AP need further investigation. Labetalol has been studied to a lesser extent and may have prolonged cardiovascular effects. The included studies varied in design, methodology, and the amount of exact data provided in the publications. Further study of beta-blocking agents in ECT is clearly necessary. PMID:24942714

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

    SciTech Connect

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

    1994-09-01

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

  13. Particle in cell simulation of laser-accelerated proton beams for radiation therapy.

    PubMed

    Fourkal, E; Shahine, B; Ding, M; Li, J S; Tajima, T; Ma, C M

    2002-12-01

    In this article we present the results of particle in cell (PIC) simulations of laser plasma interaction for proton acceleration for radiation therapy treatments. We show that under optimal interaction conditions protons can be accelerated up to relativistic energies of 300 MeV by a petawatt laser field. The proton acceleration is due to the dragging Coulomb force arising from charge separation induced by the ponderomotive pressure (light pressure) of high-intensity laser. The proton energy and phase space distribution functions obtained from the PIC simulations are used in the calculations of dose distributions using the GEANT Monte Carlo simulation code. Because of the broad energy and angular spectra of the protons, a compact particle selection and beam collimation system will be needed to generate small beams of polyenergetic protons for intensity modulated proton therapy. PMID:12512712

  14. 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

  15. Laser therapy in wound healing associated with diabetes mellitus - Review*

    PubMed Central

    de Sousa, Raquel Gomes; Batista, Keila de Nazaré Madureira

    2016-01-01

    The article discusses the results of a literature review on the application of low intensity laser therapy on the healing of wounds associated diabetes mellitus in the last 10 years. Objective To determine the most effective parameter in healing wounds related to diabetes mellitus, as well as the most widely used type of laser. Methodology consisted of bibliographic searching the databases Bireme, SciELO, PubMed/Medline and Lilacs by using the keywords related to the topic. Were selected from these keywords, papers discussing the use of laser on wounds associated with diabetes, published in the period 2005-2014, in Portuguese or English. Results After analyzing the research, 12 studies consistent with the theme were selected. Conclusion Based on this review, the studies that showed more satisfactory results in healing diabetic wounds were those who applied energy densities in the range of 3-5 J/cm2, power densities equal to or below 0.2 W/cm2 and continuous emission. The He-Ne laser with a wavelength of 632.8 nm was used more often. PMID:27579745

  16. Neurobiology of Cognitive Remediation Therapy for Schizophrenia: A Systematic Review

    PubMed Central

    Thorsen, Anders Lillevik; Johansson, Kyrre; Løberg, Else-Marie

    2014-01-01

    Cognitive impairment is an important aspect of schizophrenia, where cognitive remediation therapy (CRT) is a promising treatment for improving cognitive functioning. While neurobiological dysfunction in schizophrenia has been the target of much research, the neural substrate of cognitive remediation and recovery has not been thoroughly examined. The aim of the present article is to systematically review the evidence for neural changes after CRT for schizophrenia. The reviewed studies indicate that CRT affects several brain regions and circuits, including prefrontal, parietal, and limbic areas, both in terms of activity and structure. Changes in prefrontal areas are the most reported finding, fitting to previous evidence of dysfunction in this region. Two limitations of the current research are the few studies and the lack of knowledge on the mechanisms underlying neural and cognitive changes after treatment. Despite these limitations, the current evidence suggests that CRT is associated with both neurobiological and cognitive improvement. The evidence from these findings may shed light on both the neural substrate of cognitive impairment in schizophrenia, and how better treatment can be developed and applied. PMID:25177300

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

    PubMed Central

    Gentile, Salvatore

    2010-01-01

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

  18. 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

  19. Radionuclide therapy in neuroendocrine tumours: a systematic review.

    PubMed

    Gulenchyn, K Y; Yao, X; Asa, S L; Singh, S; Law, C

    2012-05-01

    The purpose of this systematic review was to investigate the effects of therapeutic radiopharmaceuticals in patients with different types of advanced neuroendocrine tumour (NETs). A literature search was carried out in MEDLINE and EMBASE from January 1998 to November 2010. The Cochrane Library (to Issue 10, 2010) and the Standards and Guidelines Evidence Inventory of Cancer Guidelines, including over 1100 English-language cancer guidelines from January 2003 to June 2010, were also checked. No existing systematic reviews or clinical practice guidelines based on a systematic review or randomised controlled trials focusing on this topic were found. Twenty-four fully published articles were abstracted and summarised: 16 articles focused on five peptide receptor radionuclide therapy ((111)In-DTPAOC, (90)Y-DOTALAN, (90)Y-DOTATOC, (90)Y-DOTATATE, and (177)Lu-DOTATATE) and eight focused on (131)I-MIBG treatment. Limited evidence from a historical comparison of studies in one centre supported that (177)Lu-DOTATATE might be associated with greater clinical outcomes compared with (90)Y-DOTATOC or (111)In-DTPAOC. The severe toxicities for (177)Lu-DOTATATE included hepatic insufficiency in 0.6%, myelodysplastic syndrome in 0.8% and renal insufficiency in 0.4% of patients in this study. Insufficient evidence suggested efficacy of (131)I-MIBG in adult NET patients, but the overall tumour response rate from (131)I-MIBG was 27-75% for malignant neuroblastoma, paraganglioma or pheochromocytoma. Haematological toxicities were the main severe side-effects after (131)I-MIBG and 4% of patients developed secondary malignancies in one study. To date, peptide receptor radionuclide therapy seems to be an acceptable option and is relatively safe in adult advanced NET patients with receptor uptake positive on scintigraphy, but patients' renal function must be monitored. (131)I-MIBG may be effective for malignant neuroblastoma, paraganglioma or pheochromocytoma, but its side-effects need to be

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

    ERIC Educational Resources Information Center

    Silverman, Michael J.

    2008-01-01

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

  1. Coaching as a Family-Centred, Occupational Therapy Intervention for Autism: A Literature Review

    ERIC Educational Resources Information Center

    Simpson, Desley

    2015-01-01

    Occupational therapy interventions for autism spectrum disorder (ASD) require a sound evidence-base. In the context of emerging evidence on coaching interventions in paediatric occupational therapy practice, a review of the occupational therapy literature was conducted to investigate the use of coaching interventions for children and adolescents…

  2. Characterization of scintillator crystals for usage as prompt gamma monitors in particle therapy

    NASA Astrophysics Data System (ADS)

    Roemer, K.; Pausch, G.; Bemmerer, D.; Berthel, M.; Dreyer, A.; Golnik, C.; Hueso-González, F.; Kormoll, T.; Petzoldt, J.; Rohling, H.; Thirolf, P.; Wagner, A.; Wagner, L.; Weinberger, D.; Fiedler, F.

    2015-10-01

    Particle therapy in oncology is advantageous compared to classical radiotherapy due to its well-defined penetration depth. In the so-called Bragg peak, the highest dose is deposited; the tissue behind the cancerous area is not exposed. Different factors influence the range of the particle and thus the target area, e.g. organ motion, mispositioning of the patient or anatomical changes. In order to avoid over-exposure of healthy tissue and under-dosage of cancerous regions, the penetration depth of the particle has to be monitored, preferably already during the ongoing therapy session. The verification of the ion range can be performed using prompt gamma emissions, which are produced by interactions between projectile and tissue, and originate from the same location and time of the nuclear reaction. The prompt gamma emission profile and the clinically relevant penetration depth are correlated. Various imaging concepts based on the detection of prompt gamma rays are currently discussed: collimated systems with counting detectors, Compton cameras with (at least) two detector planes, or the prompt gamma timing method, utilizing the particle time-of-flight within the body. For each concept, the detection system must meet special requirements regarding energy, time, and spatial resolution. Nonetheless, the prerequisites remain the same: the gamma energy region (2 to 10 MeV), high counting rates and the stability in strong background radiation fields. The aim of this work is the comparison of different scintillation crystals regarding energy and time resolution for optimized prompt gamma detection.

  3. 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

  4. Gabapentin Therapy in Psychiatric Disorders: A Systematic Review

    PubMed Central

    Berlin, Rachel K.; Butler, Paul M.; Perloff, Michael D.

    2015-01-01

    Objective: Gabapentin is commonly used off-label in the treatment of psychiatric disorders with success, failure, and controversy. A systematic review of the literature was performed to elucidate the evidence for clinical benefit of gabapentin in psychiatric disorders. Data sources: Bibliographic reference searches for gabapentin use in psychiatric disorders were performed in PubMed and Ovid MEDLINE search engines with no language restrictions from January 1, 1983, to October 1, 2014, excluding nonhuman studies. For psychiatric references, the keywords bipolar, depression, anxiety, mood, posttraumatic stress disorder (posttraumatic stress disorder and PTSD), obsessive-compulsive disorder (obsessive-compulsive disorder and OCD), alcohol (abuse, dependence, withdraw), drug (abuse, dependence, withdraw), opioid (abuse, dependence, withdraw), cocaine (abuse, dependence, withdraw), and amphetamine (abuse, dependence, withdraw) were crossed with gabapentin OR neurontin. Study selection and data extraction: The resulting 988 abstracts were read by 2 reviewers; references were excluded if gabapentin was not a study compound or psychiatric symptoms were not studied. The resulting references were subsequently read, reviewed, and analyzed; 219 pertinent to gabapentin use in psychiatric disorders were retained. Only 34 clinical trials investigating psychiatric disorders contained quality of evidence level II-2 or higher. Results: Gabapentin may have benefit for some anxiety disorders, although there are no studies for generalized anxiety disorder. Gabapentin has less likely benefit adjunctively for bipolar disorder. Gabapentin has clearer efficacy for alcohol craving and withdrawal symptoms and may have a role in adjunctive treatment of opioid dependence. There is no clear evidence for gabapentin therapy in depression, PTSD prevention, OCD, or other types of substance abuse. Limitations of available data include variation in dosing between studies, gabapentin as monotherapy or

  5. Modeling Combined Chemotherapy and Particle Therapy for Locally Advanced Pancreatic Cancer

    PubMed Central

    Durante, Marco; Tommasino, Francesco; Yamada, Shigeru

    2015-01-01

    Pancreatic ductal adenocarcinoma is the only cancer for which deaths are predicted to increase in 2014 and beyond. Combined radiochemotherapy protocols using gemcitabine and hypofractionated X-rays are ongoing in several clinical trials. Recent results indicate that charged particle therapy substantially increases local control of resectable and unresectable pancreas cancer, as predicted from previous radiobiology studies considering the high tumor hypoxia. Combination with chemotherapy improves the overall survival (OS). We compared published data on X-ray and charged particle clinical results with or without adjuvant chemotherapy calculating the biological effective dose. We show that chemoradiotherapy with protons or carbon ions results in 1 year OS significantly higher than those obtained with other treatment schedules. Further hypofractionation using charged particles may result in improved local control and survival. A comparative clinical trial using the standard X-ray scheme vs. the best current standard with carbon ions is crucial and may open new opportunities for this deadly disease. PMID:26217585

  6. 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

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

    PubMed

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

    2014-02-01

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

  8. Cardiac Resynchronization Therapy in CKD: A Systematic Review

    PubMed Central

    Garg, Neha; Thomas, George; Jackson, Gregory; Rickard, John; Nally, Joseph V.; Tang, W.H. Wilson

    2013-01-01

    Summary Background Cardiac resynchronization therapy (CRT) confers morbidity and mortality benefits to selected patients with heart failure. This systematic review examined effects of CRT in CKD patients (estimated GFR [eGFR] <60 ml/min per 1.73 m2). Design, setting, participants, & measurements MEDLINE and Scopus (from 1990 to December 2012) and conference proceedings abstracts were searched for relevant observational studies and randomized controlled trials (RCTs). Studies comparing the following outcomes were included: (1) CKD patients with and without CRT and (2) CKD patients with CRT to non-CKD patients with CRT. Mortality, eGFR, and left ventricular ejection fraction data were extracted and pooled when appropriate using a random-effects model. Results Eighteen studies (14 observational studies and 4 RCTs) were included. There was a modest improvement in eGFR with CRT among CKD patients (mean difference 2.30 ml/min per 1.73m2; 95% confidence interval, 0.33 to 4.27). Similarly, there was a significant improvement in left ventricular ejection with CRT in CKD patients (mean difference 6.24%; 95% confidence interval, 3.46 to 9.07). Subgroup analysis of three RCTs reported lower rates of death or hospitalization for heart failure with CRT (versus other therapy) in the CKD population. Survival outcomes of CKD patients (compared with the non-CKD population) with CRT differed among observational studies and RCTs. Conclusions CRT improves left ventricular and renal function in the CKD population with heart failure. Given the increasing use of cardiac devices, further studies examining the effects of CRT on mortality in CKD patients, particularly those with advanced kidney disease, are warranted. PMID:23660183

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

    PubMed

    Scheinfeld, Noah

    2008-01-01

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

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

    PubMed

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

    2005-03-01

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

  11. 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

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

    SciTech Connect

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

    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

  13. External beam re-irradiation, combination chemoradiotherapy, and particle therapy for the treatment of recurrent glioblastoma

    PubMed Central

    Taunk, Neil K.; Moraes, Fabio Y.; Escorcia, Freddy E.; Mendez, Lucas Castro; Beal, Kathryn; Marta, Gustavo N.

    2016-01-01

    SUMMARY Glioblastoma is a common aggressive primary malignant brain tumor, and is nearly universal in progression and mortality after initial treatment. Re-irradiation presents a promising treatment option for progressive disease, both palliating symptoms and potentially extending survival. Highly conformal radiation techniques such as stereotactic radiosurgery and hypofractionated radiosurgery are effective short courses of treatment that allow delivery of high doses of therapeutic radiation with steep dose gradients to protect normal tissue. Patients with higher performance status, younger age, and longer interval between primary treatment and progression represent the best candidates for re-irradiation. Multiple studies are also underway involving combinations of radiation and systemic therapy to bend the survival curve and improve the therapeutic index. In the multimodal treatment of recurrent high-grade glioma, the use of surgery, radiation, and systemic therapy should be highly individualized. Here we comprehensively review radiation therapy and techniques, along with discussion of combination treatment and novel strategies. PMID:26781426

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

    PubMed Central

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

    2014-01-01

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

  15. Application of 212Pb for Targeted α-particle Therapy (TAT): Pre-clinical and Mechanistic Understanding through to Clinical Translation

    PubMed Central

    Yong, Kwon; Brechbiel, Martin

    2015-01-01

    Targeted α-particle therapy (TAT), in which an α-particle emitting radionuclide is specifically directed to a biological target, is gaining more attention to treat cancers as new targets are validated. Bio-vectors such as monoclonal antibodies are able to selectively transport α-particles to destroy targeted cancer cells. TAT has the potential for an improved therapeutic ratio over β-particle targeted conjugate therapy. The short path length and the intense ionization path generated render α-emitters suitable for treatment and management of minimal disease such as micrometastases or residual tumor after surgical debulking. 212Pb is the longer-lived parent radionuclide of 212Bi and serves as an in vivo generator of 212Bi. 212Pb has demonstrated significant utility in both in vitro and in vivo models. Recent evaluation of 212Pb-TCMC-trastuzumab in a Phase I clinical trial has demonstrated the feasibility of 212Pb in TAT for the treatment of ovarian cancer patients. This review highlights progress in radionuclide production, radiolabeling chemistry, molecular mechanisms, and application of 212Pb to targeted pre-clinical and clinical radiation therapy for the management and treatment of cancer. PMID:26858987

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

    SciTech Connect

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

    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.

  17. 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.

  18. Simulated presence therapy for dementia: a systematic review protocol

    PubMed Central

    Abraha, Iosief; Rimland, Joseph M; Lozano-Montoya, Isabel; Dell'Aquila, Giuseppina; Vélez-Díaz-Pallarés, Manuel; Trotta, Fabiana M; Cherubini, Antonio

    2016-01-01

    Introduction The majority of patients with dementia develop behavioural and psychological symptoms of dementia (BPSD). Non-pharmacological interventions are an appealing alternative for the treatment of BPSD in patients with dementia. Simulated presence therapy (SPT) is a simple and inexpensive non-pharmacological intervention that can be used to treat BPSD. We propose a Cochrane protocol for the collection and assessment of evidence concerning the efficacy of SPT to treat relevant outcomes in people with dementia. Methods and analysis We will search the following electronic databases: the Cochrane Dementia and Cognitive Improvement Group's Specialised Register MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, CENTRAL and a number of trial registers as well as grey literature sources. We will include randomised and quasi-randomised controlled trials (including cross-over studies) that evaluated SPT in people with dementia. Comparators such as usual care with no additional activity, or any activity that differs in content and approach from SPT, but is additional to usual care, will be considered. The primary outcomes of interest will comprise behavioural and psychological symptoms, as measured by relevant scales, and quality of life. Two review authors working independently and in tandem will be involved in title and abstract screening, full-text screening and data abstraction. Where possible, quantitative data will be pooled, and relative risk and mean difference with 95% CI will be employed for dichotomous and continuous data, respectively. Assessment of risk of bias will be performed using the Cochrane risk-of-bias tool and the Grades of Recommendation, Assessment, Development and Evaluation approach. Ethics and dissemination Ethics approval is not required. The final results of this systematic review will be presented to the Cochrane Library and will also be disseminated at relevant conference presentations. Trial registration number CRD42015029778. PMID:27169742

  19. Review paper: basic concepts to novel therapies: a review of the diabetic foot.

    PubMed

    O'Loughlin, Aonghus; McIntosh, Caroline; Dinneen, Sean F; O'Brien, Timothy

    2010-06-01

    Diabetes mellitus is a global epidemic. Peripheral neuropathy and peripheral vascular disease are complications of diabetes mellitus and the primary causative factors for foot ulceration. Foot ulceration is the leading cause of hospitalization in people with diabetes mellitus. The burden of foot ulceration on health care systems and individual patients is immense. Despite conventional treatment, there persists a high incidence of amputation. A multidisciplinary approach is required to prevent ulcers. This review describes the etiology and risk factors for diabetic foot ulceration and a system for evaluating the diabetic foot. The assessment of neuropathy and the grading of foot ulcers are critically examined. This is important to allow for standardization in clinical trials. The management of diabetic foot syndrome is reviewed. The treatments to ensure vascular supply to the lower limb and control of infection as well as novel therapies, which are becoming available to treat nonhealing, "no-option" diabetic ulcers, are discussed. PMID:20483808

  20. Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises.

    PubMed

    Han, Byung In; Song, Hyun Seok; Kim, Ji Soo

    2011-12-01

    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

  1. 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

  2. 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

  3. 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

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

    PubMed Central

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

    2013-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-02-01

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

  6. Cost-effectiveness of Occupational Therapy in Older People: Systematic Review of Randomized Controlled Trials.

    PubMed

    Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Yamauchi, Keita

    2016-06-01

    A systematic review of the cost-effectiveness of occupational therapy for older people was conducted. MEDLINE, CINAHL, Web of Science, PsycINFO, Cochrane Library, OT seeker and unpublished trials registers were searched. Reference lists of all potentially eligible studies were searched with no language restrictions. We included trial-based full economic evaluations that considered both costs and outcomes in occupational therapy for older people compared with standard care (i.e. other therapy) or no intervention. We reviewed each trial for methodological quality using the Cochrane risk of bias tool and assessed the quality of economic evaluations using a Drummond checklist. In the results of this review, we included five eligible studies (1-5) that were randomized controlled trials with high-quality economic evaluation. Two studies were full economic evaluations of interventions for fall prevention (1 and 2); two studies were full economic evaluations of preventive occupational therapy interventions (3 and 4; one was a comparison of an occupational therapy group with a social work group); one study was a full economic evaluation of occupational therapy for individuals with dementia (5). Two of the studies (one was preventive occupational therapy [3] and the other was occupational therapy for dementia [5]) found a significant effect and confirmed the cost-effectiveness of occupational therapy for older people compared with the control group. These studies found that occupational therapy for older people was clinically effective and cost-effective in comparison with standard care or other therapies. With reference to their clinical implication, these intervention studies (using a client-centred approach) suggested potentially cost-effective means to motivate clients to maintain their own health. However, this review has limitations because of the high heterogeneity of the reviewed studies on full economic evaluations of occupational therapy for older people. Future

  7. Combined Néel and Brown rotational Langevin dynamics in magnetic particle imaging, sensing, and therapy

    SciTech Connect

    Reeves, Daniel B.; Weaver, John B.

    2015-11-30

    Magnetic nanoparticles have been studied intensely because of their possible uses in biomedical applications. Biosensing using the rotational freedom of particles has been used to detect biomarkers for cancer, hyperthermia therapy has been used to treat tumors, and magnetic particle imaging is a promising new imaging modality that can spatially resolve the concentration of nanoparticles. There are two mechanisms by which the magnetization of a nanoparticle can rotate, a fact that poses a challenge for applications that rely on precisely one mechanism. The challenge is exacerbated by the high sensitivity of the dominant mechanism to applied fields. Here, we demonstrate stochastic Langevin equation simulations for the combined rotation in magnetic nanoparticles exposed to oscillating applied fields typical to these applications to both highlight the existing relevant theory and quantify which mechanism should occur in various parameter ranges.

  8. Photodynamic therapy platform based on localized delivery of photosensitizer by vaterite submicron particles.

    PubMed

    Svenskaya, Yu I; Pavlov, A M; Gorin, D A; Gould, D J; Parakhonskiy, B V; Sukhorukov, G B

    2016-10-01

    The elaboration of biocompatible and biodegradable carriers for photosensitizer targeted delivery is one of the most promising approaches in a modern photodynamic therapy (PDT). This approach is aimed at reducing sides effects connected with incidental toxicity in healthy tissue whilst also enhancing drug accumulation in the tumour area. In the present work, Photosens-loaded calcium carbonate (CaCO3) submicron particles in vaterite modification are proposed as a novel platform for anticancer PDT. Fast penetration of the carriers (0.9±0.2μm in diameter) containing 0.12% (w/w) of the photosensitizer into NIH3T3/EGFP cells is demonstrated. The captured particles provide the dye localization inside the cell increasing its local concentration, compared with "free" Photosens solution which is uniformly distributed throughout the cell. The effect of photosensitizer encapsulation into vaterite submicron particles on cell viability under laser irradiation (670nm, 19mW/cm(2), 10min) is discussed in the work. As determined by a viability assay, the encapsulation renders Photosens more phototoxic. By this means, CaCO3 carriers allow improvement of the photosensitizer effectiveness supposing, therefore, the reduction of therapeutic dose. Summation of these effects with the simplicity, upscalability and cheapness of fabrication, biocompatibility and high payload ability of the vaterite particles hold out the prospect of a novel PDT platform. PMID:27318962

  9. 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

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

    PubMed

    Qadir, Muhammad Imran

    2015-01-01

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

  11. A review of trials evaluating nonstatin lipid-lowering therapies.

    PubMed

    Ansell, Benjamin J

    2009-01-01

    Recently reported clinical trials raise doubts on the effectiveness of nonstatin lipid-lowering therapies in reducing the residual risk of cardiovascular events after statin monotherapy. Addition of -torcetrapib to statin therapy increased overall mortality in coronary patients despite a marked increase in high-density lipoprotein cholesterol. Combining ezetimibe with statin therapy neither further reduces carotid atherosclerosis nor slows aortic stenosis, and it has not been shown to be superior to statin monotherapy in reducing cardiovascular events. Clinical trials currently in progress will more clearly delineate the cardiovascular effects of adding either ezetimibe or extended-release niacin/laropiprant to statin therapy. PMID:19080730

  12. Cost effectiveness of therapies for atrial fibrillation. A review.

    PubMed

    Teng, M P; Catherwood, L E; Melby, D P

    2000-10-01

    Atrial fibrillation is the most common supraventricular tachyarrhythmia encountered in clinical practice, affecting over 5% of persons over the age of 65 years. A common pathophysiological mechanism for arrhythmia development is atrial distention and fibrosis induced by hypertension, coronary artery disease or ventricular dysfunction. Less frequently, atrial fibrillation is caused by mitral stenosis or other provocative factors such as thyrotoxicosis, pericarditis or alcohol intoxication. Depending on the extent of associated cardiovascular disease, atrial fibrillation may produce haemodynamic compromise, or symptoms such as palpitations, fatigue, chest pain or dyspnoea. Arrhythmia-induced atrial stasis can precipitate clot formation and the potential for subsequent thromboembolism. Comprehensive management of atrial fibrillation requires a multifaceted approach directed at controlling symptoms, protecting the patient from ischaemic stroke or peripheral embolism and possible conversion to or maintenance of sinus rhythm. Numerous randomised trials have demonstrated the efficacy of warfarin--and less so aspirin (acetylsalicylic acid)--in reducing the risk of embolic events. Furthermore, therapeutic strategies exist that can favourably modify symptoms by restoring and maintaining sinus rhythm with cardioversion and antiarrhythmic prophylaxis. However, the risks and benefits of various treatments is highly dependent on patient-specific features, emphasising the need for an individualised approach. This article reviews the findings of cost-effectiveness studies published over the past decade that have evaluated different components of treatment strategies for atrial fibrillation. These studies demonstrate the economic attractiveness of acute management options, long term warfarin prophylaxis, telemetry-guided initiation of antiarrhythmic therapy, approaches to restore and maintain sinus rhythm, and the potential role of transoesophageal echocardiographic screening for

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

    PubMed

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

    2015-02-01

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

  14. Experimental investigation of irregular motion impact on 4D PET-based particle therapy monitoring.

    PubMed

    Tian, Y; Stützer, K; Enghardt, W; Priegnitz, M; Helmbrecht, S; Bert, C; Fiedler, F

    2016-01-21

    Particle therapy positron emission tomography (PT-PET) is an in vivo and non-invasive imaging technique to monitor treatment delivery in particle therapy. The inevitable patient respiratory motion during irradiation causes artefacts and inaccurate activity distribution in PET images. Four-dimensional (4D) maximum likelihood expectation maximisation (4D MLEM) allows for a compensation of these effects, but has up to now been restricted to regular motion for PT-PET investigations. However, intra-fractional motion during treatment might differ from that during acquisition of the 4D-planning CT (e.g. amplitude variation, baseline drift) and therefore might induce inaccurate 4D PET reconstruction results. This study investigates the impact of different irregular analytical one-dimensional (1D) motion patterns on PT-PET imaging by means of experiments with a radioactive source and irradiated moving phantoms. Three sorting methods, namely phase sorting, equal amplitude sorting and event-based amplitude sorting, were applied to manage the PET list-mode data. The influence of these sorting methods on the motion compensating algorithm has been analysed. The event-based amplitude sorting showed a superior performance and it is applicable for irregular motions with ⩽ 4 mm amplitude elongation and drift. For motion with 10 mm baseline drift, the normalised root mean square error was as high as 10.5% and a 10 mm range deviation was observed. PMID:26733104

  15. Experimental investigation of irregular motion impact on 4D PET-based particle therapy monitoring

    NASA Astrophysics Data System (ADS)

    Tian, Y.; Stützer, K.; Enghardt, W.; Priegnitz, M.; Helmbrecht, S.; Bert, C.; Fiedler, F.

    2016-01-01

    Particle therapy positron emission tomography (PT-PET) is an in vivo and non-invasive imaging technique to monitor treatment delivery in particle therapy. The inevitable patient respiratory motion during irradiation causes artefacts and inaccurate activity distribution in PET images. Four-dimensional (4D) maximum likelihood expectation maximisation (4D MLEM) allows for a compensation of these effects, but has up to now been restricted to regular motion for PT-PET investigations. However, intra-fractional motion during treatment might differ from that during acquisition of the 4D-planning CT (e.g. amplitude variation, baseline drift) and therefore might induce inaccurate 4D PET reconstruction results. This study investigates the impact of different irregular analytical one-dimensional (1D) motion patterns on PT-PET imaging by means of experiments with a radioactive source and irradiated moving phantoms. Three sorting methods, namely phase sorting, equal amplitude sorting and event-based amplitude sorting, were applied to manage the PET list-mode data. The influence of these sorting methods on the motion compensating algorithm has been analysed. The event-based amplitude sorting showed a superior performance and it is applicable for irregular motions with  ⩽4 mm amplitude elongation and drift. For motion with 10 mm baseline drift, the normalised root mean square error was as high as 10.5% and a 10 mm range deviation was observed.

  16. 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.

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

    ERIC Educational Resources Information Center

    Messer, Larry D., Jr.

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

  18. [Music therapy for dementia and higher cognitive dysfunction: a review].

    PubMed

    Satoh, Masayuki

    2011-12-01

    Music is known to affect the human mind and body. Music therapy utilizes the effects of music for medical purposes. The history of music therapy is quite long, but only limited evidence supports its usefulness in the treatment of higher cognitive dysfunction. As for dementia, some studies conclude that music therapy is effective for preventing cognitive deterioration and the occurrence of behavioral and psychological symptoms of dementia (BPSD). In patients receiving music therapy for the treatment of higher cognitive dysfunction, aphasia was reported as the most common symptom. Many studies have been conducted to determine whether singing can improve aphasic symptoms: singing familiar and/or unfamiliar songs did not show any positive effect on aphasia. Melodic intonation therapy (MIT) is a method that utilizes melody and rhythm to improve speech output. MIT is a method that is known to have positive effects on aphasic patients. Some studies of music therapy for patients with unilateral spatial neglect; apraxia; hemiparesis; and walking disturbances, including parkinsonian gait, are available in the literature. Studies showed that the symptoms of unilateral spatial neglect and hemiparesis significantly improved when musical instruments were played for several months as a part of the music therapy. Here, I describe my study in which mental singing showed a positive effect on parkinsonian gait. Music is interesting, and every patient can go through training without any pain. Future studies need to be conducted to establish evidence of the positive effects of music therapy on neurological and neuropsychological symptoms. PMID:22147456

  19. Complementary/alternative therapies for premenstrual syndrome: a systematic review of randomized controlled trials.

    PubMed

    Stevinson, C; Ernst, E

    2001-07-01

    Complementary/alternative therapies are popular with women who have premenstrual syndrome. This systematic review was designed to determine whether use of such therapies is supported by evidence of effectiveness from rigorous clinical trials. Trials were located through searching 7 databases and checking the reference lists of articles. Randomized controlled trials investigating a complementary/alternative therapy in women with premenstrual syndrome published in the peer-reviewed literature were included in the review. Twenty-seven trials were included investigating herbal medicine (7 trials), homeopathy (1), dietary supplements (13), relaxation (1), massage (1), reflexology (1) chiropractic (1), and biofeedback (2). Despite some positive findings, the evidence was not compelling for any of these therapies, with most trials suffering from various methodological limitations. On the basis of current evidence, no complementary/alternative therapy can be recommended as a treatment for premenstrual syndrome. PMID:11483933

  20. The use of particle acceleration machines in radiotherapy: A review

    NASA Astrophysics Data System (ADS)

    Bosio, C.; Pelliccioni, M.

    1982-10-01

    The effects of the dosage and the oxygen enhancement ratio when using particle accelerators in radiotherapy are discussed. The advantages derived from the Bragg peak effect and pion mass to energy conversion are commented on. Machines to produce electrons, X rays, protons, neutrons, heavy ions and negative pions are described. The good results observed in the case of negative pions can be attributed either to the favorable dose distribution or to the specific biological properties of the particles produced in the process of pion capture. The cost factors of the generating machines are also discussed.

  1. MONDO: A neutron tracker for particle therapy secondary emission fluxes measurements

    NASA Astrophysics Data System (ADS)

    Marafini, M.; Patera, V.; Pinci, D.; Sarti, A.; Sciubba, A.; Spiriti, E.

    2016-07-01

    Cancer treatment is performed, in Particle Therapy, using accelerated charged particles whose high irradiation precision and conformity allows the tumor destruction while sparing the surrounding healthy tissues. Dose release monitoring devices using photons and charged particles produced by the beam interaction with the patient body have already been proposed, but no attempt based on the detection of the abundant secondary radiation neutron component has been made yet. The reduced attenuation length of neutrons yields a secondary particle sample that is larger in number when compared to photons and charged particles. Furthermore, neutrons allow for a backtracking of the emission point that is not affected by multiple scattering. Since neutrons can release a significant dose far away from the tumor region, a precise measurement of their flux, production energy and angle distributions is eagerly needed in order to improve the Treatment Planning Systems (TPS) software, so to predict not only the normal tissue toxicity in the target region but also the risk of late complications in the whole body. All the aforementioned issues underline the importance for an experimental effort devoted to the precise characterization of the neutron production gaining experimental access both to the emission point and production energy. The technical challenges posed by a neutron detector aiming for a high detection efficiency and good backtracking precision will be addressed within the MONDO (MOnitor for Neutron Dose in hadrOntherapy) project. The MONDO's main goal is to develop a tracking detector targeting fast and ultrafast secondary neutrons. The tracker is composed by a scintillating fiber matrix (4 × 4 × 8cm3). The full reconstruction of protons, produced in elastic interactions, will be used to measure energy and direction of the impinging neutron. The neutron tracker will measure the neutron production yields, as a function of production angle and energy, using different

  2. 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.

  3. 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.

  4. Advances in 4D Treatment Planning for Scanned Particle Beam Therapy — Report of Dedicated Workshops

    PubMed Central

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

    2014-01-01

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

  5. Review: Particle number size distributions from seven major sources and implications for source apportionment studies

    NASA Astrophysics Data System (ADS)

    Vu, Tuan V.; Delgado-Saborit, Juana Maria; Harrison, Roy M.

    2015-12-01

    The particle number size distribution (PNSD) of airborne particles not only provides us with information about sources and atmospheric processing of particles, but also plays an important role in determining regional lung dose. As a result, urban particles and their size distributions have received much attention with a rapid increase of publications in recent years. The object of this review is to synthesise and analyse existing knowledge on particles in urban environments with a focus on their number concentration and size distribution. This study briefly reviews the characterization of PNSD from seven major sources of urban particles including traffic emissions, industrial emissions, biomass burning, cooking, transported aerosol, marine aerosol and nucleation. It then discusses atmospheric physical processes such as coagulation or condensation which have a strong influence on PNSD. Finally, the implications of PNSD datasets for source modelling are briefly discussed. Based on this review, it is concluded that the concentrations, modal structures and temporal patterns of urban particles are strongly influenced by traffic emissions, which are identified as the main source of particle number in urban environments. Information derived from particle number size distributions is beginning to play an important role in source apportionment studies.

  6. BIOLOGICAL EFFECTS OF UTAH VALLEY PARTICLES: A REVIEW

    EPA Science Inventory

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

  7. 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…

  8. 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…

  9. The Role of Descending Modulation in Manual Therapy and Its Analgesic Implications: A Narrative Review

    PubMed Central

    Vigotsky, Andrew D.; Bruhns, Ryan P.

    2015-01-01

    Manual therapy has long been a component of physical rehabilitation programs, especially to treat those in pain. The mechanisms of manual therapy, however, are not fully understood, and it has been suggested that its pain modulatory effects are of neurophysiological origin and may be mediated by the descending modulatory circuit. Therefore, the purpose of this review is to examine the neurophysiological response to different types of manual therapy, in order to better understand the neurophysiological mechanisms behind each therapy's analgesic effects. It is concluded that different forms of manual therapy elicit analgesic effects via different mechanisms, and nearly all therapies appear to be at least partially mediated by descending modulation. Additionally, future avenues of mechanistic research pertaining to manual therapy are discussed. PMID:26788367

  10. Biofield therapies in cardiovascular disease management: a brief review.

    PubMed

    Anderson, Joel G; Taylor, Ann Gill

    2011-01-01

    Though there have been advances over the last 30 years in the therapeutic approaches to cardiovascular disease (CVD), heart disease and stroke remain the leading cause of mortality and morbidity worldwide. Many medical therapies for CVD are associated with a number of side effects, often leading patients to seek non-pharmacological treatments to complement standard care. Referred to as complementary and alternative medicine (CAM), these therapies consist of a heterogeneous group of modalities used in addition to conventional health care. Biofield therapies exist within this CAM domain and involve the direction of healing energy to facilitate general health and well-being by modifying the energy field. What follows is a brief overview of three biofield therapies developed or used within the field of nursing (Therapeutic Touch, Reiki, and Healing Touch), surveying the use of these interventions for individuals with CVD, and outcomes that may impact CVD risk factors and health-related quality of life. PMID:21697661

  11. Review of ion beam therapy: Present and Future

    SciTech Connect

    Alonso, Jose R.

    2000-06-01

    First therapy efforts at the Bevalac using neon ions took place in the 70's and 80's. Promising results led to construction of HIMAC in Chiba Japan, and more recently to therapy trials at GSI. Both these facilities are now treating patients with carbon beams. Advances in both accelerator technology and beam delivery have taken place at these two centers. Plans are well along for new facilities in Europe and Japan.

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

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

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

  13. Elderly health and literature therapy: a theoretical review.

    PubMed

    Eum, Yeongcheol; Yim, Jongeun; Choi, Wonjae

    2014-01-01

    Recently, the problems of old age have been discussed in terms of two aspects: preventive and therapeutic approach. The previous studies on the preventive aspect have been mostly concerned with the educational preparation for successful approach to elderly, directing focus toward the transitional period of the old age. Most research into the therapeutic aspect on the elderly diseases has focused on organic mental disorders such as dementia and functional mental diseases such as depression. This study aims to suggest the preventive and new therapeutic possibility in old people through combining the elderly health with literature. First, the research results regarding the social background for the elderly problems indicate that geriatric diseases increase in proportion to the increase of the population. Secondly, for the literature therapy, it is initially required to seek a comprehensive understanding about the health of the elderly through the phased consideration for the elderly problems. Thirdly, for the treatment of geriatric diseases by using literature, it is necessary to develop more active and integrative literature therapy than passive bibliotherapy. Literature therapy is the use of literature in the treatment of people with emotional or mental illness. Fourthly, theoretical approach should be considered for the health of the elderly and the literature therapy. From a literary approach, the literature therapy can help the study on geriatric diseases such as dementia and depression. Thus, the program for the health of geriatric issues and literature therapy should be developed as the next step in the future. PMID:24522118

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

    NASA Astrophysics Data System (ADS)

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

    2013-09-01

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

  15. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2015-02-01

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

  17. Contemporary Cognitive Behavior Therapy: A Review of Theory, History, and Evidence.

    PubMed

    Thoma, Nathan; Pilecki, Brian; McKay, Dean

    2015-09-01

    Cognitive behavior therapy (CBT) has come to be a widely practiced psychotherapy throughout the world. The present article reviews theory, history, and evidence for CBT. It is meant as an effort to summarize the forms and scope of CBT to date for the uninitiated. Elements of CBT such as cognitive therapy, behavior therapy, and so-called "third wave" CBT, such as dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT) are covered. The evidence for the efficacy of CBT for various disorders is reviewed, including depression, anxiety disorders, personality disorders, eating disorders, substance abuse, schizophrenia, chronic pain, insomnia, and child/adolescent disorders. The relative efficacy of medication and CBT, or their combination, is also briefly considered. Future directions for research and treatment development are proposed. PMID:26301761

  18. Complementary Therapies for Significant Dysfunction from Tinnitus: Treatment Review and Potential for Integrative Medicine

    PubMed Central

    Wolever, Ruth Q.; Price, Rebecca; Hazelton, A. Garrett; Dmitrieva, Natalia O.; Bechard, Elizabeth M.; Shaffer, Janet K.; Tucci, Debara L.

    2015-01-01

    Tinnitus is a prevalent and costly chronic condition; no universally effective treatment exists. Only 20% of patients who report tinnitus actually seek treatment, and when treated, most patients commonly receive sound-based and educational (SBE) therapy. Additional treatment options are necessary, however, for nonauditory aspects of tinnitus (e.g., anxiety, depression, and significant interference with daily life) and when SBE therapy is inefficacious or inappropriate. This paper provides a comprehensive review of (1) conventional tinnitus treatments and (2) promising complementary therapies that have demonstrated some benefit for severe dysfunction from tinnitus. While there has been no systematic study of the benefits of an Integrative Medicine approach for severe tinnitus, the current paper reviews emerging evidence suggesting that synergistic combinations of complementary therapies provided within a whole-person framework may augment SBE therapy and empower patients to exert control over their tinnitus symptoms without the use of medications, expensive devices, or extended programs. PMID:26457113

  19. Boron analysis for neutron capture therapy using particle-induced gamma-ray emission.

    PubMed

    Nakai, Kei; Yamamoto, Yohei; Okamoto, Emiko; Yamamoto, Tetsuya; Yoshida, Fumiyo; Matsumura, Akira; Yamada, Naoto; Kitamura, Akane; Koka, Masashi; Satoh, Takahiro

    2015-12-01

    The neutron source of BNCT is currently changing from reactor to accelerator, but peripheral facilities such as a dose-planning system and blood boron analysis have still not been established. To evaluate the potential application of particle-induced gamma-ray emission (PIGE) for boron measurement in clinical boron neutron capture therapy, boronophenylalanine dissolved within a cell culture medium was measured using PIGE. PIGE detected 18 μgB/mL f-BPA in the culture medium, and all measurements of any given sample were taken within 20 min. Two hours of f-BPA exposure was required to create a boron distribution image. However, even though boron remained in the cells, the boron on the cell membrane could not be distinguished from the boron in the cytoplasm. PMID:26242558

  20. Design and characterization of an SRAM-based neutron detector for particle therapy

    NASA Astrophysics Data System (ADS)

    Ytre-Hauge, Kristian S.; Velure, Arild; Larsen, Eivind F.; Stokkevåg, Camilla H.; Röhrich, Dieter; Brekke, Njål; Odland, Odd Harald

    2015-12-01

    A neutron detector based on registration of radiation effects in Static Random Access Memories (SRAMs) has been developed at the University of Bergen for applications in particle therapy. Nine different SRAMs were tested and a 16 Mibit SRAM from Cypress was chosen for the final detector. The SRAMs were irradiated in beam lines at PTB Braunschweig, the Oslo Cyclotron Laboratory, The Svedberg Laboratory, The Institute for Energy Technology (IFE, Kjeller) and the CERN-EU high-energy reference field. The results from the measurements demonstrate the feasibility of using the selected SRAMs for neutron detection. The results indicate low or no sensitivity to thermal neutrons while the cross section for fast neutrons increases with neutron energy before reaching a more stable level at energies of several tenths of MeV.

  1. 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 (2σ), measured Hounsfield Unit of 28.9 ±6.1 (2σ)). 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

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

    NASA Astrophysics Data System (ADS)

    Ebina, Futaro; Umezawa, Masumi; Hiramoto, Kazuo

    2013-04-01

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

  3. 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

    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.

  4. Combinations of Radiation Therapy and Immunotherapy for Melanoma: A Review of Clinical Outcomes

    SciTech Connect

    Barker, Christopher A.; Postow, Michael A.

    2014-04-01

    Radiation therapy has long played a role in the management of melanoma. Recent advances have also demonstrated the efficacy of immunotherapy in the treatment of melanoma. Preclinical data suggest a biologic interaction between radiation therapy and immunotherapy. Several clinical studies corroborate these findings. This review will summarize the outcomes of studies reporting on patients with melanoma treated with a combination of radiation therapy and immunotherapy. Vaccine therapies often use irradiated melanoma cells, and may be enhanced by radiation therapy. The cytokines interferon-α and interleukin-2 have been combined with radiation therapy in several small studies, with some evidence suggesting increased toxicity and/or efficacy. Ipilimumab, a monoclonal antibody which blocks cytotoxic T-lymphocyte antigen-4, has been combined with radiation therapy in several notable case studies and series. Finally, pilot studies of adoptive cell transfer have suggested that radiation therapy may improve the efficacy of treatment. The review will demonstrate that the combination of radiation therapy and immunotherapy has been reported in several notable case studies, series and clinical trials. These clinical results suggest interaction and the need for further study.

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

    ERIC Educational Resources Information Center

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

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

  6. 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.

  7. Alternative medicine in periodontal therapy--a review.

    PubMed

    Mangal, Brijesh; Sugandhi, Ayushi; Kumathalli, Kanteshwari I; Sridhar, Raja

    2012-04-01

    Periodontal diseases continue to be most commonly occurring oral diseases in modern times. Many therapeutic modalities have been tried and tested to relieve these problems. The conventional therapy--scaling and root planing (SRP)--stands out to be the most used mode of treatment, and other treatments remain applicable as adjuncts to SRP, including acupuncture, acupressure, and aromatherapy. The present article discusses the applications of the abovementioned therapeutic modes and their relevance in current scenarios. Alternative medicine may be preferred as an adjunct to conventional periodontal therapy to relieve pain, bad breath, gingival inflammation, mouth ulcers, and mouth sores. PMID:22483182

  8. A Review of Methods for Evaluating Particle Stability in Suspension Based Pressurized Metered Dose Inhalers.

    PubMed

    D'Sa, Dexter; Chan, Hak-Kim

    2015-01-01

    Advances in particle engineering techniques, such as spray drying, freeze drying and supercritical fluid precipitation, have greatly enhanced the ability to control the structure, morphology, and solid state phase of inhalable sized particles (1 - 5 µm) for formulation in pressurized metered dose inhalers (pMDI). To optimize the properties of these engineered particles for formulation in hydrofluoroalkane propellants (HFA 134a / 227) it is necessary to measure both bulk and individual particle properties before, after, and during formulation. This review examines established and recently developed methods for evaluating a variety of particle properties including but not limited to size, surface and internal morphology, chemical composition, and solid state phase. Novel methods for evaluating particle physical and chemical stability directly in propellant or similar environments are also discussed. PMID:26290200

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-05-01

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

  11. Production of [211At]-Astatinated Radiopharmaceuticals and Applications in Targeted α-Particle Therapy

    PubMed Central

    Guérard, François; Gestin, Jean-François

    2013-01-01

    Abstract 211At is a promising radionuclide for α-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. 211At is produced by cyclotron irradiation of 209Bi with α-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 211At. 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

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

    PubMed

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

    2013-02-01

    (211)At is a promising radionuclide for α-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 α-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

  13. [Influence of inhaler and fine particle on efficacy of inhalation therapy in COPD].

    PubMed

    Sliwiński, Paweł; Chazan, Ryszarda; Dąbrowiecki, Piotr; Jahnz-Różyk, Karina; Mróz, Robert; Pirożyński, Michał

    2014-01-01

    Orally inhaled products delivered via inhalation exert their effect directly to the target organ. This allows to administer a very low dose of a drug compared with an oral route with similar clinical effect and significantly reduced toxicity. However inhalation therapy is also limited by several factors. Delivery of the desired dose of the drug to the airways depends on a type of the inhaler - pressurised metered-dose inhaler (pMDI) or dry powder inhaler (DPI), inhaler characteristics (low or high internal resistance, diameter of particles and distribution of the generated aerosol fine particles), thermal conditions of air, and ability of patient to generate sufficient inspiratory flow (for DPI) or to coordinate actuation with inhalation (for pMDI). Unlike pMDIs, DPIs are breath- -actuated, hence avoiding the need for the patient to coordinate actuation with inspiration. Furthermore, DPIs are propellant-free and do not produce the cold sensation on inhalation. Currently available DPIs vary widely in design, operating characteristics and performance. And poor inhalation technique may compromise treatment efficacy. Hence, there is a clear need for a careful selection of DPIs for different patient groups, including children, elderly patients and those with severe airway obstruction. PMID:24793155

  14. Antibiotic desensitization therapy in secondary syphilis and Listeria infection: case reports and review of desensitization therapy.

    PubMed

    Magpantay, Gil; Cardile, Anthony P; Madar, Cristian S; Hsue, Gunther; Belnap, Conrad

    2011-12-01

    Two adult cases, one of secondary syphilis and one of Listeria monocytogenes bacteremia, in which antibiotic desensitization therapy was utilized to assist treatment of active infection in the face of severe penicillin allergy. Clinical considerations are discussed that led to the decision to employ a formal desensitization procedure. Antibiotic desensitization protocols can facilitate optimal and safe antibiotic therapy in the appropriate clinical setting. PMID:22187514

  15. Systematic review of occupational therapy-related interventions for people with multiple sclerosis: part 2. Impairment.

    PubMed

    Yu, Chih-Huang; Mathiowetz, Virgil

    2014-01-01

    This article is the second part of a systematic review of studies on occupational therapy-related intervention for people with multiple sclerosis (MS). The objective of this systematic review was to critically appraise and synthesize the applicable findings to address the following focused question: What is the evidence for the effectiveness of interventions within the scope of occupational therapy practice for people with multiple sclerosis? Part 1 (Yu & Mathiowetz, 2014) reviewed evidence for the effectiveness of activity- and participation-based interventions for people with MS. In contrast to the top-down approach, enabling occupational performance can be achieved through remediating impaired personal abilities. Therefore, Part 2 focuses on occupational therapy interventions targeting impairment. Studies included in this review focused on improving client factors and performance skills in people with MS, including cognition, emotional regulation, and motor and praxis skills. PMID:24367953

  16. A challenge for theranostics: is the optimal particle for therapy also optimal for diagnostics?

    NASA Astrophysics Data System (ADS)

    Dreifuss, Tamar; Betzer, Oshra; Shilo, Malka; Popovtzer, Aron; Motiei, Menachem; Popovtzer, Rachela

    2015-09-01

    Theranostics is defined as the combination of therapeutic and diagnostic capabilities in the same agent. Nanotechnology is emerging as an efficient platform for theranostics, since nanoparticle-based contrast agents are powerful tools for enhancing in vivo imaging, while therapeutic nanoparticles may overcome several limitations of conventional drug delivery systems. Theranostic nanoparticles have drawn particular interest in cancer treatment, as they offer significant advantages over both common imaging contrast agents and chemotherapeutic drugs. However, the development of platforms for theranostic applications raises critical questions; is the optimal particle for therapy also the optimal particle for diagnostics? Are the specific characteristics needed to optimize diagnostic imaging parallel to those required for treatment applications? This issue is examined in the present study, by investigating the effect of the gold nanoparticle (GNP) size on tumor uptake and tumor imaging. A series of anti-epidermal growth factor receptor conjugated GNPs of different sizes (diameter range: 20-120 nm) was synthesized, and then their uptake by human squamous cell carcinoma head and neck cancer cells, in vitro and in vivo, as well as their tumor visualization capabilities were evaluated using CT. The results showed that the size of the nanoparticle plays an instrumental role in determining its potential activity in vivo. Interestingly, we found that although the highest tumor uptake was obtained with 20 nm C225-GNPs, the highest contrast enhancement in the tumor was obtained with 50 nm C225-GNPs, thus leading to the conclusion that the optimal particle size for drug delivery is not necessarily optimal for imaging. These findings stress the importance of the investigation and design of optimal nanoparticles for theranostic applications.Theranostics is defined as the combination of therapeutic and diagnostic capabilities in the same agent. Nanotechnology is emerging as an

  17. Review of Intrathecal Baclofen Therapy for Spastic and Rigidity Disorders

    ERIC Educational Resources Information Center

    Obringer, S. John; Coffey, Kenneth M.

    2002-01-01

    Intrathecal baclofen therapy, a treatment for cerebral palsy and other spastic and rigidity disorders, is showing promise as an effective intervention. This article synthesizes both the medical and rehabilitation conceptual literature to update educators and related service providers as to the efficacy of this intervention. Implications for…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  19. 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…

  20. Treating addiction with tunes: a systematic review of music therapy for the treatment of patients with addictions.

    PubMed

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

    2008-01-01

    Music therapy is the use of musical interventions in a therapeutic setting to accomplish health-related goals. Descriptions of music therapy exist in the peer-reviewed literature and indicate potential use of music therapy in treatment of patients with addiction disorders. This systematic review describes and compares the types of music therapy demonstrated in the literature and evaluates the evidence that music therapy improves outcomes of patients with addictions. A search and critical review of all the existing published literature on music therapy for the treatment of addictions was conducted using online databases and secondary search strategies. Few studies quantitatively assess the use of music therapy in the treatment of patients with addictions. Music listening provided by music therapists is commonly studied. Music therapy sessions reported were additive, not independent, treatment modalities. In the literature, no consensus exists regarding of the efficacy of music therapy as treatment for patients with addictions. PMID:19042198

  1. 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.

  2. Inhaled aerosol particle dosimetry in mice: a review.

    PubMed

    Méndez, Loyda B; Gookin, Glenn; Phalen, Robert F

    2010-10-01

    The availability of molecular and genetic tools has made the mouse the most common animal model for a variety of human diseases in toxicology studies. However, little is known about the factors that will influence the dose delivery to murine lungs during an inhalation study. Among these factors are the respiratory tract anatomy, lung physiology, and clearance characteristics. Therefore, the objective of this paper is to briefly review the current knowledge on the aforementioned factors in mice and their implications to the dose delivered to mouse models during inhalation studies. Representative scientific publications were chosen from searches using the NCBI PubMed and ISI Web of Knowledge databases. Relevant respiratory physiological differences have been widely reported for different mouse strains and sexes. The limited data on anatomical morphometry that is available for the murine respiratory tract indicates significant differences between mouse strains. These differences have implications to the dose delivered and the biological outcomes of inhalation studies. PMID:20879957

  3. Inhaled aerosol particle dosimetry in mice: a review.

    PubMed

    Méndez, Loyda B; Gookin, Glenn; Phalen, Robert F

    2010-12-01

    The availability of molecular and genetic tools has made the mouse the most common animal model for a variety of human diseases in toxicology studies. However, little is known about the factors that will influence the dose delivery to murine lungs during an inhalation study. Among these factors are the respiratory tract anatomy, lung physiology, and clearance characteristics. Therefore, the objective of this paper is to briefly review the current knowledge on the aforementioned factors in mice and their implications to the dose delivered to mouse models during inhalation studies. Representative scientific publications were chosen from searches using the NCBI PubMed and ISI Web of Knowledge databases. Relevant respiratory physiological differences have been widely reported for different mouse strains and sexes. The limited data on anatomical morphometry that is available for the murine respiratory tract indicates significant differences between mouse strains. These differences have implications to the dose delivered and the biological outcomes of inhalation studies. PMID:21142796

  4. Clostridium difficile infection: a review of current and emerging therapies

    PubMed Central

    Ofosu, Andrew

    2016-01-01

    Clostridium difficile (C. difficile) infection (CDI) is the most common cause of ­healthcare-associated infections in US hospitals. The epidemic strain NAP1/BI/ribotype 027 accounts for outbreaks worldwide, with increasing mortality and severity. CDI is acquired from an endogenous source or from spores in the environment, most easily acquired during the hospital stay. The use of antimicrobials disrupts the intestinal microflora enabling C. difficile to proliferate in the colon and produce toxins. Clinical diagnosis in symptomatic patients requires toxin detection from stool specimens and rarely in combination with stool culture to increase sensitivity. However, stool culture is essential for epidemiological studies. Oral metronidazole is the recommended therapy for milder cases of CDI and oral vancomycin or fidaxomicin for more severe cases. Treatment of first recurrence involves the use of the same therapy used in the initial CDI. In the event of a second recurrence oral vancomycin often given in a tapered dose or intermittently, or fidaxomicin may be used. Fecal transplantation is playing an immense role in therapy of recurrent CDI with remarkable results. Fulminant colitis and toxic megacolon warrant surgical intervention. Novel approaches including new antibiotics and immunotherapy against CDI or its toxins appear to be of potential value. PMID:27065726

  5. 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

  6. Gas Flow, Particle Acceleration, and Heat Transfer in Cold Spray: A review

    NASA Astrophysics Data System (ADS)

    Yin, Shuo; Meyer, Morten; Li, Wenya; Liao, Hanlin; Lupoi, Rocco

    2016-06-01

    Cold spraying is increasingly attracting attentions from both scientific and industrial communities due to its unique `low-temperature' coating build-up process and its potential applications in the additive manufacturing across a variety of industries. The existing studies mainly focused on the following subjects: particle acceleration and heating, coating build-up, coating formation mechanism, coating properties, and coating applications, among which particle acceleration and heating can be regarded as the premise of the other subjects because it directly determines whether particles have sufficient energy to deposit and form the coating. Investigations on particle acceleration and heating behavior in cold spraying have been widely conducted both numerically and experimentally over decades, where many valuable conclusions were drawn. However, existing literature on this topic is vast; a systematical summery and review work is still lack so far. Besides, some curtail issues involved in modeling and experiments are still not quite clear, which needs to be further clarified. Hence, a comprehensive summary and review of the literature are very necessary. In this paper, the gas flow, particle acceleration, and heat transfer behavior in the cold spray process are systematically reviewed. Firstly, a brief introduction is given to introduce the early analytical models for predicting the gas flow and particle velocity in cold spraying. Subsequently, special attention is directed towards the application of computational fluid dynamics technique for cold spray modeling. Finally, the experimental observations and measurements in cold spraying are summarized.

  7. Gas Flow, Particle Acceleration, and Heat Transfer in Cold Spray: A review

    NASA Astrophysics Data System (ADS)

    Yin, Shuo; Meyer, Morten; Li, Wenya; Liao, Hanlin; Lupoi, Rocco

    2016-04-01

    Cold spraying is increasingly attracting attentions from both scientific and industrial communities due to its unique `low-temperature' coating build-up process and its potential applications in the additive manufacturing across a variety of industries. The existing studies mainly focused on the following subjects: particle acceleration and heating, coating build-up, coating formation mechanism, coating properties, and coating applications, among which particle acceleration and heating can be regarded as the premise of the other subjects because it directly determines whether particles have sufficient energy to deposit and form the coating. Investigations on particle acceleration and heating behavior in cold spraying have been widely conducted both numerically and experimentally over decades, where many valuable conclusions were drawn. However, existing literature on this topic is vast; a systematical summery and review work is still lack so far. Besides, some curtail issues involved in modeling and experiments are still not quite clear, which needs to be further clarified. Hence, a comprehensive summary and review of the literature are very necessary. In this paper, the gas flow, particle acceleration, and heat transfer behavior in the cold spray process are systematically reviewed. Firstly, a brief introduction is given to introduce the early analytical models for predicting the gas flow and particle velocity in cold spraying. Subsequently, special attention is directed towards the application of computational fluid dynamics technique for cold spray modeling. Finally, the experimental observations and measurements in cold spraying are summarized.

  8. Review of 3D image data calibration for heterogeneity correction in proton therapy treatment planning.

    PubMed

    Zhu, Jiahua; Penfold, Scott N

    2016-06-01

    Correct modelling of the interaction parameters of patient tissues is of vital importance in proton therapy treatment planning because of the large dose gradients associated with the Bragg peak. Different 3D imaging techniques yield different information regarding these interaction parameters. Given the rapidly expanding interest in proton therapy, this review is written to make readers aware of the current challenges in accounting for tissue heterogeneities and the imaging systems that are proposed to tackle these challenges. A summary of the interaction parameters of interest in proton therapy and the current and developmental 3D imaging techniques used in proton therapy treatment planning is given. The different methods to translate the imaging data to the interaction parameters of interest are reviewed and a summary of the implementations in several commercial treatment planning systems is presented. PMID:27115163

  9. Particle-based simulations of red blood cells-A review.

    PubMed

    Ye, Ting; Phan-Thien, Nhan; Lim, Chwee Teck

    2016-07-26

    Particle-based methods have been increasingly attractive for solving biofluid flow problems, because of the ease and flexibility in modeling complex structure fluids afforded by the methods. In this review, we focus on popular particle-based methods widely used in red blood cell (RBC) simulations, including dissipative particle dynamics (DPD), smoothed particle hydrodynamics (SPH), and lattice Boltzmann method (LBM). We introduce their basic ideas and formulations, and present their applications in RBC simulations which are divided into three classes according to the number of RBCs in the simulation: a single RBC, two or multiple RBCs, and RBC suspension. Furthermore, we analyze their advantages and disadvantages. On weighing the pros and cons of the methods, a combination of the immersed boundary (IB) method and some forms of smoothed dissipative particle hydrodynamics (SDPD) methods may be required to deal effectively with RBC simulations. PMID:26706718

  10. Global eradication rates for Helicobacter pylori infection: systematic review and meta-analysis of sequential therapy

    PubMed Central

    Vakil, Nimish; Vaira, Dino; Scarpignato, Carmelo

    2013-01-01

    Objective To do a systematic review and meta-analysis of studies comparing sequential therapy for eradication of Helicobacter pylori with pre-existing and new therapies, thus providing a glimpse of eradication success worldwide. Design Systematic review and meta-analysis. Data sources Medline, Embase, and Cochrane Central Register of Controlled Trials up to May 2013; abstract books of major European, American, and Asian gastroenterological meetings. Study selection Randomised controlled trials in previously untreated adults, in which sequential therapy was compared with a pre-existing or new therapy. Results 46 randomised controlled trials were reviewed and analysed. 5666 patients were randomised to sequential therapy and 7866 to other (established and new) treatments. The overall eradication rate of sequential therapy was 84.3% (95% confidence interval 82.1% to 86.4%). Sequential therapy was superior to seven day triple therapy (relative risk 1.21, 95% confidence interval 1.17 to 1.25; I2=29.3%; number needed to treat 6 , 95% confidence interval 5% to 7%), marginally superior to 10 day triple therapy (1.11, 1.04 to 1.19; I2= 67.2%; NNT 10, 7 to 15), but not superior to 14 day triple therapy (1.00, 0.94 to 1.06; I2=54.3%), bismuth based therapy (1.01, 0.95 to 1.06; I2=21.1%), and non-bismuth based therapy (0.99, 0.94 to 1.05; I2=52.3%). Data on eradication according to pre-treatment antimicrobial susceptibility testing were available in eight studies, and sequential therapy was able to eradicate 72.8% (61.6% to 82.8%) of the strains resistant to clarithromycin. Conclusions Eradication rates with pre-existing and new therapies for H pylori are suboptimal. Regional monitoring of resistance rates should help to guide treatment, and new agents for treatment need to be developed. PMID:23926315

  11. A Brief Review of the Search for Isolatable Fractional Charge Elementary Particles

    SciTech Connect

    Perl, M.

    2005-01-31

    Since the initial measurements of the electron charge a century ago, experimenters have faced the persistent question as to whether elementary particles exist that have charges that are fractional multiples of the electron charge. In the standard model of particle physics the quarks are such particles, but it is assumed that quarks cannot be individually isolated, the quarks always being confined inside hadrons. This paper is a brief review of the present status of searches for isolatable fractional charge particles such as a lepton-like particle with fractional charge or an unconfined quark. There have been a very large number of searches but there is no confirmed evidence for existence of isolatable fractional charge particles. It may be that they do not exist, but it is also possible that they are very massive or that their production mechanisms are very small so that they have been missed by existing searches. Therefore the aim of this review is to urge (a) the invention of ways to substantially increase the range of known search methods and (b) to urge the invention of new search methods for isolatable fractional charge particles.

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

    PubMed Central

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

    2013-01-01

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

  13. 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

  14. 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

  15. Patient-reported outcomes after neoadjuvant therapy for rectal cancer: a systematic review.

    PubMed

    Gavaruzzi, Teresa; Lotto, Lorella; Giandomenico, Francesca; Perin, Alessandro; Pucciarelli, Salvatore

    2014-08-01

    Neoadjuvant therapy followed by total mesorectal excision is standard of care for locally advanced rectal cancer. However, this approach has been previously shown to be associated with high rate of morbidity and it may have a negative effect on patients' reported outcomes (PROs). In order to summarize findings on the effect of the neoadjuvant approach on PROs, we systematically reviewed articles published in the last five years. Thirty-five articles met the inclusion criteria. Ten articles compared the effect of surgery with and without neoadjuvant therapy, six articles compared different neoadjuvant therapies, ten articles reported on patients who were all treated with neoadjuvant therapy, and nine articles examined the effect of neoadjuvant therapy in the analyses. The results are summarized by function investigated and critically commented. PMID:24745308

  16. Stabilized plasmid-lipid particles for regional gene therapy: formulation and transfection properties.

    PubMed

    Zhang, Y P; Sekirov, L; Saravolac, E G; Wheeler, J J; Tardi, P; Clow, K; Leng, E; Sun, R; Cullis, P R; Scherrer, P

    1999-08-01

    Previous work (Wheeler et al, Gene Therapy 1999; 6: 271-281) has shown that plasmid DNA can be entrapped in 'stabilized plasmid-lipid particles' (SPLP) containing the fusogenic lipid dioleoylphosphatidylethanolamine (DOPE), low levels (5-10 mol%) of cationic lipid, and stabilized by a polyethyleneglycol (PEG) coating. The PEG moieties are attached to a ceramide anchor containing an arachidoyl acyl group (PEG-CerC20). These SPLP exhibit low transfection potencies in vitro, due in part to the long residence time of the PEG-CerC20 on the SPLP surface. In this work we employed SPLP stabilized by PEG attached to ceramide containing an octanoyl acyl group (PEG-CerC8), which is able to quickly exchange out of the SPLP, to develop systems that give rise to optimized in vitro and in vivo (regional) transfection. A particular objective was to achieve cationic lipid contents that give rise to maximum transfection levels. It is shown that by performing the dialysis procedure in the presence of increasing concentrations of citrate, SPLP containing up to 30 mol% of the cationic lipid dioleoydimethylammonium chloride (DODAC) could be generated. The SPLP produced could be isolated from empty vesicles by sucrose density gradient centrifugation, and exhibited a narrow size distribution (62 +/- 8 nm, as determined by freeze-fracture electron microscopy) and a high plasmid-to-lipid ratio of 65 microg/micromol (corresponding to one plasmid per particle) regardless of the DODAC content. It was found that isolated SPLP containing 20-24 mol% DODAC resulted in optimum transfection of COS-7 and HepG2 cells in vitro, with luciferase expression levels comparable to those achieved for plasmid DNA-cationic lipid complexes. In vivo studies employing an intraperitoneal B16 tumor model and intraperitoneal administration of SPLP also demonstrated maximum luciferase expression for DODAC contents of 20-24 mol% and significantly improved gene expression in tumor tissue as compared with complexes. We

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

    PubMed Central

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

    2008-01-01

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

  18. Effect of temporomandibular disorder therapy on otologic signs and symptoms: a systematic review.

    PubMed

    Stechman-Neto, J; Porporatti, A L; Porto de Toledo, I; Costa, Y M; Conti, P C R; De Luca Canto, G; Mezzomo, L A

    2016-06-01

    The most common temporomandibular disorders (TMD) signs and symptoms are related to muscle sensitivity through palpation, restricted mouth opening, asymmetric mandibular movements, joint sounds, pain and otologic signs and symptoms. To date, counselling, occlusal splints, exercises, biofeedback and acupuncture are examples of conservative modalities proposed for TMD therapy. The aim of this systematic review was to investigate the effect of these conservative therapies for TMD on otologic signs and symptoms. The authors searched the following electronic databases published up to 1st May 2015: PubMed, LILACS, Scopus, Web of Science and Science Direct with no time or language limitations. Using a two-phase selection process, the authors identified 08 articles and used them to conduct a qualitative analysis. Methodological quality of each article was performed with the aid of 'Quality Assessment of a Cohort Study' and 'Quality Assessment of a Randomized Clinical Trial', developed by the Dutch Cochrane Centre, a centre of the Cochrane Collaboration. This systematic review showed in seven of the eight studies included that a total or partial resolution of otologic complains occurred after counselling, exercise therapies and occlusal splint therapy. Upon the limitations of the studies included in this systematic review, the present outcomes suggested that there is insufficient evidence in favour or against the conservative therapies for TMD on changes in otologic signs and symptoms. Thus, further studies with a higher level of evidence and more representative samples should be conducted to better understand the relationship of TMD therapy changes on otologic complains. PMID:26749516

  19. Integrative Therapies and Cardiovascular Disease in the Breast Cancer Population: A Review, Part 1

    PubMed Central

    Lucius, Khara; Trukova, Kristen

    2015-01-01

    The cardiovascular toxicities of breast cancer treatment are important health problems, with potential public health consequences. Integrative therapies may represent important tools for prevention in this population. This article reviews the cardiotoxicity of conventional breast cancer therapy, including chemotherapy, radiation, and hormonal therapy. Data are presented on the benefits of substances such as curcumin, melatonin, Ginkgo biloba, resveratrol, coenzyme Q10, and l-carnitine. Although clinical studies on many of these substances are limited both in size and number, preclinical studies are available for several, and this article summarizes the potential mechanisms of action. Areas for future research are also identified. PMID:26770154

  20. Chest CT for suspected pulmonary complications of oncologic therapies: how I review and report.

    PubMed

    Diederich, Stefan

    2016-01-01

    In cancer patient during or following oncologic therapies with respiratory symptoms and pulmonary pathology at chest CT the differential diagnosis includes infection, therapy-induced disease and tumour progression.Although CT morphology may be typical or even pathognomonic in some conditions the diagnosis is usually made by a synopsis of imaging, clinical and laboratory features.Close communication with referring colleagues and a good knowledge of potential side effects of therapeutic concepts, their time course and CT morphology is crucial in the differential diagnosis.This review describes a personal approach to the radiological diagnosis of therapy-induced pulmonary abnormalities in cancer patients. PMID:27067027

  1. 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 (γ,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

  2. Integrative Therapies and Cardiovascular Disease in the Breast Cancer Population: A Review, Part 1.

    PubMed

    Lucius, Khara; Trukova, Kristen

    2015-08-01

    The cardiovascular toxicities of breast cancer treatment are important health problems, with potential public health consequences. Integrative therapies may represent important tools for prevention in this population. This article reviews the cardiotoxicity of conventional breast cancer therapy, including chemotherapy, radiation, and hormonal therapy. Data are presented on the benefits of substances such as curcumin, melatonin, Ginkgo biloba, resveratrol, coenzyme Q10, and l-carnitine. Although clinical studies on many of these substances are limited both in size and number, preclinical studies are available for several, and this article summarizes the potential mechanisms of action. Areas for future research are also identified. PMID:26770154

  3. 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

  4. Review of antifungal therapy and the severity index for assessing onychomycosis: part I.

    PubMed

    Baran, Robert; Hay, Rod J; Garduno, Javier I

    2008-01-01

    This review outlines recent data on treatment modalities and outcomes with antifungal therapy in onychomycosis. Included are topical, mechanical, chemical and systemic treatments or a combination thereof. Topical treatments, or transungual drug delivery systems (TUDDS), including ciclopirox and amorolfine were shown to be effective if used alone for mild-moderate nail involvement. Specifically, superficial white onychomycosis (SWO) restricted to the dorsum of the nail plate and moderate distal lateral subungual onychomycosis (DLSO). Mechanical treatments were mostly effective as adjuncts to topical therapy which include nail avulsion and abrasion. In particular, partial nail avulsion aids topical therapy in DLSO and partial subungual onychomycosis for a more effective therapy. Chemical avulsion is a painless method of debridement which uses a keratinolysis formula that is effective only in limited and early disease. Systemic therapies have been shown to be effective with terbinafine and itraconazole is suggested as being the most cost-effective therapy. Systemic therapies require consideration of side effects and monitoring by both patient and physician prior to treatment application. An effective suggestion is the use of a topical with debridement for mild-moderate onychomycosis and systemic (terbinafine) plus topical for severe onychomycosis. Most treatment modalities will require long-term use from 3 to 9 months to be most effective, with strategies presented in Part II of this review. PMID:18484426

  5. A systematic review of Internet-based therapy for the treatment of addictions.

    PubMed

    Gainsbury, Sally; Blaszczynski, Alex

    2011-04-01

    Traditional therapies for addictions are underutilized and characterized by high attrition rates suggesting they may not meet the needs of a proportion of individuals with addiction-related problems including problem drinking, smoking, substance use and problem gambling. Internet-based therapy has emerged as a new treatment modality for psychological disorders and health issues and this review is the first attempt to summarize and evaluate the evidence of the effectiveness of Internet therapy for addictions. Extensive literature searches were conducted to identify studies meeting the criteria of delivering structured Internet-based treatment programs for addictions that incorporated a component of trained therapist interaction. Only nine studies met criteria for inclusion with seven representing a randomized controlled trial. These included seven papers reporting on tobacco-cessation programs, one Internet-based therapy for pathological gambling, and one treatment program for substance abuse. A range of therapeutic models, treatment components and outcome measures was included across these studies. Positive treatment effects were reported following completion of therapy and at longer-term follow-up. The review concluded that Internet-based therapies for addictions are effective in achieving positive behavioral changes but that more research is required to determine the comparative effectiveness of various Internet-based therapies and their components. PMID:21146272

  6. Can particle beam therapy be improved using helium ions? - a planning study focusing on pediatric patients.

    PubMed

    Knäusl, Barbara; Fuchs, Hermann; Dieckmann, Karin; Georg, Dietmar

    2016-06-01

    Aim To explore the potential of scanned helium ion beam therapy ((4)He) compared to proton therapy in a comparative planning study focusing on pediatric patients. This was motivated by the superior biological and physical characteristics of (4)He. Material and methods For eleven neuroblastoma (NB), nine Hodgkin lymphoma (HL), five Wilms tumor (WT), five ependymoma (EP) and four Ewing sarcoma (EW) patients, treatment plans were created for protons and (4)He. Dose prescription to the planning target volume (PTV) was 21 Gy [relative biological effectiveness (RBE)] (NB), 19.8 Gy (RBE) (HL), 25.2 Gy (RBE) for the WT boost volume and 54 Gy (RBE) for EP and EW patients. A pencil beam algorithm for protons (constant RBE = 1.1) and (4)He was implemented in the treatment planning system Hyperion. For (4)He the relative biological effectiveness (RBE) was calculated with a 'zonal' model based on different linear energy transfer regions. Results Target constraints were fulfilled for all indications. For NB patients differences for kidneys and liver were observed for all dose-volume areas, except the high-dose volume. The body volume receiving up to 12.6 Gy (RBE) was reduced by up to 10% with (4)He. For WT patients the mean and high-dose volume for the liver was improved when using (4)He. For EP normal tissue dose was reduced using (4)He with 12.7% of the voxels receiving higher doses using protons. For HL and EW sarcoma patients the combination of large PTV volumes with the position of the organs at risk (OARs) obliterated the differences between the two particle species, while patients with the heart close to the PTV could benefit from (4)He. Conclusion Treatment plan quality improved with (4)He compared to proton plans, but advantages in OAR sparing were depending on indication and tumor geometries. These first results of scanned (4)He therapy motivate comprehensive research on (4)He, including acquisition of experimental data to improve modeling of (4)He. PMID

  7. 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 β+-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

  8. Adverse Events of Auricular Therapy: A Systematic Review

    PubMed Central

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

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-03-01

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

  10. Review of the economic evaluations of hormonal therapy for patients with locally advanced prostate cancer.

    PubMed

    Hatoum, Hind T; Crawford, E David; Nielsen, Sandy Kildegaard; Lin, Swu-Jane; Marshall, Dennis C

    2013-04-01

    Androgen deprivation therapy (ADT) is used as first-line therapy for locally advanced or metastatic prostate cancer aiming to reduce testosterone to castrate levels. The authors present an overview of the existing cost-effectiveness studies of ADT in prostate cancer. Cost-effectiveness of ADT was reviewed using a systematic search of the peer-reviewed literature, as well as research abstracts presented at various scientific and industry meetings. Most cost-effectiveness analyses of ADT reported results within the accepted societal threshold of US$50,000 cost/quality-adjusted life year needed to adopt new technology. PMID:23570436

  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. Particle Disease: A Current Review of the Biological Mechanisms in Periprosthetic Osteolysis After Hip Arthroplasty

    PubMed Central

    Sukur, Erhan; Akman, Yunus Emre; Ozturkmen, Yusuf; Kucukdurmaz, Fatih

    2016-01-01

    Background: Inflammatory responses to wear debris cause osteolysis that leads to aseptic prosthesis loosening and hip arthroplasty failure. Although osteolysis is usually associated with aseptic loosening, it is rarely seen around stable implants. Aseptic implant loosening is a simple radiologic phenomenon, but a complex immunological process. Particulate debris produced by implants most commonly causes osteolysis, and this is called particle-associated periprosthetic osteolysis (PPO). Objective: The objective of this review is to outline the features of particle-associated periprosthetic osteolysis to allow the physician to recognise this condition and commence early treatment, thereby optimizing patient outcome. Methods: A thorough literature search was performed using available databases, including Pubmed, to cover important research published covering particle-associated PPO. Results: Although osteolysis causes bone resorption, clinical, animal, and in vitro studies of particle bioreactivity suggest that particle-associated PPO represents the culmination of several biological reactions of many cell types, rather than being caused solely by the osteoclasts. The biological activity is highly dependent on the characteristics and quantity of the wear particles. Conclusion: Despite advances in total hip arthroplasty (THA), particle-associated PPO and aseptic loosening continue to be major factors that affect prosthetic joint longevity. Biomarkers could be exploited as easy and objective diagnostic and prognostic targets that would enable testing for osteolysis after THA. Further research is needed to identify new biomarkers in PPO. A comprehensive understanding of the underlying biological mechanisms is crucial for developing new therapeutic interventions to reverse or suppress biological responses to wear particles. PMID:27499822

  13. Emission of ultrafine particles from the incineration of municipal solid waste: A review

    NASA Astrophysics Data System (ADS)

    Jones, Alan M.; Harrison, Roy M.

    2016-09-01

    Ultrafine particles (diameter <100 nm) are of great topical interest because of concerns over possible enhanced toxicity relative to larger particles of the same composition. While combustion processes, and especially road traffic exhaust are a known major source of ultrafine particle emissions, relatively little is known of the magnitude of emissions from non-traffic sources. One such source is the incineration of municipal waste, and this article reviews studies carried out on the emissions from modern municipal waste incinerators. The effects of engineering controls upon particle emissions are considered, as well as the very limited information on the effects of changing waste composition. The results of measurements of incinerator flue gas, and of atmospheric sampling at ground level in the vicinity of incinerators, show that typical ultrafine particle concentrations in flue gas are broadly similar to those in urban air and that consequently, after the dispersion process dilutes incinerator exhaust with ambient air, ultrafine particle concentrations are typically indistinguishable from those that would occur in the absence of the incinerator. In some cases the ultrafine particle concentration in the flue gas may be below that in the local ambient air. This appears to be a consequence of the removal of semi-volatile vapours in the secondary combustion zone and abatement plant, and the high efficiency of fabric filters for ultrafine particle collection.

  14. 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.

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

    PubMed

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

    2014-08-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-06-01

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

  17. The use of Monte Carlo methods in heavy charged particle radiation therapy.

    NASA Astrophysics Data System (ADS)

    Paganetti, Harald

    2007-03-01

    This presentation will demonstrate the importance of Monte Carlo (MC) simulations in proton therapy. MC applications will be shown which aim at 1. Modeling of the beam delivery system. MC can be used for quality assurance verification in order to understand the sensitivity of beam characteristics and how these influence the dose delivered. 2. Patient treatment dose verification. The capability of reading CT information has to be implemented into the MC code. Simulating the ionization chamber reading in the treatment head allows the dose to be specified for treatment plan verification. 3. 4D dose calculation. The patient geometry may be time dependent due to respiratory or cardiac motion. To consider this, patient specific 4D CT data can be used in combination with MC simulations. 4. Simulating positron emission. Positron emitters are produced via nuclear interactions along the beam path penetration and can be detected after treatment. Comparison between measured and MC simulated PET images can provide feedback on the intended dose in the patient. 5. Studies on radiation induced cancer risk. MC calculations based on computational anthropomorphic phantoms allow the estimation of organ dose and particle energy distributions everywhere in the patient.

  18. 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...

  19. Critical review of a quantitative study of a specialty in high energy particle physics

    SciTech Connect

    White, D H; Sullivan, D

    1980-01-01

    A review is made of the authors' series of quantitative, historical, and social studies of the weak interactions of elementary particles. A short intellectual history, the quantitative methodology, and a summary of the papers analyzing specific episodes in this field are presented. The social organization of the field is described, and an overall policy for resource management is discussed. 6 figures, 3 tables.

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

    PubMed Central

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

    2013-01-01

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

  1. 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

  2. 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

  3. Complementary and alternative therapies for treating multiple sclerosis symptoms: a systematic review.

    PubMed

    Huntley, A; Ernst, E

    2000-06-01

    Multiple sclerosis (MS) is a chronic disease of the central nervous system without a known cure. Thus the role of complementary and alternative therapies (CATs) for the management of symptoms lies in palliative care and this is borne out by the popularity of these treatments amongst MS sufferers. This review is aimed at determining whether this use is supported by evidence of effectiveness from rigorous clinical trials. Database literature searches were performed and papers were extracted in a pre-defined manner. Twelve randomized controlled trials were located that investigated a CAT for MS: nutritional therapy (4), massage (1), Feldenkrais bodywork (1), reflexology (1), magnetic field therapy (2), neural therapy (1) and psychological counselling (2). The evidence is not compelling for any of these therapies, with many trials suffering from significant methodological flaws. There is evidence to suggest some benefit of nutritional therapy for the physical symptoms of MS. Magnetic field therapy and neural therapy appear to have a short-term beneficial effect on the physical symptoms of MS. Massage/bodywork and psychological counselling seem to improve depression, anxiety and self-esteem. The effectiveness for other CATs is unproven at this time. In all the CATs examined further investigations are needed in the form of rigorous large-scale trials. PMID:10859602

  4. A Review of GM-CSF Therapy in Sepsis.

    PubMed

    Mathias, Brittany; Szpila, Benjamin E; Moore, Frederick A; Efron, Philip A; Moldawer, Lyle L

    2015-12-01

    Determine what clinical role, if any, GM-CSF may have in the clinical treatment of sepsis in the adult patient. Advancements in the management of sepsis have led to significant decreases in early mortality; however, sepsis remains a significant source of long-term mortality and disability which places strain on healthcare resources with a substantial growing economic impact. Historically, early multiple organ failure (MOF) and death in patients with severe sepsis was thought to result from an exaggerated proinflammatory response called the systemic inflammatory response syndrome (SIRS). Numerous prospective randomized controlled trials (PRCTs) tested therapies aimed at decreasing the organ injury associated with an exaggerated inflammatory response. With few exceptions, the results from these PRCTs have been disappointing, and currently no specific therapeutic agent is approved to counteract the early SIRS response in patients with severe sepsis. It has long been recognized that there is a delayed immunosuppressive state that contributes to long-term morbidity. However, recent findings now support a concurrent proinflammatory and anti-inflammatory response present throughout sepsis. Multiple immunomodulating agents have been studied to combat the immunosuppressive phase of sepsis with the goal of decreasing secondary infection, reducing organ dysfunction, decreasing ICU stays, and improving survival. Granulocyte-macrophage colony stimulating factor (GM-CSF), a myelopoietic growth factor currently used in patients with neutropenia secondary to chemotherapy-induced myelosuppression, has been studied as a potential immune-activating agent. The applicability of GM-CSF as a standard therapy for generalized sepsis is still largely understudied; however, small-scale studies available have demonstrated some improved recovery from infection, decreased hospital length of stay, decreased days requiring mechanical ventilation, and decreased medical costs. PMID:26683913

  5. Hybrid therapy for Helicobacter pylori infection: A systemic review and meta-analysis

    PubMed Central

    Hsu, Ping-I; Lin, Pei-Chin; Graham, David Y

    2015-01-01

    AIM: To compare the effectiveness of hybrid therapy with other recommended regimens using meta-analysis. METHODS: Bibliographical searches for randomized trials comparing hybrid and other therapies were performed in PubMed, the Cochrane Library and relevant congresses up to February 2015 using the following keywords (all fields and/or MeSH): (“Helicobacter pylori” or “H. pylori”) and (“hybrid therapy” or “sequential-concomitant therapy”). Meta-analyses were performed with Cochrane Review Manager 5.1. The random effect model proposed by DerSimonian and Laird and the Mantel-Haenszel method were used to estimate the pooled relative risk and 95%CI of the efficacy outcomes between hybrid therapy and other eradication therapies. RESULTS: Eight studies (2516 subjects) met entry criteria. The antimicrobial resistance in the study groups ranged from 6.9% to 23.5%. The mean cure rates of hybrid therapy by intention-to-treat (ITT) and per-protocol analyses were 88.5% (n = 1207; range: 80.0% to 97.4%) and 93.3% (n = 1109; range: 85.7% to 99.1%), respectively. Meta-analysis showed there was no significant difference in ITT eradication rate between hybrid and sequential therapy (relative risk: 1.01; 95%CI: 0.92-1.11). Subgroup analysis revealed hybrid therapy was more effective than sequential therapy in the non-Italian populations (95%CI: 1.01-1.18) and was only less effective in one, Italian population (95%CI: 0.83-0.98). There was no significant difference in eradication rate between hybrid therapy and concomitant therapy (95%CI: 0.93-1.02). No head-to-head comparisons of hybrid therapy and standard triple therapy or bismuth quadruple therapy were found. However, a multicenter, randomized trial showed that reverse hybrid therapy was superior to standard triple therapy (95.5% vs 88.6% ITT; P = 0.011). CONCLUSION: Hybrid therapy appears to be an effective, safe, and well-tolerated treatment for H. pylori infection in the era of increasing antibiotic resistance

  6. Method for the systematic reviews on occupational therapy and neurodegenerative diseases.

    PubMed

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

    2014-01-01

    Systematic reviews of the literature relevant to neurodegenerative diseases, including Parkinson's disease (PD), multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS), are important to the practice of occupational therapy. We describe the four questions that served as the focus for systematic reviews of the effectiveness of occupational therapy interventions for PD, MS, and ALS. 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 systematic 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:24367950

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

    PubMed

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

    2014-01-01

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

  8. 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

  9. A review of the clinical diagnosis and therapy of cholangiocarcinoma.

    PubMed

    Yao, Denghua; Kunam, Vamsi Krishna; Li, Xiao

    2014-02-01

    Cholangiocarcinoma (CCA) is the second most common primary hepatic malignancy worldwide. The incidence of intrahepatic CCA is increasing, whereas that of extrahepatic CCA is decreasing. This review looks at the new advances that have been made in the management of CCA, based on a PubMed and Science Citation Index search of results from randomized controlled trials, reviews, and cohort, prospective and retrospective studies. Aggressive interventional approaches and new histopathological techniques have been developed to make a histological diagnosis in patients with high risk factors or suspected CCA. Resectability of the tumour can now be assessed using multiple radiological imaging studies; the main prognostic factor after surgery is a histologically negative resection margin. Biliary drainage and/or portal vein embolization may be performed before extended radical resection, or liver transplantation may be undertaken in combination with neoadjuvant chemotherapy or chemoradiotherapy. Though many advances have been made in the management of CCA, the standard modality of treatment has not yet been established. This review focuses on the clinical options for different stages of CCA. PMID:24366497

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

    PubMed Central

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

    2001-01-01

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

  11. 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

  12. The polarization of light scattered by small particles: A personal review

    NASA Astrophysics Data System (ADS)

    Hovenier, J. W.

    2012-12-01

    A personal review of the author's field of research is presented at the occasion of his receipt of the first Van de Hulst Light-Scattering Award. Special attention is given to the relation between the author's work and the contributions of Professor H.C. van de Hulst to the field of light scattering by small particles. History, people and research are intertwined in this paper. The polarization of light scattered by particles is brought into focus. First, the interpretation of the polarization of Venus in terms of properties of its cloud particles is recorded, followed by a discussion of symmetry principles and their interrelationships. The structure of a variety of Mueller matrices is exposed. Experimental work on light scattering is also considered. Finally, the fast growth of knowledge over the past few decades pertaining to light scattering by non-spherical particles is indicated.

  13. Adjunctive Therapies to Cerclage for the Prevention of Preterm Birth: A Systematic Review

    PubMed Central

    DeFranco, Emily A.; Valent, Amy Miyoshi; Newman, Tondra; Regan, Jodi; Smith, Jessica; Muglia, Louis J.

    2013-01-01

    The aim of this paper is to provide a thorough summary of published studies that have assessed the efficacy of adjunctive therapies used in addition to cervical cerclage as a preventive measure for preterm birth. We limited our paper to patients treated with cerclage plus an additional prophylactic therapy compared to a reference group of women with cerclage alone. The specific adjunctive therapies included in this systematic review are progesterone, reinforcing or second cerclage placement, tocolytics, antibiotics, bedrest, and pessary. We searched PubMed and Cochrane databases without date criteria with restriction to English language and human studies and performed additional bibliographic review of selected articles and identified 305 total studies for review. Of those, only 12 studies compared the use of an adjunctive therapy with cerclage to a reference group of cerclage alone. None of the 12 were prospective randomized clinical trials. No comparative studies were identified addressing the issues of antibiotics, bedrest, or pessary as adjunctive treatments to cerclage. None of the 12 studies included in this paper demonstrated a clear benefit of any adjunctive therapy used in addition to cerclage over and above cerclage used alone; however, few studies with small numbers limited the strength of the conclusions. PMID:23606847

  14. Pelvic floor physical therapy for lifelong vaginismus: a retrospective chart review and interview study.

    PubMed

    Reissing, Elke D; Armstrong, Heather L; Allen, Caroline

    2013-01-01

    Pelvic floor physical therapy is used in the treatment of sexual pain disorders; however, women with lifelong vaginismus have not yet been included in treatment studies or have not been differentiated from women with acquired vaginismus and/or dyspareunia. This retrospective chart review and interview study was intended to obtain initial information on physical therapy interventions, course, and outcome in women who have never been able to experience vaginal intercourse. The files of 53 women, consecutively treated at one physical therapy clinic, were included in the chart review; 13 of these women volunteered to be interviewed. The chart review revealed significant pelvic floor pathology and an average treatment course of 29 sessions. Internal manual techniques were found to be most effective, followed by patient education, dilatation exercises, and home exercises. Although participants were very satisfied with the physical therapy, some symptoms, such as pain, anxiety/fear, and pelvic floor tension remained and scores on the Female Sexual Distress Scale and Female Sexual Function Index indicated clinical levels of sexual distress and impaired sexual function after treatment. Although there appears to be no linear relation between symptom reduction and healthy sexual function, this initial information suggests that physical therapy may be a promising treatment option for some women with lifelong vaginismus and merits further evaluation. PMID:23470141

  15. B-type natriuretic peptide-guided therapy: a systematic review.

    PubMed

    Balion, Cynthia; McKelvie, Robert; Don-Wauchope, Andrew C; Santaguida, Pasqualina L; Oremus, Mark; Keshavarz, Homa; Hill, Stephen A; Booth, Ronald A; Ali, Usman; Brown, Judy A; Bustamam, Amy; Sohel, Nazmul; Raina, Parminder

    2014-08-01

    BNP/NT-proBNP measurement has not gained widespread use for the management of patients with heart failure (HF) despite several randomized controlled trials. A systematic review addressing the question of whether patients with HF benefit from BNP-assisted therapy or intensified therapy compared with usual care was undertaken. Relevant randomized controlled trial (RCTs) were selected by searching Medline, Embase, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL for English-language articles published from 1980 to 2012. Selected studies required patients to be treated for chronic HF with medical therapy based on BNP/NT-proBNP or usual care. There were no restrictions except that BNP/NT-proBNP measurement had to be done by an FDA approved method. Nine RCTs were identified with 2,104 patients with study duration that ranged from 3 to 18 months. Overall, there was a wide variation in study design and how parameters were reported including patient selection, baseline characteristics, therapy goals, BNP/NT-proBNP cutpoint, and outcome types. Meta-analysis was not appropriate given this study heterogeneity. The strength of evidence for the outcome of mortality, reported in seven studies, was found to be low due to inconsistency and imprecision. This systematic review showed that the evidence is of low quality and insufficient to support the use of BNP/NT-proBNP to guide HF therapy. Further trials with improved design are needed. PMID:25074674

  16. 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

  17. Antithrombotic therapy in nonvalvular atrial fibrillation: a narrative review.

    PubMed

    Sá, Susana P D; Rodrigues, Rui P; Santos-Antunes, João; Rocha Gonçalves, Francisco; Nunes, José Pedro L

    2011-12-01

    Atrial fibrillation (AF) is an important and potentially modifiable cause of stroke. It has been known since 1989 that oral anticoagulant drugs, such as warfarin, lead to a dramatic decrease in stroke associated with AF. The best risk-benefit ratio is obtained with intensity of oral anticoagulant treatment for an INR of 2-3, even in the elderly. Given the risks of anticoagulant therapy, including bleeding, individual thromboembolic risk must be assessed in patients with AF. In 2009, dabigatran was shown to be a reasonable alternative to vitamin K antagonists, establishing itself as a major alternative to warfarin in AF patients. Rivaroxaban and apixaban have subsequently also been shown to be alternatives to warfarin. When there are contraindications to vitamin K antagonists, antiplatelet agents can produce a therapeutic effect, although much less than oral anticoagulants. Apixaban may be a better alternative to aspirin in this setting. Patients with low-risk atrial fibrillation (no risk factors) have not been the subjects of specific clinical trials. It is unclear what would be the best therapeutic choice for these patients. PMID:22094310

  18. Photodynamic therapy: a review of applications in neurooncology and neuropathology

    NASA Astrophysics Data System (ADS)

    Uzdensky, Anatoly B.; Berezhnaya, Elena; Kovaleva, Vera; Neginskaya, Marya; Rudkovskii, Mikhail; Sharifulina, Svetlana

    2015-06-01

    Photodynamic therapy (PDT) effect is a promising adjuvant modality for diagnosis and treatment of brain cancer. It is of importance that the bright fluorescence of most photosensitizers provides visualization of brain tumors. This is successfully used for fluorescence-guided tumor resection according to the principle "to see and to treat." Non-oncologic application of PDT effect for induction of photothrombotic infarct of the brain tissue is a well-controlled and reproducible stroke model, in which a local brain lesion is produced in the predetermined brain area. Since normal neurons and glial cells may also be damaged by PDT and this can lead to unwanted neurological consequences, PDT effects on normal neurons and glial cells should be comprehensively studied. We overviewed the current literature data on the PDT effect on a range of signaling and epigenetic proteins that control various cell functions, survival, necrosis, and apoptosis. We hypothesize that using cell-specific inhibitors or activators of some signaling proteins, one can selectively protect normal neurons and glia, and simultaneously exacerbate photodynamic damage of malignant gliomas.

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

    PubMed

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

    2015-03-12

    A one-step synthesis of Prussian blue nanoparticles possessing a concentration gradient of Gd3+ counterions, g-Gd-PB, has been developed, and the potential for the particles to perform as both MRI positive contrast agents and photothermal therapy agents is demonstrated. The synthesis of potassium/gadolinium ironhexacyanoferrate is performed under increasing concentration of Gd3+ ions forming particles with a higher concentration of gadolinium toward the outer layers. The proton relaxivity (r1) measured for the particles is 12.3 mM(-1) s(-1), and T1 weighted images of phantoms containing the particles show their potential as MRI contrast agents. In addition, the Prussian blue host can rapidly and efficiently convert energy from near-IR light into thermal energy, allowing g-Gd-PB to be used as a photothermal therapy agent. The photothermal properties are demonstrated by measuring temperature changes of particle suspensions under irradiation and by photothermal ablation of CCRF-CEM cancer cells. PMID:25706057

  20. Possible adverse events in children treated by manual therapy: a review

    PubMed Central

    2010-01-01

    Background Pediatric manual therapy is controversial within the medical community particularly with respect to adverse events. Pediatric manual therapy (Ped MT) is commonly used by a number of professions such as chiropractors, osteopaths and naturopaths for a variety of treatments in children. Ped MT interventions range from advice, light touch, massage, through to mobilisation and high velocity spinal manipulation. However, current evidence related to adverse events associated with Ped MT is not well understood. Objective To update the clinical research literature from the 2007 report by Vohra, Johnston, Cramer and Humphreys on possible adverse events in children treated by spinal manipulation. Methods A review of the clinical research literature from June 2004 until January 2010 as reported in MEDLINE, PubMed and PubMed Central for adverse events specifically related to the treatment of pediatric cases by manual therapy. Results Only three new clinical studies, one systematic review with meta-analysis and one evidence report were identified. Two clinical studies reported on chiropractic care and one on osteopathic spinal manipulation in children. The systematic review investigated all studies of adverse events and manual therapy and was not specific for pediatric patients. The evidence review focused on effectiveness of spinal manipulation in a variety of musculoskeletal conditions. No serious or catastrophic adverse events were reported in the clinical studies or systematic review. However for adults, it has been estimated that between 0.003% and 0.13% of manual therapy treatments may result in a serious adverse event. Although mild to moderate adverse events are common in adults, an accurate estimate from high quality pediatric studies is currently not available. Conclusions There is currently insufficient research evidence related to adverse events and manual therapy. However, clinical studies and systematic reviews from adult patients undergoing manual

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

    PubMed Central

    Quon, H.; Loblaw, D.A.

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Gellis, Zvi D.; Kenaley, Bonnie

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Gingerich, Wallace J.; Peterson, Lance T.

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    PubMed

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

    2014-09-01

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

  8. Review of antifungal therapy, part II: treatment rationale, including specific patient populations.

    PubMed

    Baran, Robert; Hay, Rod J; Garduno, Javier I

    2008-01-01

    This portion of the antifungal review focuses on treatment rationale and suggestions, including special populations such as the elderly, children, and pregnant and immunocompromised individuals. In elderly individuals, the pathogen may be associated with certain comorbidities; treatment should begin with local treatments such as debridement (mechanical or chemical) and a topical. In children, the pathogen most commonly isolated is Trichophyton rubrum. Children should be examined for concomitant tinea and treatment options can begin with a chemical debridement (non-painful) and a topical, with non-responders being treated with combination therapy as in adults. It is suggested that blood tests are monitored at baseline and every 4-8 weeks in children on systemic therapy. Terbinafine is the only systemic in category B and local therapies should be the primary treatment modalities in pregnancy. Prevalence of onychomycosis is high in immunocompromised patients with higher relapse rates after treatment. The same fungal infections that are seen in healthy populations are usually represented in the immunocompromised host. There is a stepwise approach that is suggested in the treatment of onychomycosis. Before treatment, several factors should be determined, which include risk for failure and compliance issues. Strategies for therapy include monotherapy, combination therapy, supplemental therapy, and intermittent therapy. Topical monotherapy is effective in early distal nail disease and for the prevention of reinfection of the cured nail. Combination therapy is an appropriate progression of therapy for patients who failed monotherapy or are at risk for failure. Combined therapies are shown to increase cure rates. Mechanical interventions are essential in reducing fungal burdens to allow other modalities to penetrate, especially in dermatophytomas and onycholysis. PMID:18569273

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

    PubMed Central

    dos Santos, Ariolana A; Carvalho, Adriana A

    2015-01-01

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

  10. Dual Antiplatelet Therapy after Coronary Artery Bypass Graft Surgery: A Review.

    PubMed

    Soomro, Hala; Aleem, Salik; Alam, Ali; Qadeer, Mohammad Ali; Essam, Nabeeha; Siddiqui, Anas Ahmed; Mansuri, Muhammad Fasih; Fatima, Huda; Raza, Ali; Sultan, Ayyaz Alam; Jameel, Rohail; Begg, Maha; Khan, Maaz Hasan; Musharraf, Muhammad Bazil; Burhan, Arbab; Lashari, Muhammad Nawaz

    2016-01-01

    Coronary artery bypass graft surgery (CABG) is the gold standard treatment for relieving angina symptoms and reducing mortality among ischemic heart disease patients. As post-operative thrombosis of the grafts has been a frequent complication of CABG, antiplatelet therapy remains essential to maintain graft patency. Since a long time, aspirin has been used as a single anti-platelet agent post CABG. However, in some high risk patients aspirin alone is insufficient in preventing graft occlusion. Therefore, dual antiplatelet therapy involving aspirin plus clopidogrel is becoming increasingly popular. Aspirin plus clopidogrel therapy has proved to be highly efficacious in patients with acute coronary syndrome; however, its role in patients after CABG has remained unclear. In this review, we outline the effects of dual antiplatelet therapy involving aspirin plus clopidogrel with respect to graft patency, post-operative angina/myocardial infarction, major bleeding event and mortality. PMID:27530557

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

    PubMed

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

    2013-01-01

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

  12. Interleukin-10 therapy--review of a new approach.

    PubMed

    Asadullah, K; Sterry, W; Volk, H D

    2003-06-01

    Interleukin (IL)-10 is an important immunoregulatory cytokine produced by many cell populations. Its main biological function seems to be the limitation and termination of inflammatory responses and the regulation of differentiation and proliferation of several immune cells such as T cells, B cells, natural killer cells, antigen-presenting cells, mast cells, and granulocytes. However, very recent data suggest IL-10 also mediates immunostimulatory properties that help to eliminate infectious and noninfectious particles with limited inflammation. Numerous investigations, including expression analyses in patients, in vitro and animal experiments suggest a major impact of IL-10 in inflammatory, malignant, and autoimmune diseases. So IL-10 overexpression was found in certain tumors as melanoma and several lymphomas and is considered to promote further tumor development. Systemic IL-10 release is a powerful tool of the central nervous system to prevent hyperinflammatory processes by activation of the neuro-endocrine axis following acute stress reactions. In contrast, a relative IL-10 deficiency has been observed and is regarded to be of pathophysiological relevance in certain inflammatory disorders characterized by a type 1 cytokine pattern such as psoriasis. Recombinant human IL-10 has been produced and is currently being tested in clinical trials. This includes rheumatoid arthritis, inflammatory bowel disease, psoriasis, organ transplantation, and chronic hepatitis C. The results are heterogeneous. They give new insight into the immunobiology of IL-10 and suggest that the IL-10/IL-10 receptor system may become a new therapeutic target. PMID:12773629

  13. Targeted therapies in small cell lung cancer: a review

    PubMed Central

    Abidin, Aidalena Z.; Garassino, Marina C.; Califano, Raffaele; Harle, Amelie; Blackhall, Fiona

    2010-01-01

    Small cell lung cancer (SCLC) is an aggressive form of lung cancer that is characterized by a rapid doubling time, early onset of dissemination and high sensitivity to chemotherapy. Despite the potential for cure in patients with limited disease with concurrent chemoradiation and an initial good response to chemotherapy in extensive disease, there is a high chance of disease relapse with an overall poor median survival for both stages. With increasing translational research and a better understanding of the molecular basis of cancer, a number of molecular targets have been identified in various preclinical studies. This review summarizes potentially viable targets and new agents that have been developed and employed in recent, ongoing and future clinical trials to attempt to improve clinical outcomes in this disease. PMID:21789124

  14. Coanalgesics for chronic pain therapy: a narrative review.

    PubMed

    Bair, Matthew J; Sanderson, Tamara R

    2011-11-01

    Chronic pain is inadequately treated in many patients, which has led clinicians and researchers to investigate new indications for existing medications with pain-relieving or adjuvant properties. These medications are known as coanalgesics. This review provides an evidence-based overview of select coanalgesics that are used in clinical practice for a variety of neuropathic and musculoskeletal pain disorders. The coanalgesics include antidepressants, anticonvulsants, topical agents, skeletal muscle relaxants, and antispasmodic agents. An update on emergent treatments and uses is also presented. The goals of this article are to highlight coanalgesic treatment options that are currently available for patients with chronic pain as well as provide guidelines for their use in clinical practice. PMID:22104463

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

    PubMed

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

    2015-03-01

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

  16. Endometrial cancer-targeted therapies myth or reality? Review of current targeted treatments.

    PubMed

    Lheureux, Stephanie; Oza, Amit M

    2016-05-01

    Endometrial cancer (EC) is the most common gynaecological malignancy in developed countries and its incidence is increasing related to obesity. EC is divided into histologic subtypes, most frequently endometrioid adenocarcinoma. Options for treatment of advanced or persistent disease remain limited, and survival has not changed in the last decade. No targeted therapy beyond hormonal therapy is approved for EC. Though hormonal therapy has been a 'standard' for four decades, prediction of its efficacy with receptor evaluation or understanding mechanisms of resistance remain important challenges. The clinical impact of deregulation of different pathways such as phosphatidylinositide 3-kinase, HER or MAPK warrant further investigation to use in a prognostic or predictive manner. The cell cycle and DNA repair pathways constitute potential targets for the development of precision therapies. Targeting the microenvironment and more recently immune infiltration are promising areas. Advances in the understanding of cell biology have allowed EC to be divided into multiple diseases that respond differently to targeted therapy. Translational clinical trials that link biology with precision targeted therapy are key to improve outcome and will require careful analysis or identification of potential biomarkers in early phase studies and validation in randomised trials. This approach requires collaborative efforts to achieve meaningful improvement in the prognosis of women with EC. This review aims to summarise the latest published trials on targeted therapies in EC and propose future directions. PMID:27017291

  17. A systematic review of oral fungal infections in patients receiving cancer therapy

    PubMed Central

    Latortue, Marie C.; Hong, Catherine H.; Ariyawardana, Anura; D’Amato-Palumbo, Sandra; Fischer, Dena J.; Martof, Andrew; Nicolatou-Galitis, Ourania; Patton, Lauren L.; Elting, Linda S.; Spijkervet, Fred K. L.; Brennan, Michael T.

    2010-01-01

    Purpose The aims of this systematic review were to determine, in patients receiving cancer therapy, the prevalence of clinical oral fungal infection and fungal colonization, to determine the impact on quality of life and cost of care, and to review current management strategies for oral fungal infections. Methods Thirty-nine articles that met the inclusion/exclusion criteria were independently reviewed by two calibrated reviewers, each using a standard form. Information was extracted on a number of variables, including study design, study population, sample size, interventions, blinding, outcome measures, methods, results, and conclusions for each article. Areas of discrepancy between the two reviews were resolved by consensus. Studies were weighted as to the quality of the study design, and recommendations were based on the relative strength of each paper. Statistical analyses were performed to determine the weighted prevalence of clinical oral fungal infection and fungal colonization. Results For all cancer treatments, the weighted prevalence of clinical oral fungal infection was found to be 7.5% pretreatment, 39.1% during treatment, and 32.6% after the end of cancer therapy. Head and neck radiotherapy and chemotherapy were each independently associated with a significantly increased risk for oral fungal infection. For all cancer treatments, the prevalence of oral colonization with fungal organisms was 48.2% before treatment, 72.2% during treatment, and 70.1% after treatment. The prophylactic use of fluconazole during cancer therapy resulted in a prevalence of clinical fungal infection of 1.9%. No information specific to oral fungal infections was found on quality of life or cost of care. Conclusions There is an increased risk of clinically significant oral fungal infection during cancer therapy. Systemic antifungals are effective in the prevention of clinical oral fungal infection in patients receiving cancer therapy. Currently available topical antifungal

  18. Sequential Therapy or Standard Triple Therapy for Helicobacter pylori Infection: An Updated Systematic Review.

    PubMed

    Feng, Li; Wen, Mao-Yao; Zhu, Yong-Jun; Men, Ruo-Ting; Yang, Li

    2016-01-01

    The effectiveness of standard triple therapy (STT) for the eradication of Helicobacter pylori has decreased recently. Sequential therapy (SQT) is a new regimen proposed to address this problem. The aim of this study was to compare the efficacy of SQT versus STT for H. pylori eradication. We searched The Cochrane Library, MEDLINE, Web of Science, and EMBASE databases up to July 2014. The risk ratios (RRs) of eradication rate were pooled, with a 95% confidence interval (CI). Thirty-six randomized clinical trials including a total of 10,316 patients met the inclusion criteria. The RR for eradication of H. pylori with SQT compared with STT was 1.14 (95% CI: 1.09-1.17), the eradication rates were 84.1% and 75.1%, respectively. There was significant heterogeneity between trial results (I = 73%; P < 0.00001). Subgroup analyses showed that SQT was superior to both 7- and 10-day STT, but not significantly better than 14-day STT. This superiority existed when patients were treated with either metronidazole or tinidazole. Patients with single clarithromycin-resistant strain showed a greater benefit of SQT over STT (eradication rates 80.9% vs. 40.7%), RR = 1.98 (95% CI: 1.33-2.94). There was no significant difference between groups in terms of the risk of adverse effects. In conclusion, SQT is more efficacious than STT (7 days and 10 days) in the eradication of HP, but the pooled rate seemed suboptimal. Further research is needed to develop more effective therapeutic approaches. Surveillance of resistance rates should be performed to guide treatment. PMID:25569598

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

    PubMed Central

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

    2014-01-01

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

  20. The effect of orthodontic therapy on periodontal health: a review of the literature.

    PubMed

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

    2014-01-01

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

  1. 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.

  2. 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

  3. A review of over-the-counter drug therapy.

    PubMed

    Esmay, J B; Wertheimer, A I

    1979-01-01

    The authors review the extent of the use of nonprescription drugs as well as possible variables influencing such consumption. Various studies indicate that age, sex, personality characteristics, perceptions of health status, socioeconomic factors, parental example, and pharmacists all play parts in determining over-the-counter (OTC) drug utilization. Several sources express concern about the inaccessibility of accurate OTC drug information to the consumer. Indeed, even the FDA has occasional difficulty obtaining reliable facts on both the numbers and formulae of such products. Several studies indicate that consumers acquire information about their home remedies through advertising, friends and relatives, physicians, pharmacists, and product labels. By far the most influential of these is advertising, and much concern has been voiced over consumers' unquestioning faith in drug ads. Examples are cited of deceptive, inaccurate, and unfair advertising practices used by some OTC drug manufacturers. The pros and cons of the "drug-oriented society" theory are discussed, including an analysis of its underlying origins. Testing of the safety and efficacy of nonrescription remedies has proved to be controversial, especially when considering the ramifications of the placebo effect. Different surveys report widespread misuse of OTC's by consumers through overuse, taking several drugs concurrently, and using home remedies to treat potentially serious diseases. PMID:500849

  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. Antioxidant Therapy Against Trypanosome Infections: A Review Update.

    PubMed

    Ibrahim, Mohammed Auwal; Bindawa Isah, Murtala; Abdullahi Salman, Abdulmalik

    2016-01-01

    Trypanosomiasis is a serious parasitic disease that affects humans and animals resulting in heavy health and economic burdens. Disturbance of redox equilibrium represents a classical challenge for both the host and the parasite during infections with either extracellular African or intracellular American trypanosomes species. This is in spite of existing detoxification mechanisms in both the host and the parasite for maintaining oxidative balance. However, oxidative stress still plays vital roles in the induction of numerous host-associated pathological damages such as anemia, hepatic and renal damages as well as cardiomyopathy while on the other hand, drugs that specifically induce oxidative stress to the parasite have been effective. Therefore, antioxidants have been deemed to play a role in modulating trypanosome infections. This review provides a current update on most of the studies conducted on the potential use of antioxidants as therapeutic agents against trypanosomes. The most frequently studied plant-derived phenolic antioxidants are resveratrol, cucurmin, gallic acid and quercetin while other antioxidants such as vitamins (A, C, E) and trace elements (selenium and iron) have been investigated. Some of the investigations monitored the direct trypanocidal or trypanostatic effects of the antioxidants while others studied the potentials of the antioxidants as adjuncts to trypanocidal drugs. So far, none of these approaches has sufficient data to allow a definite statement on the actual therapeutic potential of antioxidants in the treatment of clinical trypanosomiasis. Therefore, suggestions are made on the most therapeutically and clinically relevant role of antioxidants in trypanosome infections. PMID:27072713

  6. Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review

    PubMed Central

    Shirley, Debbie-Ann; Moonah, Shannon

    2016-01-01

    Background Amebic colitis, caused by intestinal infection with the parasite, Entamoeba histolytica, is a common cause of diarrhea worldwide. Fulminant amebic colitis is the most devastating complication of this infection, associated with both high mortality and morbidity. We conducted a review of the English literature to describe cases of fulminant amebic colitis associated with exposure to corticosteroid medications in order to identify the risk factors for poor outcome and determine difficulties in diagnosis and treatment. Methodology and Principal Findings Articles reporting severe and fulminant forms of amebic colitis between 1991 and 2016 were collected. 525 records were screened to identify 24 cases for qualitative analysis associated with corticosteroid use. Cases arose from areas of high endemicity or travel to such areas. Most cases (14 of 24, 58%) were given corticosteroids for initially misdiagnosed colitis, mainly inflammatory bowel, resulting in rapid progression of disease. Nearly half of all cases underwent surgical intervention, and 25% of cases died, despite all patients eventually receiving treatment with metronidazole. The odds of death did not differ significantly by prior misdiagnosis, co-morbidities, bowel perforation or need for surgery. Conclusions and Significance Infection with E. histolytica should be considered prior to the administration of corticosteroids, in particular for patients residing in endemic areas or those with appropriate travel history, especially prior to the diagnosis of inflammatory bowel disease. The development of preventative and treatment interventions are needed to improve outcomes of fulminant disease. PMID:27467600

  7. Triple therapy in type 2 diabetes; a systematic review and network meta-analysis

    PubMed Central

    Bettington, Emilie K.; Gunton, Jenny E.; Turkstra, Erika

    2015-01-01

    Aims. The purpose was to evaluate the evidence for triple therapy regimen using medicines available in Australia for type 2 diabetes. Methods. A systematic literature review was performed to update the relevant evidence from 2002 to 2014 on triple therapy for type 2 diabetes. A multiple-treatments network meta-analysis was undertaken to summarise the comparative efficacy and harms of different triple therapies. Results. Twenty seven trials were identified, most were six months of duration. The following combinations were included in the network meta-analysis: metformin (MET) + sulfonylureas (SU) (used as reference combination); MET + SU+ dipeptidyl peptidase 4 inhibitors (DPP-4-i); MET + SU+ thiazolidinediones (TZD); MET + SU+ glucagon-like peptide-1 receptor agonists (GLP-1-RA); MET + SU+ insulins; MET + TZD + DPP-4-i; and MET + SU+ sodium/glucose cotransporter 2 inhibitors (SGLT2-i). For HbA1c reduction, all triple therapies were statistically superior to MET+SU dual therapy, except for MET + TZD + DPP-4-i. None of the triple therapy combinations demonstrated differences in HbA1c compared with other triple therapies. MET + SU + SGLT2-i and MET + SU + GLP-1-RA resulted in significantly lower body weight than MET + SU + DPP-4-i, MET+SU+insulin and MET + SU + TZDs; MET + SU + DPP-4-i resulted in significantly lower body weight than MET + SU + insulin and MET + SU + TZD. MET + SU + insulin, MET + SU + TZD and MET + SU + DPP-4-i increased the odds of hypoglycaemia when compared to MET + SU. MET + SU + GLP-1-RA reduced the odds of hypoglycaemia compared to MET + SU + insulin. Conclusion. Care when choosing a triple therapy combination is needed as there is often a risk of increased hypoglycaemia events associated with this regimen and there are very limited data surrounding the long-term effectiveness and safety of combined therapies. PMID:26664803

  8. Dynamically important wave-particle interactions in solar wind - magnetosphere - ionosphere coupling: A review

    NASA Astrophysics Data System (ADS)

    Cairns, Iver

    2012-07-01

    As plasma waves grow or damp they extract or deposit energy, respectively, and alter the phase-space gradients of particle distributions, perhaps leading to instability or damping of other waves. In addition, wave electric and magnetic fields can scatter particles in both position and velocity, altering their motion and sometimes energizing them or causing them to escape or enter physical regions of interest. Plasma waves can also be used to diagnose plasma properties (e.g., the density and magnetic field strength) and the presence of nonthermal particles. Nevertheless, even though plasma waves can heat, cool, energize, scatter, reflect, and characterize plasma particles the question remains: Are plasma waves actually dynamically important in space plasmas? Here this question is addressed in the context of solar wind - magnetosphere - ionosphere coupling by considering multiple regions where plasma waves might be dynamically important. These include: the slowing of the solar wind upstream of the bow shock associated with Fermi acceleration; heating and thermalization at the bow shock; limitation of the electron and ion temperature anisotropies and electron heat flux in the solar wind and magnetosheath; heating, flows, and particle acceleration in magnetic reconnection regions in Earth's magnetotail and magnetopause; precipitation of radiation belt particles into the loss cone and thence the ionosphere; and the development of auroral plasma cavities. In each case existing observations and theory are reviewed and compared, focusing on the importance to the plasma dynamics of plasma waves versus ``static'' macroscopic fields and other effects.

  9. Helicobacter pylori eradication therapy for functional dyspepsia: Systematic review and meta-analysis

    PubMed Central

    Du, Li-Jun; Chen, Bin-Rui; Kim, John J; Kim, Sarah; Shen, Jin-Hua; Dai, Ning

    2016-01-01

    AIM: To evaluate whether Helicobacter pylori (H. pylori) eradication therapy benefits patients with functional dyspepsia (FD). METHODS: Randomized controlled trials (RCTs) investigating the efficacy and safety of H. pylori eradication therapy for patients with functional dyspepsia published in English (up to May 2015) were identified by searching PubMed, EMBASE, and The Cochrane Library. Pooled estimates were measured using the fixed or random effect model. Overall effect was expressed as a pooled risk ratio (RR) or a standard mean difference (SMD). All data were analyzed with Review Manager 5.3 and Stata 12.0. RESULTS: This systematic review included 25 RCTs with a total of 5555 patients with FD. Twenty-three of these studies were used to evaluate the benefits of H. pylori eradication therapy for symptom improvement; the pooled RR was 1.23 (95%CI: 1.12-1.36, P < 0.0001). H. pylori eradication therapy demonstrated symptom improvement during long-term follow-up at ≥ 1 year (RR = 1.24; 95%CI: 1.12-1.37, P < 0.0001) but not during short-term follow-up at < 1 year (RR = 1.26; 95%CI: 0.83-1.92, P = 0.27). Seven studies showed no benefit of H. pylori eradication therapy on quality of life with an SMD of -0.01 (95%CI: -0.11 to 0.08, P = 0.80). Six studies demonstrated that H. pylori eradication therapy reduced the development of peptic ulcer disease compared to no eradication therapy (RR = 0.35; 95%CI: 0.18-0.68, P = 0.002). Eight studies showed that H. pylori eradication therapy increased the likelihood of treatment-related side effects compared to no eradication therapy (RR = 2.02; 95%CI: 1.12-3.65, P = 0.02). Ten studies demonstrated that patients who received H. pylori eradication therapy were more likely to obtain histologic resolution of chronic gastritis compared to those who did not receive eradication therapy (RR = 7.13; 95%CI: 3.68-13.81, P < 0.00001). CONCLUSION: The decision to eradicate H. pylori in patients with functional dyspepsia requires individual

  10. Effectiveness of physiotherapy, occupational therapy, and speech pathology for people with Huntington's disease: a systematic review.

    PubMed

    Bilney, Belinda; Morris, Meg E; Perry, Alison

    2003-03-01

    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, occupational therapy, and speech pathology. The electronic databases for Medline, Embase, CINAHL, Cochrane Controlled Trials Register, and PEDro were searched up to May 2002. Articles meeting the review criteria were graded for study type and rated for quality using checklists to assess study validity and methodology. The majority of articles that examined therapy outcomes for people with Huntington's disease were derived from observational studies of low methodological quality. A low level of evidence exists to support the use of physiotherapy for addressing impairments of balance, muscle strength, and flexibility. There was a small amount of evidence to support the use of speech pathology for the management of eating and swallowing disorders. The current evidence is insufficient to make strong recommendations regarding the usefulness of physiotherapy, occupational therapy, or speech pathology for people with Huntington's disease. There is further need for therapy outcomes research in Huntington's disease so that clinicians may use evidence-based practice to assist clinical decision making. PMID:12645441

  11. Combining Dopaminergic Facilitation with Robot-Assisted Upper Limb Therapy in Stroke Survivors: A Focused Review.

    PubMed

    Tran, Duc A; Pajaro-Blazquez, Marta; Daneault, Jean-Francois; Gallegos, Jaime G; Pons, Jose; Fregni, Felipe; Bonato, Paolo; Zafonte, Ross

    2016-06-01

    Despite aggressive conventional therapy, lasting hemiplegia persists in a large percentage of stroke survivors. The aim of this article is to critically review the rationale behind targeting multiple sites along the motor learning network by combining robotic therapy with pharmacotherapy and virtual reality-based reward learning to alleviate upper extremity impairment in stroke survivors. Methods for personalizing pharmacologic facilitation to each individual's unique biology are also reviewed. At the molecular level, treatment with levodopa was shown to induce long-term potentiation-like and practice-dependent plasticity. Clinically, trials combining conventional therapy with levodopa in stroke survivors yielded statistically significant but clinically unconvincing outcomes because of limited personalization, standardization, and reproducibility. Robotic therapy can induce neuroplasticity by delivering intensive, reproducible, and functionally meaningful interventions that are objective enough for the rigors of research. Robotic therapy also provides an apt platform for virtual reality, which boosts learning by engaging reward circuits. The future of stroke rehabilitation should target distinct molecular, synaptic, and cortical sites through personalized multimodal treatments to maximize motor recovery. PMID:26829074

  12. Pharmacological therapies for pediatric and neonatal ALI/ARDS: an evidence-based review.

    PubMed

    De Luca, Daniele; Piastra, Marco; Tosi, Federica; Pulitanò, Silvia; Mancino, Aldo; Genovese, Orazio; Pietrini, Domenico; Conti, Giorgio

    2012-06-01

    Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are life-threating conditions still lacking a definite therapy and carrying a high mortality and morbidity, especially in children and infants. Albeit respiratory assistance and supportive therapies are crucial for ALI/ARDS, many drugs have been proposed to treat such syndromes through various mechanisms of action. On the whole the pharmacological therapy might play an important role in such a complex clinical situation but few evidence based data are available in pediatric and neonatal critical care. This review will focus on drugs directly available on the bedside, that is, medicines already administered in the practice or investigated in at least one clinical study. We will value the differences due to patient's age and the various causes of the syndrome, that may affect the response to the pharmacological therapy. A special attention will be given to the drugs directly deliverable into the lungs, as this strategy allows a total availability to the lung tissue. The experimental background behind each drug will be discussed and then clinical data in neonates and infants will be presented, if available. Data coming from adult critical care and thought to be somehow pertinent for the pediatric setting will otherwise be reviewed. Quality and evidence for or against each therapy will be evaluated according to the Scottish Intercollegiate Guidelines Network statement and practical reminders for clinicians will accordingly be provided. PMID:22512390

  13. Herbal therapy: A review of emerging pharmacological tools in the management of diabetes mellitus in Africa

    PubMed Central

    Kibiti, Cromwell Mwiti; Afolayan, Anthony Jide

    2015-01-01

    Background: Diabetes mellitus is a chronic physiological glucose metabolic disorder. It has affected millions of people all over the world thereby having a significant impact on quality of life. The management of diabetes includes both nonpharmacological and conventional interventions. Drawbacks in conventional therapy have led to seeking alternative therapy in herbal medicine. Therefore, the need to review, elucidate and classify their mode of action in therapy for diabetes disease arises. Materials and Methods: Comprehensive literature reports were used to review all conventional agents and herbal therapy used in the management of diabetes. An online database search was conducted for medicinal plants of African origin that have been investigated for their antidiabetic therapeutic potentials. Results: The results showed that of the documented sixty five plants used, fourteen inhibit intestinal absorption of glucose, three exhibit insulin-mimetic properties, seventeen stimulate insulin secretion from pancreatic beta cells, twelve enhance peripheral glucose uptake, one promotes regeneration of beta-cell of islets of Langerhans, thirteen ameliorate oxidative stress and twenty induces hypoglycemic effect (mode of action is still obscure). Thirteen of these plants have a duplicate mode of actions while one of them has three modes of actions. These agents have a similar mechanism of action as the conventional drugs. Conclusion: In conclusion, antidiabetic activities of these plants are well established; however, the molecular modulation remains unknown. It is envisaged that the use of herbal therapy will promote good health and improve the status of diabetic patients. PMID:26664014

  14. Effect of Music Therapy on Postoperative Pain Management in Gynecological Patients: A Literature Review.

    PubMed

    Sin, Wai Man; Chow, Ka Ming

    2015-12-01

    Unrelieved postoperative pain may have a negative impact on the physiological and psychological well-being of patients. Pharmacological methods are currently used to relieve such pain in gynecological patients; however, inadequate pain control is still reported, and the use of nonpharmacological pain-relieving methods is increasingly being advocated, one of which is music therapy. The purpose of this literature review was to identify, summarize, and critically appraise current evidence on music therapy and postoperative pain management among gynecological patients. A systematic search of MEDLINE, CINAHL, PsycINFO, British Nursing Index, and Allied and Complementary Medicine was conducted using the search terms music, gynecological, pain, surgery, operative, and post-operative to identify relevant articles in English from 1995 to the present. All identified articles were assessed independently for inclusion into review. A total of 7 articles were included after removal of duplicates and exclusion of irrelevant studies. All the included studies assessed the effects of music therapy on postoperative pain intensity, and three of them measured pain-related physiological symptoms. The findings indicated that music therapy, in general, was effective in reducing pain intensity, fatigue, anxiety, and analgesic consumption in gynecological patients during the postoperative period. It is recommended as an adjunct to pharmacological pain-relieving methods in reducing postoperative pain. Future researches on music therapy to identify the most effective application and evaluate its effect by qualitative study are recommended. PMID:26697822

  15. Hyperbaric oxygen therapy for treatment of children with autism: a systematic review of randomized trials.

    PubMed

    Ghanizadeh, Ahmad

    2012-01-01

    There is a controversy about the efficacy of hyperbaric oxygen (HBO) therapy for the treatment of autism. This study systematically reviews the current evidences for treating of autism with HBO therapy. According to PRISMA guidelines for a systematic review, the databases of MEDLINE/Pubmed, Google Scholar, and Randomised Controlled Trials in Hyperbaric Medicine were electronically searched. In addition, medical subject heading terms and text words for hyperbaric oxygen therapy and autism were used. The main inclusion criteria were published studies which reported the original data from the trials conducted on the patients with autism and assessed outcomes with a valid and reliable instrument. A quality assessment was also conducted. The electronically search resulted in 18 title of publications. Two studies were randomized, double-blind, controlled-clinical trials. While some uncontrolled and controlled studies suggested that HBO therapy is effective for the treatment of autism, these promising effects are not replicated. Therefore, sham-controlled studies with rigorous methodology are required to be conducted in order to provide scientific evidence-based HBO therapy for autism treatment. PMID:22577817

  16. Hyperbaric oxygen therapy for treatment of children with autism: a systematic review of randomized trials

    PubMed Central

    2012-01-01

    There is a controversy about the efficacy of hyperbaric oxygen (HBO) therapy for the treatment of autism. This study systematically reviews the current evidences for treating of autism with HBO therapy. According to PRISMA guidelines for a systematic review, the databases of MEDLINE/Pubmed, Google Scholar, and Randomised Controlled Trials in Hyperbaric Medicine were electronically searched. In addition, medical subject heading terms and text words for hyperbaric oxygen therapy and autism were used. The main inclusion criteria were published studies which reported the original data from the trials conducted on the patients with autism and assessed outcomes with a valid and reliable instrument. A quality assessment was also conducted. The electronically search resulted in 18 title of publications. Two studies were randomized, double-blind, controlled-clinical trials. While some uncontrolled and controlled studies suggested that HBO therapy is effective for the treatment of autism, these promising effects are not replicated. Therefore, sham-controlled studies with rigorous methodology are required to be conducted in order to provide scientific evidence-based HBO therapy for autism treatment. PMID:22577817

  17. Antimicrobial Photodynamic Therapy and Dental Plaque: A Systematic Review of the Literature

    PubMed Central

    Santin, G. C.; Oliveira, D. S. B.; Galo, R.; Borsatto, M. C.; Corona, S. A. M.

    2014-01-01

    Background. The aim of this study was to perform a systematic review of the literature on the efficacy of antimicrobial photodynamic therapy (PDTa) on cariogenic dental biofilm. Types of Studies Reviewed. Studies in vivo, in vitro, and in situ were included. Articles that did not address PDTa, those that did not involve cariogenic biofilm, those that used microorganisms in the plankton phase, and reviews were excluded. Data extraction and quality assessments were performed independently by two raters using a scale. Results. Two hundred forty articles were retrieved; only seventeen of them met the eligibility criteria and were analyzed in the present review. Considerable variability was found regarding the methodologies and application protocols for antimicrobial PDTa. Two articles reported unfavorable results. Practical Implications. The present systematic review does not allow drawing any concrete conclusions regarding the efficacy of antimicrobial PDTa, although this method seems to be a promising option. PMID:25379545

  18. Characterization of Iron-Oxide Loaded Adult Stem Cells for Magnetic Particle Imaging in Targeted Cancer Therapy

    NASA Astrophysics Data System (ADS)

    Lüdtke-Buzug, Kerstin; Rapoport, Daniel Hans; Schneider, Dagmar

    2010-12-01

    Recently, magnetic particle imaging (MPI) has been presented as a new method for the measurement of the spatial distribution of superparamagnetic iron oxide nanoparticles (SPIONs). MPI is based on the nonlinear magnetization response of nanoparticles that are subjected to a sinusoidal magnetic field. Spatial resolution and signal to noise ratio of MPI depend on the particle quality. This is particularly important when stem cells shall be tracked with MPI. Stem cell-based treatment is an upcoming technology in targeted cancer-therapy. In this study, we analyzed the particle quality of newly developed dextran-coated SPIONs—with respect to their response in the imaging experiment—using magnetic particle spectrometry. The uptake of dextran-coated SPIONs into rat and human adult stem cells was monitored via transmission electron microscopy. Furthermore, adult stem cells were incubated with FITC-dextran-coated SPIONs and stained for confocal laser scanning microscopy. The dextran- and FITC-dextran coated SPIONs were localized in the cytoplasm of rat and human adult stem cells. MPI promises real-time imaging with high spatial resolution at high sensitivity. Our data support iron oxide loaded adult stem cells as a powerful tool for targeted cancer therapy.

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

    PubMed Central

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

    2010-01-01

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

  20. Optimization of Radiation Therapy Techniques for Prostate Cancer With Prostate-Rectum Spacers: A Systematic Review

    SciTech Connect

    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.

  1. [The potential of general magnetic therapy for the treatment and rehabilitation (a review)].

    PubMed

    Kulikov, A G; Vordonina, D D

    2016-01-01

    This paper was designed to describe the main characteristics of general magnetic therapy and the mechanisms underlying its biological and therapeutic action. Special attention is given to the extensive application of this method in the routine clinical practice. The publications in the current scientific literature are reviewed in order to evaluate the potential of general magnetic therapy as a component of the combined treatment of various somatic pathologies, rehabilitation of the patients after surgical intervention with special reference to the management of the patients presenting with the oncological problems. The data suggesting good tolerability and high therapeutic effectiveness of the physiotherapeutic method under consideration. PMID:27340720

  2. Barrier-free design: a review and critique of the occupational therapy perspective.

    PubMed

    Cooper, B A; Cohen, U; Hasselkus, B R

    1991-04-01

    This review of the occupational therapy literature on barrier-free design identifies both a paucity of related occupational therapy research on the topic and a lack of a common conceptual base with which to guide the development and use of environmental assessments. Nonetheless, two fledgling themes can be extrapolated: the consistent reference to the concepts of accessibility, mobility, function, and safety and an increased awareness among occupational therapists regarding the accessibility standards developed by the American National Standards Institute (ANSI) (ANSI, 1971, 1980). A problem-solving model suggested by designers for the 1979 revision of ANSI standards that incorporates these conceptual themes is described and discussed. PMID:2035606

  3. 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

  4. Role of polyethylene particles in peri-prosthetic osteolysis: A review

    PubMed Central

    Atkins, Gerald J; Haynes, David R; Howie, Donald W; Findlay, David M

    2011-01-01

    There is convincing evidence that particles produced by the wear of joint prostheses are causal in the peri-prosthetic loss of bone, or osteolysis, which, if it progresses, leads to the phenomenon of aseptic loosening. It is important to fully understand the biology of this bone loss because it threatens prosthesis survival, and loosened implants can result in peri-prosthetic fracture, which is disastrous for the patient and presents a difficult surgical scenario. The focus of this review is the bioactivity of polyethylene (PE) particles, since there is evidence that these are major players in the development and progression of osteolysis around prostheses which use PE as the bearing surface. The review describes the biological consequences of interaction of PE particles with macrophages, osteoclasts and cells of the osteoblast lineage, including osteocytes. It explores the possible cellular mechanisms of action of PE and seeks to use the findings to date to propose potential non-surgical treatments for osteolysis. In particular, a non-surgical approach is likely to be applicable to implants containing newer, highly cross-linked PEs (HXLPEs), for which osteolysis seems to occur with much reduced PE wear compared with conventional PEs. The caveat here is that we know little as yet about the bioactivity of HXLPE particles and addressing this constitutes our next challenge. PMID:22474627

  5. Photodynamic therapy in the treatment of aggressive periodontitis: A systematic review

    PubMed Central

    Doufexi, Aikaterini-Ellisavet

    2016-01-01

    Background Aggressive periodontitis (AgP) is a severe form of periodontal diseases with rapid destruction of the supporting bone around teeth. The efficacy of PDT in suppressing periodontal pathogens may be crucial in adopting new protocols for the treatment of AgP. Thus, the aim of this systematic review was to investigate the possible role of PDT in the treatment of AgP as an adjunctive therapy or monotherapy. Material and Methods A systematic search of the literature was performed. Additionally, the references from all the selected full-text studies were searched for relevant articles. Two reviewers screened independently titles and abstracts or full text copies. Quality assessment of all the included studies was held. Results Initial screening of electronic databases yielded 418 potentially relevant publications. After screening of the titles and full-text examination, five studies were included in the systematic review. Four publications evaluated the effects of PDT adjunctive to SRP in patients with AgP: two of them compared the clinical outcomes of SRP and PDT with a control group that received therapy with SRP and antibiotics (metronidazole and amoxicillin); two publications included SRP and PDT in the test group, and SRP alone in the control group. In one study, PDT was tested as a monotherapy compared with SRP alone. Conclusions Within the limitations of this review, PDT may exhibit a beneficial role in the therapy of aggressive periodontitis after repeated applications. In the future, more methodologically sound, long-term randomized clinical trials are needed to be conducted. Key words:Photodynamic therapy, periodontitis, systematic review. PMID:26595837

  6. A Review of Pharmacological Interactions Between HIV or HCV Medications and Opioid Agonist Therapy: Implications and Management for Clinical Practice

    PubMed Central

    Bruce, R. Douglas; Moody, David E.; Altice, Frederick L.; Gourevitch, Marc N.; Friedland, Gerald H.

    2014-01-01

    Global access to opioid agonist therapy and HIV/HCV treatment is expanding but when used concurrently, problematic pharmacokinetic and pharmacodynamic interactions may occur. Review of articles from 1966 into 2012 in Medline using the following keywords: HIV, AIDS, HIV therapy, HCV, HCV therapy, antiretroviral therapy, HAART, drug interactions, methadone, and buprenorphine. Additionally, abstracts from national and international meetings and a review of conference proceedings were conducted; selected reports were reviewed as well. The metabolism of both opioid and antiretroviral therapies, description of their known interactions, and clinical implications and management of these interactions are reviewed. Important pharmacokinetic and pharmacodynamic drug interactions affecting either methadone or HIV medications have been demonstrated within each class of antiretroviral agents. Drug interactions between methadone, buprenorphine and HIV medications are known and may have important clinical consequences. Clinicians must be alert to these interactions and have a basic knowledge regarding their management. PMID:23656339

  7. Gene therapy for ocular diseases meditated by ultrasound and microbubbles (Review)

    PubMed Central

    WAN, CAIFENG; LI, FENGHUA; LI, HONGLI

    2015-01-01

    The eye is an ideal target organ for gene therapy as it is easily accessible and immune-privileged. With the increasing insight into the underlying molecular mechanisms of ocular diseases, gene therapy has been proposed as an effective approach. Successful gene therapy depends on efficient gene transfer to targeted cells to prove stable and prolonged gene expression with minimal toxicity. At present, the main hindrance regarding the clinical application of gene therapy is not the lack of an ideal gene, but rather the lack of a safe and efficient method to selectively deliver genes to target cells and tissues. Ultrasound-targeted microbubble destruction (UTMD), with the advantages of high safety, repetitive applicability and tissue targeting, has become a potential strategy for gene- and drug delivery. When gene-loaded microbubbles are injected, UTMD is able to enhance the transport of the gene to the targeted cells. High-amplitude oscillations of microbubbles act as cavitation nuclei which can effectively focus ultrasound energy, produce oscillations and disruptions that increase the permeability of the cell membrane and create transient pores in the cell membrane. Thereby, the efficiency of gene therapy can be significantly improved. The UTMD-mediated gene delivery system has been widely used in pre-clinical studies to enhance gene expression in a site-specific manner in a variety of organs. With reasonable application, the effects of sonoporation can be spatially and temporally controlled to improve localized tissue deposition of gene complexes for ocular gene therapy applications. In addition, appropriately powered, focused ultrasound combined with microbubbles can induce a reversible disruption of the blood-retinal barrier with no significant side effects. The present review discusses the current status of gene therapy of ocular diseases as well as studies on gene therapy of ocular diseases meditated by UTMD. PMID:26151686

  8. In Vitro Polyvinylformaldehyde Particle Compatibility with Chemotherapeutic Drugs Used for Chemoembolization Therapy

    SciTech Connect

    Vallee, Jean-Noel E-mail: jean-noel.vallee@psl.ap-hop-paris.fr; Guillevin, Remy; Lo, Daouda; Adem, Carmen; Benois, Florence; Chiras, Jacques

    2003-06-15

    Purpose: Because the effects of pirarubicin and carboplatin on the physical structure of particles made from polyvinylformaldehyde are not well known, we describe an experiment to test the in vitro polyvinylformaldehyde particle compatibility with these drugs used for chemoembolization of bone metastases. Materials and Methods: Polyvinylformaldehydeparticles (Ultra-Drivalon) were mixed in vitro with either pirarubicinor carboplatin as experimental samples, and with distilled water as control samples, and left for 24 h at 37{sup o}C. The particles used measured 150-250 {mu}m and 600-1000 {mu}m in diameter. Particle morphology, including appearance, overall shape, and surface characteristics were examined using a microscope equipped with a videocamera. Particle size was measured by granulometry. Qualitative and quantitative variables were analyzed using, respectively, the two-sided Fisher's exact test and the Wilcoxon signed-rank rank test for paired values, with a significance level of 0.05. Results: No broken particles or microscopic degradations in the appearance, overall shape, or surface characteristics of any particles were observed. The particle size distribution was not significantly different between the experimental samples containing pirarubicin or carboplatin and the control sample of particles with diameters in the same range. Conclusion: Particles made from polyvinylformaldehyde can be mixed with pirarubicin or carboplatin without any risk of damaging their physical properties.

  9. Mind-body therapies and control of inflammatory biology: A descriptive review.

    PubMed

    Bower, Julienne E; Irwin, Michael R

    2016-01-01

    The use of mind-body therapies, including Tai Chi, Qigong, yoga, and meditation, has grown steadily in recent years. These approaches have been shown to be effective in reducing symptoms and improving quality of life, and research has begun to examine the impact of these therapies on biological processes, including inflammation. A review of 26 randomized controlled trials was conducted to describe the effects of mind-body therapies (MBTs) on circulating, cellular, and genomic markers of inflammation. This qualitative evaluation showed mixed effects of MBTs on circulating inflammatory markers, including CRP and IL-6, and on measures of stimulated cytokine production. More consistent findings were seen for genomic markers, with trials showing decreased expression of inflammation-related genes and reduced signaling through the proinflammatory transcription factor NF-κB. Potential mechanisms for these effects are discussed, including alterations in neuroendocrine, neural, and psychological and behavioral processes. PMID:26116436

  10. Carcinoma of penis. Review of cases treated by surgery and radiation therapy 1960-1977

    SciTech Connect

    Krieg, R.M.; Luk, K.H.

    1981-08-01

    Cases of squamous cell carcinoma of the penis treated by surgery and radiation therapy at Moffitt Hospital, University of California, and Mount Zion Hospital and Medical Center are reviewed. Only cases followed for more than three years or with autopsy findings are presented. For the primary lesion, over-all surgical control rate locally was 15/17 or 88 per cent. Over-all control rate with radiation therapy alone was 9/12 (75 per cent), and with surgical salvage 11/12 (92 per cent). Radiation therapy appears to be the treatment of choice for early stage lesions, reserving surgery for salvage. Prophylactic ilioinguinal lymph node dissection for N0 lesions is not warranted. The role of chemotherapy needs further investigation.

  11. Low-Level Laser Therapy (LLLT) for periodontal pockets: a review

    NASA Astrophysics Data System (ADS)

    Pribac, Valentin; Todea, Carmen; Duma, Virgil-Florin

    2016-03-01

    The applications of lasers in medicine, both in the field of diagnosis and treatment are gaining momentum. In dentistry in particular, numerous types of lasers with a wide range of characteristics are being utilized in all fields. In consequence, a lot of experience and knowledge has been gained in the last two decades in this domain; this resulted in the development of novel technologies and devices. A brief overview is made in the first part of this article on these topics. The treatment of periodontal disease with laser therapy is pointed out, as well as the photodynamic therapy which is using LLLT for the activation of the sensitizing gel that is introduced in the periodontal pockets. This paper reviews also the application of photodynamic therapy in clinical trials which have different results; a standardization of the protocol utilized for this procedure is concluded to be necessary.

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

    PubMed Central

    Norred, Sarah E.; Johnson, Jacqueline Anne

    2014-01-01

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

  13. A review of basic to clinical studies of irreversible electroporation therapy.

    PubMed

    Jiang, Chunlan; Davalos, Rafael V; Bischof, John C

    2015-01-01

    The use of irreversible electroporation (IRE) for cancer treatment has increased sharply over the past decade. As a nonthermal therapy, IRE offers several potential benefits over other focal therapies, which include 1) short treatment delivery time, 2) reduced collateral thermal injury, and 3) the ability to treat tumors adjacent to major blood vessels. These advantages have stimulated widespread interest in basic through clinical studies of IRE. For instance, many in vitro and in vivo studies now identify treatment planning protocols (IRE threshold, pulse parameters, etc.), electrode delivery (electrode design, placement, intraoperative imaging methods, etc.), injury evaluation (methods and timing), and treatment efficacy in different cancer models. Therefore, this study reviews the in vitro, translational, and clinical studies of IRE cancer therapy based on major experimental studies particularly within the past decade. Further, this study provides organized data and facts to assist further research, optimization, and clinical applications of IRE. PMID:25389236

  14. Effect of Cardiac Resynchronization Therapy on Inflammation in Congestive Heart Failure: A Review.

    PubMed

    Lappegård, K T; Bjørnstad, H; Mollnes, T E; Hovland, A

    2015-09-01

    Congestive heart failure is associated with increased levels of several inflammatory mediators, and animal studies have shown that infusion of a number of cytokines can induce heart failure. However, several drugs with proven efficacy in heart failure have failed to affect inflammatory mediators, and anti-inflammatory therapy in heart failure patients has thus far been disappointing. Hence, to what extent heart failure is caused by or responsible for the increased inflammatory burden in the patient is still unclear. Over the past couple of decades, resynchronization therapy with a biventricular pacemaker has emerged as an effective treatment in a subset of heart failure patients, reducing both morbidity and mortality. Such treatment has also been shown to affect the inflammation associated with heart failure. In this study, we review recent data on the association between heart failure and inflammation, and in particular how resynchronization therapy can affect the inflammatory process. PMID:26099323

  15. Moving from virtual reality exposure-based therapy to augmented reality exposure-based therapy: a review.

    PubMed

    Baus, Oliver; Bouchard, Stéphane

    2014-01-01

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

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

    PubMed Central

    Baus, Oliver; Bouchard, Stéphane

    2014-01-01

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

  17. Renal replacement therapies after abdominal aortic aneurysm repair--a review.

    PubMed

    Hudorović, Narcis; Lovricević, Ivo; Brkić, Petar; Ahel, Zaky; Vicić-Hudorović, Visnja

    2011-09-01

    The objective of this review is to assess the incidence of postoperative acute renal failure that necessitates the application of hemofiltration and to determine the factors that influence the outcome in patients undergoing surgical repair of abdominal aortic aneurysm. In addition, the review aims to assess the outcomes of postoperative early hemofiltration as compared to late intensive hemofiltration. Different forms of renal replacement therapies for use in abdominal aortic aneurysm surgery patients are discussed. Electronic literature searches were performed using Pubmed, Medline, Embase, Sumsearch, Cinahil, The Cochrane Central Register of Controlled Trials and Excerpta Medica. The search identified 419 potentially eligible studies, of which 119 were excluded based on the title and abstract. Of the remaining 300 studies, full articles were collected and re-evaluated. Forty-five articles satisfied our inclusion criteria, of which only 12 were of the IA Level of evidence. The search results indicated that the underlying disease, its severity and stage, the etiology of acute renal failure, clinical and hemodynamic status of the patient, the resources available, and different costs of therapy might all influence the choice of the renal replacement therapy strategy. However, clear guidelines on renal replacement therapy duration are still lacking. Moreover, it is not known whether in acute renal failure patients undergoing abdominal aortic aneurysm surgery, renal replacement therapy modalities can eliminate significant amounts of clinically relevant inflammatory mediators. This review gives current information available in the literature on the possible mechanisms underlying acute renal failure and recent developments in continuous renal replacement treatment modalities. PMID:22384777

  18. 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 (αRPT) is currently enjoying increasing attention as a viable alternative to chemotherapy for targeting of disseminated micrometastatic disease. In theory, αRPT can be personalized through pre-therapeutic imaging and dosimetry. However, in practice, given the particularities of α-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 α-particle radiation differ markedly from the effects caused by traditional external beam (photon or electron) radiation or β-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(α/β), has recently been proposed by the ICRU. In concert with EQD2(α/β), we introduce a new, redefined RBE quantity, named RBE2(α/β), as the ratio of the two linear coefficients that characterize the α 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

  19. Safety, effectiveness and economic evaluation of intra-operative radiation therapy: a systematic review

    PubMed Central

    Najafipour, Farshad; Hamouzadeh, Pejman; Arabloo, Jalal; Mobinizadeh, Mohammadreza; Norouzi, Amir

    2015-01-01

    Background: Intra-operative radiation therapy (IORT) is the transfer of a single large radiation dose to the tumor bed during surgery with the final goal of improving regional tumor control. This study aimed to investigate the safety, effectiveness and economic evaluation of intra-operative radiation therapy. Methods: The scientific literature was searched in the main biomedical databases (Centre for Reviews and Dissemination, Cochrane Library and PubMed) up to March 2014. Two independent reviewers selected the papers based on pre-established inclusion criteria, with any disagreements being resolved by consensus. Data were then extracted and summarized in a structured form. Results from studies were analyzed and discussed within a descriptive synthesis. Results: Sixteen studies met the inclusion criteria. It seems that outcomes from using intraoperative radiation therapy can be considered in various kinds of cancers like breast, pancreatic and colorectal cancers. The application of this method may provide significant survival increase only for colorectal cancer, but this increase was not significant for other types of cancer. This technology had low complications; and it is relatively safe. Using intra-operative radiation therapy could potentially be accounted as a cost-effective strategy for controlling and managing breast cancer. Conclusion: According to the existing evidences, that are the highest medical evidences for using intra-operative radiation therapy, one can generally conclude that intra-operative radiation therapy is considered as a relatively safe and cost-effective method for managing early-stage breast cancer and it can significantly increase the survival of patients with colorectal cancer. Also, the results of this study have policy implications with respect to the reimbursement of this technology. PMID:26793649

  20. A Review on Novel Breast Cancer Therapies: Photodynamic Therapy and Plant Derived Agent Induced Cell Death Mechanisms.

    PubMed

    George, Blassan Plackal Adimuriyil; Abrahamse, Heidi

    2016-01-01

    This review article presents an extensive examination of risk factors for breast cancer, treatment strategies with special attention to photodynamic therapy and natural product based treatments. Breast cancer remains the most commonly occurring cancer in women worldwide and the detection, treatment, and prevention are prominent concerns in public health. Background information on current developments in treatment helps to update the approach towards risk assessment. Breast cancer risk is linked to many factors such as hereditary, reproductive and lifestyle factors. Minimally invasive Photodynamic therapy (PDT) can be used in the management of various cancers; it uses a light sensitive drug (a photosensitizer, PS) and a light of visible wavelength, to destroy targeted cancer cells. State of the art analyses has been carried out to investigate advancement in the search for the cure and control of cancer progression using natural products. Traditional medicinal plants have been used as lead compounds for drug discovery in modern medicine. Both PDT and plant derived drugs induce cell death via different mechanisms including apoptosis, necrosis, autophagy, cell cycle regulation and even the regulation of various cell signalling pathways. PMID:26499768

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

    PubMed

    Golisz, Kathleen

    2014-01-01

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

  2. Role of the Technical Aspects of Hypofractionated Radiation Therapy Treatment of Prostate Cancer: A Review

    SciTech Connect

    Clemente, Stefania; Nigro, Roberta; Oliviero, Caterina; Marchioni, Chiara; Esposito, Marco; Giglioli, Francesca Romana; Mancosu, Pietro; Marino, Carmelo; Russo, Serenella; Stasi, Michele; Strigari, Lidia; Veronese, Ivan; Landoni, Valeria

    2015-01-01

    The increasing use of moderate (<35 fractions) and extreme (<5 fractions) hypofractionated radiation therapy in prostate cancer is yielding favorable results, both in terms of maintained biochemical response and toxicity. Several hypofractionation (HF) schemes for the treatment of prostate cancer are available, although there is considerable variability in the techniques used to manage intra-/interfraction motion and deliver radiation doses. We performed a review of the published studies on HF regimens as a topic of interest for the Stereotactic Ablative Radiotherapy working group, which is part of the Italian Association of Medical Physics. Aspects of organ motion management (imaging for contouring, target volume definition, and rectum/bladder preparation) and treatment delivery (prostate localization, image guided radiation therapy strategy and frequency) were evaluated and categorized to assess outcome relative to disease control and toxicity. Despite the heterogeneity of the data, some interesting trends that emerged from the review might be useful in identifying an optimum HF strategy.

  3. 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

  4. Concise Review: Workshop Review: Understanding and Assessing the Risks of Stem Cell-Based Therapies

    PubMed Central

    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.; Park, B. Kevin

    2015-01-01

    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

  5. Music therapy for service users with dementia: a critical review of the literature.

    PubMed

    Blackburn, R; Bradshaw, T

    2014-12-01

    Dementia is an organic mental health problem that has been estimated to affect over 23 million people worldwide. With increasing life expectancy in most countries, it has been estimated that the prevalence of dementia will continue to significantly increase in the next two decades. Dementia leads to cognitive impairments most notably short-term memory loss and impairments in functioning and quality of life (QOL). National policy in the UK advocates the importance of early diagnosis, treatment and social inclusion in maintaining a good QOL. First-line treatment options often involve drug therapies aimed at slowing down the progression of the illness and antipsychotic medication to address challenging behaviours. To date, research into non-pharmacological interventions has been limited. In this manuscript, we review the literature that has reported evaluations of the effects of music therapy, a non-pharmacological intervention. The results of six studies reviewed suggest that music therapy may have potential benefits in reducing anxiety, depression and agitated behaviour displayed by elderly people with dementia as well as improving cognitive functioning and QOL. Furthermore, music therapy is a safe and low-cost intervention that could potentially be offered by mental health nurses and other carers working in residential settings. PMID:25303405

  6. Cost-effectiveness of drug therapy for hypercholesterolaemia: a review of the literature.

    PubMed

    Thompson, D; Oster, G

    1992-07-01

    In this article we review published studies of the cost-effectiveness of drug therapy for hypercholesterolaemia to take stock of the principal findings that have been reported to date. We identified 9 studies that met all criteria for inclusion in our review, including 3 of bile-acid sequestrants (cholestyramine, colestipol), 2 of HMG-CoA reductase inhibitor (lovastatin), and 4 that considered both an HMG-CoA reductase inhibitor (simvastatin) and a bile-acid sequestrant (cholestyramine). While these studies were largely consistent in methodological approach, some differences were noted in the costs attributed to drug therapy. The cost-effectiveness of therapy with bile-acid sequestrants was found to range from $100 000 to $209 000 per year of life saved (1991 $US) for middle-aged men (42 to 55 years of age) with moderately high cholesterol levels (280 to 290 mg/dl) and otherwise average coronary risk characteristics. Corresponding cost-effectiveness ratios that have been reported for lovastatin range from $64 000 to $82 000, while those for simvastatin range from $45 000 to $65 000. Studies to date therefore suggest that therapy with HMG-CoA reductase inhibitors (i.e. lovastatin and simvastatin) is substantially more cost-effective than treatment with bile-acid sequestrants. PMID:10146977

  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. Concise Review: Apoptotic Cell-Based Therapies-Rationale, Preclinical Results and Future Clinical Developments.

    PubMed

    Saas, Philippe; Daguindau, Etienne; Perruche, Sylvain

    2016-06-01

    The objectives of this review are to summarize the experimental data obtained using apoptotic cell-based therapies, and then to discuss future clinical developments. Indeed, apoptotic cells exhibit immunomodulatory properties that are reviewed here by focusing on more recent mechanisms. These immunomodulatory mechanisms are in particular linked to the clearance of apoptotic cells (called also efferocytosis) by phagocytes, such as macrophages, and the induction of regulatory T cells. Thus, apoptotic cell-based therapies have been used to prevent or treat experimental inflammatory diseases. Based on these studies, we have identified critical steps to design future clinical trials. This includes: the administration route, the number and schedule of administration, the appropriate apoptotic cell type to be used, as well as the apoptotic signal. We also have analyzed the clinical relevancy of apoptotic-cell-based therapies in experimental models. Additional experimental data are required concerning the treatment of inflammatory diseases (excepted for sepsis) before considering future clinical trials. In contrast, apoptotic cells have been shown to favor engraftment and to reduce acute graft-versus-host disease (GvHD) in different relevant models of transplantation. This has led to the conduct of a phase 1/2a clinical trial to alleviate GvHD. The absence of toxic effects obtained in this trial may support the development of other clinical studies based on this new cell therapy. Stem Cells 2016;34:1464-1473. PMID:27018198

  9. Hoarding Disorder and a Systematic Review of Treatment with Cognitive Behavioral Therapy.

    PubMed

    Williams, Monnica; Viscusi, Jenifer A

    2016-01-01

    Until recently, compulsive hoarding has been treated as a type of obsessive-compulsive disorder with mixed results. Little research exists on the efficacy of behavioral interventions specifically designed to treat hoarding disorder, and most existing research is limited with regard to the numbers of participants, their ethnic and cultural diversity, and study replication; therefore, the generalizability of findings is limited. This article reviews the prevalence of hoarding disorder, cognitive behavioral therapy treatment approaches, and measurement of symptoms. A systematic review compares the efficacy of various CBT methods, with particular attention to comparing therapy that is traditionally used to treat OCD with those designed specifically to treat hoarding disorder. Only clinical studies using CBT interventions designed to treat hoarding associated with OCD or hoarding disorder were included. Studies included participants of all ages, and articles were published in peer-reviewed journals. Case studies were excluded. After a comprehensive search and removing duplicates from databases and references, 65 articles were reviewed, of which 12 met criteria for review. Preliminary results demonstrate improvement in hoarding symptoms with CBT interventions that are both for OCD and those designed to specifically treat hoarding disorder; however, when compared to each other, the efficacy of these treatments is inconclusive, thus more research is needed. PMID:26795499

  10. Stem Cell Therapy for the Treatment of Hip Osteonecrosis: A 30-Year Review of Progress

    PubMed Central

    Trousselier, Matthieu; Roubineau, François; Bouthors, Charlie; Chevallier, Nathalie; Rouard, Helene; Flouzat-Lachaniette, Charles-Henri

    2016-01-01

    Avascular necrosis of the femoral head is caused by a multitude of etiologic factors and is associated with collapse with a risk of hip arthroplasty in younger populations. A focus on early disease management with the use of stem cells was proposed as early as 1985 by the senior author (PH). We undertook a systematic review of the medical literature to examine the progress in cell therapy during the last 30 years for the treatment of early stage osteonecrosis. PMID:26929793

  11. Salvage therapy of small volume prostate cancer nodal failures: a review of the literature.

    PubMed

    De Bari, Berardino; Alongi, Filippo; Buglione, Michela; Campostrini, Franco; Briganti, Alberto; Berardi, Genoveffa; Petralia, Giuseppe; Bellomi, Massimo; Chiti, Arturo; Fodor, Andrei; Suardi, Nazareno; Cozzarini, Cesare; Nadia, Di Muzio; Scorsetti, Marta; Orecchia, Roberto; Montorsi, Francesco; Bertoni, Filippo; Magrini, Stefano Maria; Jereczek-Fossa, Barbara Alicja

    2014-04-01

    New imaging modalities may be useful to identify prostate cancer patients with small volume, limited nodal relapse ("oligo-recurrent") potentially amenable to local treatments (radiotherapy, surgery) with the aim of long-term control of the disease, even in a condition traditionally considered prognostically unfavorable. This report reviews the new diagnostic tools and the main published data about the role of surgery and radiation therapy in this particular subgroup of patients. PMID:24315428

  12. Coronary Microvascular Dysfunction and Microvascular Angina: A Systematic Review of Therapies

    PubMed Central

    Marinescu, Mark A; Löffler, Adrián I.; Ouellette, Michelle; Smith, Lavone; Kramer, Christopher M.; Bourque, Jamieson

    2015-01-01

    Angina without coronary artery disease (CAD) has substantial morbidity and is present in 10–30% of patients undergoing angiography. Coronary microvascular dysfunction (CMD) is present in 50–65% of these patients. The optimal treatment of this cohort is undefined. We performed a systematic review to evaluate treatment strategies for objectively defined CMD in the absence of CAD. We included studies assessing therapy in human subjects with angina and coronary flow reserve (CFR) or myocardial perfusion reserve (MPR) <2.5 by positron emission tomography (PET), cardiac magnetic resonance imaging (CMR), dilution methods, or intracoronary Doppler in the absence of coronary artery stenosis ≥50% or structural heart disease. Only 8 articles met strict inclusion criteria. The articles were heterogeneous, using different treatments, end-points, and definitions of CMD. Small sample sizes severely limit the power of these studies, with an average of 11 patients per analysis. Studies evaluating, sildenafil, quinapril, estrogen, and transcutaneous electrical nerve stimulation (TENS) application demonstrated benefits in their respective endpoints. No benefit was found with L-arginine, doxazosin, pravastatin, and diltiazem. Our systematic review highlights that there is little data to support therapies for CMD. We assess the data meeting rigorous inclusion criteria and review the related but excluded literature. We additionally describe the next steps needed to address this research gap, including a standardized definition of CMD, routine assessment of CMD in studies of chest pain without obstructive CAD, and specific therapy assessment in the population with confirmed CMD. PMID:25677893

  13. Physiological Effects of Nature Therapy: A Review of the Research in Japan

    PubMed Central

    Song, Chorong; Ikei, Harumi; Miyazaki, Yoshifumi

    2016-01-01

    Humans have evolved into what they are today after the passage of 6–7 million years. If we define the beginning of urbanization as the rise of the industrial revolution, less than 0.01% of our species’ history has been spent in modern surroundings. Humans have spent over 99.99% of their time living in the natural environment. The gap between the natural setting, for which our physiological functions are adapted, and the highly urbanized and artificial setting that we inhabit is a contributing cause of the “stress state” in modern people. In recent years, scientific evidence supporting the physiological effects of relaxation caused by natural stimuli has accumulated. This review aimed to objectively demonstrate the physiological effects of nature therapy. We have reviewed research in Japan related to the following: (1) the physiological effects of nature therapy, including those of forests, urban green space, plants, and wooden material and (2) the analyses of individual differences that arise therein. The search was conducted in the PubMed database using various keywords. We applied our inclusion/exclusion criteria and reviewed 52 articles. Scientific data assessing physiological indicators, such as brain activity, autonomic nervous activity, endocrine activity, and immune activity, are accumulating from field and laboratory experiments. We believe that nature therapy will play an increasingly important role in preventive medicine in the future. PMID:27527193

  14. Physiological Effects of Nature Therapy: A Review of the Research in Japan.

    PubMed

    Song, Chorong; Ikei, Harumi; Miyazaki, Yoshifumi

    2016-01-01

    Humans have evolved into what they are today after the passage of 6-7 million years. If we define the beginning of urbanization as the rise of the industrial revolution, less than 0.01% of our species' history has been spent in modern surroundings. Humans have spent over 99.99% of their time living in the natural environment. The gap between the natural setting, for which our physiological functions are adapted, and the highly urbanized and artificial setting that we inhabit is a contributing cause of the "stress state" in modern people. In recent years, scientific evidence supporting the physiological effects of relaxation caused by natural stimuli has accumulated. This review aimed to objectively demonstrate the physiological effects of nature therapy. We have reviewed research in Japan related to the following: (1) the physiological effects of nature therapy, including those of forests, urban green space, plants, and wooden material and (2) the analyses of individual differences that arise therein. The search was conducted in the PubMed database using various keywords. We applied our inclusion/exclusion criteria and reviewed 52 articles. Scientific data assessing physiological indicators, such as brain activity, autonomic nervous activity, endocrine activity, and immune activity, are accumulating from field and laboratory experiments. We believe that nature therapy will play an increasingly important role in preventive medicine in the future. PMID:27527193

  15. A focused review of hematopoietic neoplasms occurring in the therapy-related setting

    PubMed Central

    Zhang, Liping; Wang, Sa A

    2014-01-01

    Hematological neoplasms developed in patients with a history of cytotoxic therapies comprise a group of diseases with a poor clinical outcome, and collectively categorized as “therapy-related myeloid neoplasms” (t-MN) in the 2008 World Health Organization (WHO) Classification. In recent years, numerous publications have emerged, and these studies have greatly expanded the scope of our understanding in this field. We here focused our review on several selected areas including secondary malignancies occurring in patients with autoimmune diseases; radiation therapy alone as a causative agent; the similarity and differences between therapy-related myelodysplastic syndromes (t-MDS) and acute myeloid leukemia (t-AML); clinical behavior and treatment outcome of t-AML patients with favorable cytogenetics; the incidence and clinical features of myelodysplastic/myeloproliferative neoplasms, as well as acute lymphoblastic leukemia and myeloproliferative neoplasms in patients with prior cytotoxic exposure. These recent studies have shown that therapy-related hematopoietic neoplasms are heterogeneous, and may manifest in various forms, more complex than we have recognized previously. Cytogenetic abnormalities and underlying mutations are likely to be the major factors dictating prognosis. PMID:25120730

  16. Clinical research evidence of cupping therapy in China: a systematic literature review

    PubMed Central

    2010-01-01

    Background Though cupping therapy has been used in China for thousands of years, there has been no systematic summary of clinical research on it. This review is to evaluate the therapeutic effect of cupping therapy using evidence-based approach based on all available clinical studies. Methods We included all clinical studies on cupping therapy for all kinds of diseases. We searched six electronic databases, all searches ended in December 2008. We extracted data on the type of cupping and type of diseases treated. Results 550 clinical studies were identified published between 1959 and 2008, including 73 randomized controlled trials (RCTs), 22 clinical controlled trials, 373 case series, and 82 case reports. Number of RCTs obviously increased during past decades, but the quality of the RCTs was generally poor according to the risk of bias of the Cochrane standard for important outcome within each trials. The diseases in which cupping was commonly employed included pain conditions, herpes zoster, cough or asthma, etc. Wet cupping was used in majority studies, followed by retained cupping, moving cupping, medicinal cupping, etc. 38 studies used combination of two types of cupping therapies. No serious adverse effects were reported in the studies. Conclusions According to the above results, quality and quantity of RCTs on cupping therapy appears to be improved during the past 50 years in China, and majority of studies show potential benefit on pain conditions, herpes zoster and other diseases. However, further rigorous designed trials in relevant conditions are warranted to support their use in practice. PMID:21078197

  17. 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

  18. Management of adverse events in the treatment of patients with immunoglobulin therapy: A review of evidence.

    PubMed

    Cherin, Patrick; Marie, Isabelle; Michallet, Mauricette; Pelus, Eric; Dantal, Jacques; Crave, Jean-Charles; Delain, Jean-Christophe; Viallard, Jean-François

    2016-01-01

    Immunoglobulin (IG) therapy is actually used for a broad range of diseases including primary and secondary immunodeficiency disorders, and autoimmune diseases. This therapy is available for intravenous (IV) and subcutaneous (SC) administration. The efficacy of the IG therapy has been demonstrated in numerous studies and across different diseases. Generally, IG infusions are well tolerated; however some well-known adverse reactions, ranging from mild to severe, are associated with the therapy. The most common adverse reactions including headache, nausea, myalgia, fever, chills, chest discomfort, skin and anaphylactic reactions, could arise immediately during or after the infusion. Delayed events could be more severe and include migraine headaches, aseptic meningitis, haemolysis renal impairment and thrombotic events. This paper reviews all the potential adverse events related to IG therapy and establishes a comprehensive guideline for the management of these events. Moreover it resumes the opinions and clinical experience of expert endorsers on the utilization of the treatment. Published data were classified into levels of evidence and the strength of the recommendation was given for each intervention according to the GRADE system. PMID:26384525

  19. A Review of Gene Therapy in Canine and Feline Models of Lysosomal Storage Disorders

    PubMed Central

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

    2015-01-01

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

  20. The art of gene therapy for glioma: a review of the challenging road to the bedside

    PubMed Central

    Tobias, Alex; Ahmed, Atique; Moon, Kyung-Sub; Lesniak, Maciej S

    2012-01-01

    Glioblastoma multiforme (GBM) is a highly invasive brain tumour that is unvaryingly fatal in humans despite even aggressive therapeutic approaches such as surgical resection followed by chemotherapy and radiotherapy. Unconventional treatment options such as gene therapy provide an intriguing option for curbing glioma related deaths. To date, gene therapy has yielded encouraging results in preclinical animal models as well as promising safety profiles in phase I clinical trials, but has failed to demonstrate significant therapeutic efficacy in phase III clinical trials. The most widely studied antiglioma gene therapy strategies are suicide gene therapy, genetic immunotherapy and oncolytic virotherapy, and we have attributed the challenging transition of these modalities into the clinic to four major roadblocks: (1) anatomical features of the central nervous system, (2) the host immune system, (3) heterogeneity and invasiveness of GBM and (4) limitations in current GBM animal models. In this review, we discuss possible ways to jump these hurdles and develop new gene therapies that may be used alone or in synergy with other modalities to provide a powerful treatment option for patients with GBM. PMID:22993449

  1. A review of empirically supported psychological therapies for mood disorders in adults

    PubMed Central

    Hollon, Steven D.; Ponniah, Kathryn

    2010-01-01

    Background The mood disorders are prevalent and problematic. We review randomized controlled psychotherapy trials to find those that are empirically supported with respect to acute symptom reduction and the prevention of subsequent relapse and recurrence. Methods We searched the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to identify appropriate articles. Results One hundred twenty-five studies were found evaluating treatment efficacy for the various mood disorders. With respect to the treatment of major depressive disorder (MDD), interpersonal psychotherapy (IPT), cognitive behavior therapy (CBT), and behavior therapy (BT) are efficacious and specific and brief dynamic therapy (BDT) and emotion-focused therapy (EFT) are possibly efficacious. CBT is efficacious and specific, mindfulness-based cognitive therapy (MBCT) efficacious, and BDT and EFT possibly efficacious in the prevention of relapse/recurrence following treatment termination and IPT and CBT are each possibly efficacious in the prevention of relapse/recurrence if continued or maintained. IPT is possibly efficacious in the treatment of dysthymic disorder. With respect to bipolar disorder, CBT and family-focused therapy (FFT) are efficacious and interpersonal social rhythm therapy (IPSRT) possibly efficacious as adjuncts to medication in the treatment of depression. Psycho-education (PE) is efficacious in the prevention of mania/hypomania (and possibly depression) and FFT is efficacious and IPSRT and CBT possibly efficacious in preventing bipolar episodes. Conclusions The newer psychological interventions are as efficacious as and more enduring than medications in the treatment of MDD and may enhance the efficacy of medications in the treatment of bipolar disorder. PMID:20830696

  2. Adrenal Function Testing Following Hormone Therapy for Infantile Spasms: Case Series and Review of Literature

    PubMed Central

    Mytinger, John R.; Bowden, Sasigarn A.

    2015-01-01

    Prednisolone and adrenocorticotropic hormone (ACTH) are “hormone” therapies for infantile spasms. There is limited data on the occurrence of decreased adrenal reserve or signs of clinical adrenal insufficiency after hormone therapy. This is a retrospective medical record review of patients referred to our Infantile Spasms Program. Our standardized infantile spasms management guideline began in September 2012 and initially included a post-hormone laboratory assessment of adrenal function. Medical records were assessed for hormone treatments, adrenal function testing, and signs of adrenal insufficiency. Forty-two patients who received one or both hormone therapies met inclusion criteria. A post-hormone laboratory assessment of adrenal function was done in 14 patients. Of these 14 patients, 2 had an abnormal laboratory assessment of adrenal function, both by adrenal stimulation testing – one after ACTH and one after prednisolone. One patient received hydrocortisone replacement and the other received stress dose hydrocortisone as needed; neither patient developed signs of adrenal insufficiency. Another patient treated with both types of hormone therapy in tandem, who did not have a post-hormone laboratory assessment, developed signs of mild adrenal insufficiency and required replacement hydrocortisone. Our study suggests that adrenal suppression can occur after modern hormone therapy regimens. We found two patients with abnormal adrenal function testing after hormone therapy and another patient with signs adrenal insufficiency. Given the seriousness of adrenal crisis, caregiver education on the signs of adrenal insufficiency is critical. Greater vigilance may be indicated in patients receiving both types of hormone therapy in tandem. Although a routine post-hormone laboratory assessment of adrenal function may not be feasible in all patients, replacement or stress dose hydrocortisone is necessary for all patients with suspected adrenal insufficiency. PMID

  3. 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...

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

    PubMed Central

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

    2014-01-01

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

  5. Silver (Ag) Transport Mechanisms in TRISO Coated Particles: A Critical Review

    SciTech Connect

    IJ van Rooyen; ML Dunzik-Gougar; PM van Rooyen

    2014-05-01

    Transport of 110mAg in the intact SiC layer of TRISO coated particles has been studied for approximately 30 years without arriving at a satisfactory explanation of the transport mechanism. In this paper the possible mechanisms postulated in previous experimental studies, both in-reactor and out-of reactor research environment studies are critically reviewed and of particular interest are relevance to very high temperature gas reactor operating and accident conditions. Among the factors thought to influence Ag transport are grain boundary stoichiometry, SiC grain size and shape, the presence of free silicon, nano-cracks, thermal decomposition, palladium attack, transmutation products, layer thinning and coated particle shape. Additionally new insight to nature and location of fission products has been gained via recent post irradiation electron microscopy examination of TRISO coated particles from the DOE’s fuel development program. The combined effect of critical review and new analyses indicates a direction for investigating possible the Ag transport mechanism including the confidence level with which these mechanisms may be experimentally verified.

  6. 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.

  7. TOPICAL REVIEW: Charged-particle multiplicity in proton-proton collisions

    NASA Astrophysics Data System (ADS)

    Fiete Grosse-Oetringhaus, Jan; Reygers, Klaus

    2010-08-01

    This review summarizes and critically reviews measurements of charged-particle multiplicity distributions and pseudorapidity densities in p+p(\\bar{p}) collisions between \\sqrt{s} = 23.6 {\\;GeV} and \\sqrt{s} = 1.8\\;TeV. Related theoretical concepts are briefly introduced. Moments of multiplicity distributions are presented as a function of \\sqrt{s}. Feynman scaling, KNO scaling as well as the description of multiplicity distributions with a single negative binomial distribution and with combinations of two or more negative binomial distributions is discussed. Moreover, similarities between the energy dependence of charged-particle multiplicities in p+p(\\bar{p}) and e+e- collisions are studied. Finally, various predictions for pseudorapidity densities, average multiplicities in full phase space and multiplicity distributions of charged particles in p+p(\\bar{p}) collisions at the LHC energies of \\sqrt{s} = 7\\;TeV, 10\\;TeV and 14 TeV are summarized and compared.

  8. 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

  9. Heat transfer and lethality considerations in aseptic processing of liquid/particle mixtures: a review.

    PubMed

    Ramaswamy, H S; Awuah, G B; Simpson, B K

    1997-04-01

    Consumer awareness and demand for nutritious yet inexpensive food products call for innovative processing techniques that have both safety and quality as primary objectives. These challenges appear to have been met by aseptic processing techniques, especially for liquid and high-acid foods. However, the extension of aseptic processing principles to low-acid foods containing discrete particles in viscous sauces has not been approved by regulatory agencies, particularly in North America. This apparent limitation is due primarily to the lack of adequate temperature monitoring devices to keep track of particles in dynamic motion, as well as to the residence time distribution of particles flowing in the continuous heat-hold-cool sections of the aseptic processing system. These problems have prompted active research to describe the phenomenal behavior of particulates through sound mathematical modeling and computer simulators. The accuracy of mathematical models depends heavily on how accurate input parametric values are. These parameters include the thermophysical properties of the carrier fluid and particles, as well as the aseptic processing system characteristics in relation to residence time distribution and the fluid-to-particle interfacial heat transfer coefficient. Apparently, several contradictory findings have been reported in the literature with respect to the effect of various processing parameters on the above-mentioned input parametric values. The need therefore arises for more collaborative studies involving the industry and academia. This review brings to perspective, the current status on the aseptic processing of particulate foods with respect to the critical processing parameters which affect the fluid-to-particle convective heat transfer coefficient associated with particulate laden products. PMID:9143820

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

    PubMed Central

    2014-01-01

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

  11. TENS and heat therapy for pain relief and quality of life improvement in individuals with primary dysmenorrhea: A systematic review.

    PubMed

    Igwea, Sylvester Emeka; Tabansi-Ochuogu, Chidinma Samantha; Abaraogu, Ukachukwu Okoroafor

    2016-08-01

    The present systematic review aimed to synthesize evidence for the effectiveness of TENS and heat therapy interventions from randomized trials. Six relevant databases were searched for studies on TENS and heat therapy for primary dysmenorrhea. Menstrual pain intensity and quality of life were the primary and secondary outcomes respectively. The search yielded 46 citations from which six studies on TENS and three studies on heat therapy were systematically reviewed. On the PEDRO quality scale, the trials methodological quality was 4.8 out of 10 for TENS and 6.3 out of 10 for heat therapy. TENS and heat therapy both showed evidence of pain reduction, but no study included quality of life as an outcome. Meta-analysis was not possible due to substantial heterogeneity in included studies. TENS and heat therapy show potential as adjunct remedies in the management of primary dysmenorrhea, but rigorous high quality trials are still needed to made conclusive recommendation. PMID:27502806

  12. Assessment of potential advantages of relevant ions for particle therapy: A model based study

    SciTech Connect

    Grün, Rebecca; Friedrich, Thomas; Krämer, Michael; Scholz, Michael; Zink, Klemens; Durante, Marco; Engenhart-Cabillic, Rita

    2015-02-15

    Purpose: Different ion types offer different physical and biological advantages for therapeutic applications. The purpose of this work is to assess the advantages of the most commonly used ions in particle therapy, i.e., carbon ({sup 12}C), helium ({sup 4}He), and protons ({sup 1}H) for different treatment scenarios. Methods: A treatment planning analysis based on idealized target geometries was performed using the treatment planning software TRiP98. For the prediction of the relative biological effectiveness (RBE) that is required for biological optimization in treatment planning the local effect model (LEM IV) was used. To compare the three ion types, the peak-to-entrance ratio (PER) was determined for the physical dose (PER{sub PHY} {sub S}), the RBE (PER{sub RBE}), and the RBE-weighted dose (PER{sub BIO}) resulting for different dose-levels, field configurations, and tissue types. Further, the dose contribution to artificial organs at risk (OAR) was assessed and a comparison of the dose distribution for the different ion types was performed for a patient with chordoma of the skull base. Results: The study showed that the advantages of the ions depend on the physical and biological properties and the interplay of both. In the case of protons, the consideration of a variable RBE instead of the clinically applied generic RBE of 1.1 indicates an advantage in terms of an increased PER{sub RBE} for the analyzed configurations. Due to the fact that protons show a somewhat better PER{sub PHY} {sub S} compared to helium and carbon ions whereas helium shows a higher PER{sub RBE} compared to protons, both protons and helium ions show a similar RBE-weighted dose distribution. Carbon ions show the largest variation of the PER{sub RBE} with tissue type and a benefit for radioresistant tumor types due to their higher LET. Furthermore, in the case of a two-field irradiation, an additional gain in terms of PER{sub BIO} is observed when using an orthogonal field configuration

  13. 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 ϱe 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 ϱe that covers the entire range of tissue compositions (except lung tissue). Elemental mass fractions are predicted from the ϱe 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

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

    SciTech Connect

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

    2014-06-15

    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 ϱ{sub e} and effective atomic number Z{sub eff} are calculated for 71 tabulated tissue compositions. For MC simulations, the mass density is derived via one linear fit in the ϱ{sub e} that covers the entire range of tissue compositions (except lung tissue). Elemental mass fractions are predicted from the ϱ{sub e} and the Z{sub eff} 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%. MeanI-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

  15. Application of iron sulfide particles for groundwater and soil remediation: A review.

    PubMed

    Gong, Yanyan; Tang, Jingchun; Zhao, Dongye

    2016-02-01

    Rapid industrialization and urbanization have resulted in elevated concentrations of hazardous inorganic and organic contaminants in groundwater and soil, which has become a paramount concern to the environment and the public health. In recent years, iron sulfide (FeS), a major constituent of acid-volatile sulfides, has elicited extensive interests in environmental remediation due to its ubiquitous presence and high treatment efficiency in anoxic environment. This paper provides a comprehensive review on recent advances in: (1) synthesis of FeS particles (including nanoscale FeS); and (2) reactivity of FeS towards a variety of common environmental contaminants in groundwater and soil over extended periods of time, namely, heavy metals (Hg(II), Cu(II), Pb(II), and Cr(VI)), oxyanions (arsenite, arsenate, selenite, and selenate), radionuclides (e.g., uranium (U) and neptunium (Np)), chlorinated organic compounds (e.g., trichloroethane, trichloroethylene, and p-chloroaniline), nitroaromatic compounds, and polychlorinated biphenyls. Different physiochemical and biological methods for preparing FeS with desired particle size, structure, and surface properties are discussed. Reaction principles and removal effectiveness/constraints are discussed in details. Special attention is placed to the application of nanoscale FeS particles because of their unique properties, such as small particle size, large specific surface area, high surface reactivity, and soil deliverability in the subsurface. Moreover, current knowledge gaps and further research needs are identified. PMID:26707732

  16. Science and engineering of nanodiamond particle surfaces for biological applications (Review).

    PubMed

    Shenderova, Olga A; McGuire, Gary E

    2015-01-01

    Diamond has outstanding bulk properties such as super hardness, chemical inertness, biocompatibility, luminescence, to name just a few. In the nanoworld, in order to exploit these outstanding bulk properties, the surfaces of nanodiamond (ND) particles must be accordingly engineered for specific applications. Modification of functional groups on the ND's surface and the corresponding electrostatic properties determine their colloidal stability in solvents, formation of photonic crystals, controlled adsorption and release of cargo molecules, conjugation with biomolecules and polymers, and cellular uptake. The optical activity of the luminescent color centers in NDs depends on their proximity to the ND's surface and surface termination. In order to engineer the ND surface, a fundamental understanding of the specific structural features and sp(3)-sp(2) phase transformations on the surface of ND particles is required. In the case of ND particles produced by detonation of carbon containing explosives (detonation ND), it should also be taken into account that its structure depends on the synthesis parameters and subsequent processing. Thus, for development of a strategy of surface modification of detonation ND, it is imperative to know details of its production. In this review, the authors discuss ND particles structure, strategies for surface modification, electrokinetic properties of NDs in suspensions, and conclude with a brief overview of the relevant bioapplications. PMID:26245200

  17. Risk Associated with Bee Venom Therapy: A Systematic Review and Meta-Analysis

    PubMed Central

    Park, Jeong Hwan; Yim, Bo Kyung; Lee, Jun-Hwan; Lee, Sanghun; Kim, Tae-Hun

    2015-01-01

    Objective The safety of bee venom as a therapeutic compound has been extensively studied, resulting in the identification of potential adverse events, which range from trivial skin reactions that usually resolve over several days to life-threating severe immunological responses such as anaphylaxis. In this systematic review, we provide a summary of the types and prevalence of adverse events associated with bee venom therapy. Methods We searched the literature using 12 databases from their inception to June 2014, without language restrictions. We included all types of clinical studies in which bee venom was used as a key intervention and adverse events that may have been causally related to bee venom therapy were reported. Results A total of 145 studies, including 20 randomized controlled trials, 79 audits and cohort studies, 33 single-case studies, and 13 case series, were evaluated in this review. The median frequency of patients who experienced adverse events related to venom immunotherapy was 28.87% (interquartile range, 14.57–39.74) in the audit studies. Compared with normal saline injection, bee venom acupuncture showed a 261% increased relative risk for the occurrence of adverse events (relative risk, 3.61; 95% confidence interval, 2.10 to 6.20) in the randomized controlled trials, which might be overestimated or underestimated owing to the poor reporting quality of the included studies. Conclusions Adverse events related to bee venom therapy are frequent; therefore, practitioners of bee venom therapy should be cautious when applying it in daily clinical practice, and the practitioner’s education and qualifications regarding the use of bee venom therapy should be ensured. PMID:25996493

  18. 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

  19. Movement therapy induced neural reorganization and motor recovery in stroke: a review.

    PubMed

    Arya, Kamal Narayan; Pandian, Shanta; Verma, Rajesh; Garg, R K

    2011-10-01

    This paper is a review conducted to provide an overview of accumulated evidence on contemporary rehabilitation methods for stroke survivors. Loss of functional movement is a common consequence of stroke for which a wide range of interventions has been developed. Traditional therapeutic approaches have shown limited results for motor deficits as well as lack evidence for their effectiveness. Stroke rehabilitation is now based on the evidence of neuroplasticity, which is responsible for recovery following stroke. The neuroplastic changes in the structure and function of relevant brain areas are induced primarily by specific rehabilitation methods. The therapeutic method which induces neuroplastic changes, leads to greater motor and functional recovery than traditional methods. Further, the recovery is permanent in nature. During the last decade various novel stroke rehabilitative methods for motor recovery have been developed. This review focuses on the methods that have evidence of associated cortical level reorganization, namely task-specific training, constraint-induced movement therapy, robotic training, mental imaging, and virtual training. All of these methods utilize principles of motor learning. The findings from this review demonstrated convincing evidence both at the neural and functional level in response to such therapies. The main aim of the review was to determine the evidence for these methods and their application into clinical practice. PMID:21943628

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

    PubMed

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

    2014-11-01

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

  1. 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)

  2. 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

  3. Does Complementarity Promote or Hinder Client Change in Brief Therapy? A Review of the Evidence from Two Theoretical Perspectives.

    ERIC Educational Resources Information Center

    Friedlander, Mynra L.

    1993-01-01

    Reviews and contrasts 23 interpersonal personality theory (IPT) and 19 relational control theory (RCT) studies of observable client-therapist interactions in brief individual and family therapy. Notes that, although results do not consistently confirm either model, evidence tends to support IPT in context of individual therapy and RCT in context…

  4. Biomedical properties of edible seaweed in cancer therapy and chemoprevention trials: a review.

    PubMed

    Namvar, Farideh; Tahir, Paridah M d; Mohamad, Rosfarizan; Mahdavi, Mahnaz; Abedi, Parvin; Najafi, Tahereh Fathi; Rahmanand, Heshu Sulaiman; Jawaid, Mohammad

    2013-12-01

    This review article summarizes in vitro and in vivo experiments on seaweed anticancer activity and seaweed chemical components. Seaweed use in cancer therapy, chemopreventive randomized control trials (RCTs) and quasi-experiments are discussed. The literature reviewed in this article was obtained from various scientific sources and encompasses publications from 2000-2012. Seaweed therapeutic effects were deemed scientifically plausible and may be partially explained by the in vivo and in vitro pharmacological studies described. Although the mechanisms of action remain unclear, seaweed's anticancer properties may be attributable to its major biologically active metabolites. Much of the seaweed research outlined in this paper can serve as a foundation for explaining seaweed anticancer bioactivity. This review will open doors for developing strategies to treat malignancies using seaweed natural products. PMID:24555303

  5. A Review on Technical and Clinical Impact of Microsoft Kinect on Physical Therapy and Rehabilitation

    PubMed Central

    Mousavi Hondori, Hossein; Khademi, Maryam

    2014-01-01

    This paper reviews technical and clinical impact of the Microsoft Kinect in physical therapy and rehabilitation. It covers the studies on patients with neurological disorders including stroke, Parkinson's, cerebral palsy, and MS as well as the elderly patients. Search results in Pubmed and Google scholar reveal increasing interest in using Kinect in medical application. Relevant papers are reviewed and divided into three groups: (1) papers which evaluated Kinect's accuracy and reliability, (2) papers which used Kinect for a rehabilitation system and provided clinical evaluation involving patients, and (3) papers which proposed a Kinect-based system for rehabilitation but fell short of providing clinical validation. At last, to serve as technical comparison to help future rehabilitation design other sensors similar to Kinect are reviewed. PMID:27006935

  6. Proton synchrotrons for cancer therapy

    NASA Astrophysics Data System (ADS)

    Coutrakon, George B.

    2001-07-01

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

  7. 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

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

    PubMed

    Yao, Aihua; Chen, Qi; Ai, Fanrong; Wang, Deping; Huang, Wenhai

    2011-10-01

    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 Fe(3)O(4) nanoparticles. The magnetic properties and heat generation ability of the composite particles were characterized. Furthermore, temperature and alternating magnetic field (AMF) triggered drug release behaviors of vitamin B(12)-loaded composite particles were also examined. It was found that composite particles enabled drug release to be controlled through temperature changes in the neighborhood of lower critical solution temperature. Continuous application of AMF resulted in an accelerated release of the loaded drug. On the other hand, intermittent AMF application to the composite particles resulted in an "on-off", stepwise release pattern. Longer release duration and larger overall release could be achieved by intermittent application of AMF as compared to continuous magnetic field. Such composite particles may be used for magnetic drug targeting followed by simultaneous hyperthermia and drug release. PMID:21833605

  9. Adoptive T-cell therapy for cancer in the United kingdom: a review of activity for the British Society of Gene and Cell Therapy annual meeting 2015.

    PubMed

    Gilham, David Edward; Anderson, John; Bridgeman, John Stephen; Hawkins, Robert Edward; Exley, Mark Adrian; Stauss, Hans; Maher, John; Pule, Martin; Sewell, Andrew Kelvin; Bendle, Gavin; Lee, Steven; Qasim, Waseem; Thrasher, Adrian; Morris, Emma

    2015-05-01

    Adoptive T-cell therapy is delivering objective clinical responses across a number of cancer indications in the early phase clinical setting. Much of this clinical activity is taking place at major clinical academic centers across the United States. This review focuses upon cancer-focused cell therapy activity within the United Kingdom as a contribution to the 2015 British Society of Gene and Cell Therapy annual general meeting. This overview reflects the diversity and expansion of clinical and preclinical studies within the United Kingdom while considering the background context of this work against new infrastructural developments and the requirements of nationalized healthcare delivery within the UK National Health Service. PMID:25860661

  10. Adoptive T-Cell Therapy for Cancer in the United Kingdom: A Review of Activity for the British Society of Gene and Cell Therapy Annual Meeting 2015

    PubMed Central

    Anderson, John; Bridgeman, John Stephen; Hawkins, Robert Edward; Exley, Mark Adrian; Stauss, Hans; Maher, John; Pule, Martin; Sewell, Andrew Kelvin; Bendle, Gavin; Lee, Steven; Qasim, Waseem; Thrasher, Adrian; Morris, Emma

    2015-01-01

    Abstract Adoptive T-cell therapy is delivering objective clinical responses across a number of cancer indications in the early phase clinical setting. Much of this clinical activity is taking place at major clinical academic centers across the United States. This review focuses upon cancer-focused cell therapy activity within the United Kingdom as a contribution to the 2015 British Society of Gene and Cell Therapy annual general meeting. This overview reflects the diversity and expansion of clinical and preclinical studies within the United Kingdom while considering the background context of this work against new infrastructural developments and the requirements of nationalized healthcare delivery within the UK National Health Service. PMID:25860661

  11. 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

  12. Effects of Whole-Body Vibration Therapy in Patients with Fibromyalgia: A Systematic Literature Review

    PubMed Central

    Collado-Mateo, Daniel; Adsuar, Jose C.; Olivares, Pedro R.; del Pozo-Cruz, Borja; Parraca, Jose A.; del Pozo-Cruz, Jesus; Gusi, Narcis

    2015-01-01

    Objective. To review the literature on the effects of whole-body vibration therapy in patients with fibromyalgia. Design. Systematic literature review. Patients. Patients with fibromyalgia. Methods. An electronic search of the literature in four medical databases was performed to identify studies on whole-body vibration therapy that were published up to the 15th of January 2015. Results. Eight articles satisfied the inclusion and exclusion criteria and were analysed. According to the Dutch CBO guidelines, all selected trials had a B level of evidence. The main outcomes that were measured were balance, fatigue, disability index, health-related quality of life, and pain. Whole-body vibration appeared to improve the outcomes, especially balance and disability index. Conclusion. Whole-body vibration could be an adequate treatment for fibromyalgia as a main therapy or added to a physical exercise programme as it could improve balance, disability index, health-related quality of life, fatigue, and pain. However, this conclusion must be treated with caution because the paucity of trials and the marked differences between existing trials in terms of protocol, intervention, and measurement tools hampered the comparison of the trials. PMID:26351517

  13. A review of lower extremity assistive robotic exoskeletons in rehabilitation therapy.

    PubMed

    Chen, Gong; Chan, Chow Khuen; Guo, Zhao; Yu, Haoyong

    2013-01-01

    The rapid advancement of robotics technology in recent years has pushed the development of a distinctive field of robotic applications, namely robotic exoskeletons. Because of the aging population, more people are suffering from neurological disorders such as stroke, central nervous system disorder, and spinal cord injury. As manual therapy seems to be physically demanding for both the patient and therapist, robotic exoskeletons have been developed to increase the efficiency of rehabilitation therapy. Robotic exoskeletons are capable of providing more intensive patient training, better quantitative feedback, and improved functional outcomes for patients compared to manual therapy. This review emphasizes treadmill-based and over-ground exoskeletons for rehabilitation. Analyses of their mechanical designs, actuation systems, and integrated control strategies are given priority because the interactions between these components are crucial for the optimal performance of the rehabilitation robot. The review also discusses the limitations of current exoskeletons and technical challenges faced in exoskeleton development. A general perspective of the future development of more effective robot exoskeletons, specifically real-time biological synergy-based exoskeletons, could help promote brain plasticity among neurologically impaired patients and allow them to regain normal walking ability. PMID:24941413

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

    PubMed Central

    2007-01-01

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

  15. 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.

  16. The Metabolic Syndrome and Mind-Body Therapies: A Systematic Review

    PubMed Central

    Anderson, Joel G.; Taylor, Ann Gill

    2011-01-01

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

  17. 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

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

    PubMed Central

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

    2014-01-01

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

  19. Systematic Review of the Use of Phytochemicals for Management of Pain in Cancer Therapy.

    PubMed

    Harrison, Andrew M; Heritier, Fabrice; Childs, Bennett G; Bostwick, J Michael; Dziadzko, Mikhail A

    2015-01-01

    Pain in cancer therapy is a common condition and there is a need for new options in therapeutic management. While phytochemicals have been proposed as one pain management solution, knowledge of their utility is limited. The objective of this study was to perform a systematic review of the biomedical literature for the use of phytochemicals for management of cancer therapy pain in human subjects. Of an initial database search of 1,603 abstracts, 32 full-text articles were eligible for further assessment. Only 7 of these articles met all inclusion criteria for this systematic review. The average relative risk of phytochemical versus control was 1.03 [95% CI 0.59 to 2.06]. In other words (although not statistically significant), patients treated with phytochemicals were slightly more likely than patients treated with control to obtain successful management of pain in cancer therapy. We identified a lack of quality research literature on this subject and thus were unable to demonstrate a clear therapeutic benefit for either general or specific use of phytochemicals in the management of cancer pain. This lack of data is especially apparent for psychotropic phytochemicals, such as the Cannabis plant (marijuana). Additional implications of our findings are also explored. PMID:26576425

  20. Transarterial embolization therapies for the treatment of hepatocellular carcinoma: CEPO review and clinical recommendations

    PubMed Central

    Boily, Gino; Villeneuve, Jean-Pierre; Lacoursière, Luc; Chaudhury, Prosanto; Couture, Félix; Ouellet, Jean-François; Lapointe, Réal; Goulet, Stéphanie; Gervais, Normand; Comité de l'évolution des pratiques en oncologie

    2015-01-01

    Background Hepatocellular carcinoma (HCC) is one of the most deadly cancers in the world and its incidence rate has consistently increased over the past 15 years in Canada. Although transarterial embolization therapies are palliative options commonly used for the treatment of HCC, their efficacy is still controversial. The objective of this guideline is to review the efficacy and safety of transarterial embolization therapies for the treatment of HCC and to develop evidence-based recommendations. Method A review of the scientific literature published up to October 2013 was performed. A total of 38 studies were included. Recommendations Considering the evidence available to date, the CEPO recommends the following: (i) transarterial chemoembolization therapy (TACE) be considered a standard of practice for the palliative treatment of HCC in eligible patients; (ii) drug-eluting beads (DEB)-TACE be considered an alternative and equivalent treatment to conventional TACE in terms of oncological efficacy (overall survival) and incidence of severe toxicities; (iii) the decision to treat with TACE or DEB-TACE be discussed in tumour boards; (iv) bland embolization (TAE) not be considered for the treatment of HCC; (v) radioembolization (TARE) not be considered outside of a clinical trial setting; and (vi) sorafenib combined with TACE not be considered outside of a clinical trial setting. PMID:24961288

  1. Systematic Review of the Use of Phytochemicals for Management of Pain in Cancer Therapy

    PubMed Central

    Harrison, Andrew M.; Heritier, Fabrice; Childs, Bennett G.; Bostwick, J. Michael; Dziadzko, Mikhail A.

    2015-01-01

    Pain in cancer therapy is a common condition and there is a need for new options in therapeutic management. While phytochemicals have been proposed as one pain management solution, knowledge of their utility is limited. The objective of this study was to perform a systematic review of the biomedical literature for the use of phytochemicals for management of cancer therapy pain in human subjects. Of an initial database search of 1,603 abstracts, 32 full-text articles were eligible for further assessment. Only 7 of these articles met all inclusion criteria for this systematic review. The average relative risk of phytochemical versus control was 1.03 [95% CI 0.59 to 2.06]. In other words (although not statistically significant), patients treated with phytochemicals were slightly more likely than patients treated with control to obtain successful management of pain in cancer therapy. We identified a lack of quality research literature on this subject and thus were unable to demonstrate a clear therapeutic benefit for either general or specific use of phytochemicals in the management of cancer pain. This lack of data is especially apparent for psychotropic phytochemicals, such as the Cannabis plant (marijuana). Additional implications of our findings are also explored. PMID:26576425

  2. Lipodystrophy among patients with HIV infection on antiretroviral therapy: a systematic review protocol

    PubMed Central

    Lana, Lorena Gomes Cunha; Junqueira, Daniela Rezende Garcia; Perini, Edson; Menezes de Pádua, Cristiane

    2014-01-01

    Introduction Lipodystrophy is a frequent and disfiguring adverse effect of antiretroviral therapy (ART) in patients with HIV. It affects the quality of life of the patient and adherence to treatment, and generates new needs for comprehensive healthcare services. The aim of this study will be to conduct a systematic review of the literature from observational studies and describe lipodystrophy among patients with HIV infection during current or previous use of ART. Methods and analysis A systematic review of observational studies published in MEDLINE, CINAHL, LILACS, EMBASE and International Pharmaceutical Abstracts will be carried out. Citations of included studies will be checked to identify additional studies not identified in the electronic searches. It will include any observational study that considered lipodystrophy as the primary or secondary outcome and that had enrolled adolescent and adult patients with HIV infection who were on current or previous ART for at least 6 months. Data extraction and analysis will be performed independently by two reviewers. The extracted data will be discussed, decisions documented and, where necessary, the authors of the studies will be contacted for clarification. Measures of frequency, prevalence and incidence of lipodystrophy will be stratified according to definition, method of diagnosis and risk factors of the outcome. Ethics and dissemination Ethics is not required given this is a protocol for a systematic review. The findings of this study will be widely disseminated through peer-reviewed publications and conference presentations. Updates of the review will be conducted to inform and guide healthcare practice. Protocol registration PROSPERO—42013005450. PMID:24625638

  3. Serious adverse effects of unconventional therapies for children and adolescents: a systematic review of recent evidence.

    PubMed

    Ernst, Edzard

    2003-02-01

    Unconventional therapies have become popular in paediatric and adolescent populations. It is therefore important to define their risks. The aim of this systematic review was to summarise the recent evidence. Computerised literature searches were carried out in five databases to identify all recent reports of adverse events associated with unconventional therapies in children. The reports were summarised in narrative and tabular form. The results show that numerous case reports and several case series have been published since 1990. Investigations of a more systematic nature are, however, rare. Most of the adverse events were associated with herbal medications. Inadequately regulated herbal medicines may contain toxic plant material, be contaminated with heavy metals, or be adulterated with synthetic drugs. The adverse events included bradycardia, brain damage, cardiogenic shock, diabetic coma, encephalopathy, heart rupture, intravascular haemolysis, liver failure, respiratory failure, toxic hepatitis and death. A high degree of uncertainty regarding a causal relationship between therapy and adverse event was frequently noted. The size of the problem and its importance relative to the well-documented risks of conventional treatments are presently unknown. Several unconventional therapies may constitute a risk to the health of children and adolescents. At present, it is impossible to provide reliable incidence figures. It seems important to be vigilant and investigate this area more systematically. PMID:12548381

  4. Targeted Therapies in HER2-Positive Breast Cancer – a Systematic Review

    PubMed Central

    Schramm, Amelie; De Gregorio, Nikolaus; Widschwendter, Peter; Fink, Visnja; Huober, Jens

    2015-01-01

    Summary About 20% of all breast cancer patients have a human epidermal growth factor receptor 2 (HER2)-positive breast tumor. This entity underwent an impressive change in prognosis, with notable improvement of progression-free survival and overall survival. Due to more aggressive tumors and no specific therapy, HER2 overexpression was historically seen as a negative prognostic marker, with worse prognosis and increased risk of recurrent disease. Trastuzumab, the first anti-HER2 antibody, revolutionized the systemic therapy options in HER2-positive breast cancer and initiated several targeted therapies and more personalized treatment strategies. Over the years, multiple HER2-targeting drugs stepped into clinical practice, for the curative as well as the metastatic situation. This review summarizes the targeted treatment options in HER2-positive breast cancer and their current impact in the clinical routine. Results of the most outstanding trials in HER2-targeted therapies and important ongoing trials are subsequently described for an up-to-date overview. PMID:26557822

  5. Psychological therapy for anxiety in bipolar spectrum disorders: a systematic review.

    PubMed

    Stratford, Hannah J; Cooper, Myra J; Di Simplicio, Martina; Blackwell, Simon E; Holmes, Emily A

    2015-02-01

    Comorbid anxiety is common in bipolar spectrum disorders [BPSD], and is associated with poor outcomes. Its clinical relevance is highlighted by the "anxious distress specifier" in the revised criteria for Bipolar Disorders in the Diagnostic and Statistical Manual 5th Edition [DSM-5]. This article reviews evidence for the effectiveness of psychological therapy for anxiety in adults with BPSD (bipolar I, II, not otherwise specified, cyclothymia, and rapid cycling disorders). A systematic search yielded 22 treatment studies that included an anxiety-related outcome measure. Cognitive behavioural therapy [CBT] for BPSD incorporating an anxiety component reduces anxiety symptoms in cyclothymia, "refractory" and rapid cycling BPSD, whereas standard bipolar treatments have only a modest effect on anxiety. Preliminary evidence is promising for CBT for post-traumatic stress disorder and generalised anxiety disorder in BPSD. Psychoeducation alone does not appear to reduce anxiety, and data for mindfulness-based cognitive therapy [MBCT] appear equivocal. CBT during euthymic phases has the greatest weight of evidence. Where reported, psychological therapy appears acceptable and safe, but more systematic collection and reporting of safety and acceptability information is needed. Development of psychological models and treatment protocols for anxiety in BPSD may help improve outcomes. PMID:25462111

  6. The effects of light therapy on sleep problems: A systematic review and meta-analysis.

    PubMed

    van Maanen, Annette; Meijer, Anne Marie; van der Heijden, Kristiaan B; Oort, Frans J

    2016-10-01

    Although bright light therapy seems a promising treatment for sleep problems, research shows inconclusive results. This meta-analysis is the first to systematically review the effect of light therapy on sleep problems in general and on specific types of sleep problems in particular (circadian rhythm sleep disorders, insomnia, sleep problems related to Alzheimer's disease and dementia). Fifty-three studies with a total of 1154 participants were included. Overall effects and effects on separate circadian and sleep outcomes were examined. We calculated Hedges' g effect sizes and we investigated the effects of twelve moderators (design-related, treatment-related, participant-related). Light therapy was found effective in the treatment of sleep problems in general (g = 0.39), and for circadian rhythm sleep disorders (g = 0.41), insomnia (g = 0.47), and sleep problems related to Alzheimer's disease/dementia (g = 0.30) specifically. For circadian rhythm sleep disorders, effects were smaller for randomised controlled trials. For insomnia, we found larger effects for studies using a higher light intensity, and for sleep problems related to Alzheimer's disease/dementia larger effects were found for studies with more female participants. There was indication of publication bias. To conclude, light therapy is effective for sleep problems in general, particularly for circadian outcomes and insomnia symptoms. However, most effect sizes are small to medium. PMID:26606319

  7. Gene therapy as a potential tool for treating neuroblastoma-a focused review.

    PubMed

    Kumar, M D; Dravid, A; Kumar, A; Sen, D

    2016-05-01

    Neuroblastoma, a solid tumor caused by rapid division of undifferentiated neuroblasts, is the most common childhood malignancy affecting children aged <5 years. Several approaches and strategies developed and tested to cure neuroblastoma have met with limited success due to different reasons. Many oncogenes are deregulated during the onset and development of neuroblastoma and thus offer an opportunity to circumvent this disease if the expression of these genes is restored to normalcy. Gene therapy is a powerful tool with the potential to inhibit the deleterious effects of oncogenes by inserting corrected/normal genes into the genome. Both viral and non-viral vector-based gene therapies have been developed and adopted to deliver the target genes into neuroblastoma cells. These attempts have given hope to bringing in a new regime of treatment against neuroblastoma. A few gene-therapy-based treatment strategies have been tested in limited clinical trials yielding some positive results. This mini review is an attempt to provide an overview of the available options of gene therapy to treat neuroblastoma. PMID:27080224

  8. 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

  9. Gene therapy with growth factors for periodontal tissue engineering–A review

    PubMed Central

    Gupta, Shipra; Mahendra, Aneet

    2012-01-01

    The treatment of oral and periodontal diseases and associated anomalies accounts for a significant proportion of the healthcare burden, with the manifestations of these conditions being functionally and psychologically debilitating. A challenge faced by periodontal therapy is the predictable regeneration of periodontal tissues lost as a consequence of disease. Growth factors are critical to the development, maturation, maintenance and repair of oral tissues as they establish an extra-cellular environment that is conducive to cell and tissue growth. Tissue engineering principles aim to exploit these properties in the development of biomimetic materials that can provide an appropriate microenvironment for tissue development. The aim of this paper is to review emerging periodontal therapies in the areas of materials science, growth factor biology and cell/gene therapy. Various such materials have been formulated into devices that can be used as vehicles for delivery of cells, growth factors and DNA. Different mechanisms of drug delivery are addressed in the context of novel approaches to reconstruct and engineer oral and tooth supporting structure. Key words: Periodontal disease, gene therapy, regeneration, tissue repair, growth factors, tissue engineering. PMID:22143705

  10. Interleukin-27 as a Novel Therapy for Inflammatory Bowel Disease: A Critical Review of the Literature.

    PubMed

    Andrews, Caroline; McLean, Mairi H; Durum, Scott K

    2016-09-01

    Inflammatory bowel disease (IBD) is an inflammatory disorder of the intestine that affects an estimated 329 per 100,000 people in the United States and is increasing in incidence within a number of cultures worldwide. Likely due to its incompletely understood pathophysiology and etiology, the standard treatments for IBD are only efficacious in subsets of patients and often do not induce lasting remission. As a result, novel therapies are needed. The success of anti-tumor necrosis factor-α treatment in a subset of patients with IBD demonstrated that therapy targeting a single cytokine could be efficacious in IBD, and clinical trials investigating the blockade of a variety of cytokines have commenced. Interleukin (IL) 27 is a relatively recently discovered type I cytokine with established roles in infectious disease, autoimmunity, and cancer in a variety of organs. IL-27 was identified as a candidate gene for IBD, and a number of studies in mouse models of IBD have demonstrated that IL-27 therapy is protective. However, in contrast to these investigations, genetic deletion of the IL-27 receptor has been shown to be protective in some mouse models of IBD. The purpose of this review is to highlight the recent literature investigating the role of IL-27 in IBD and to discuss the possible explanations for the sometimes conflicting results of these studies. Evidence supporting IL-27 therapy as a treatment for IBD will also be discussed. PMID:27243591

  11. Magnetic particle hyperthermia: nanoparticle magnetism and materials development for cancer therapy

    NASA Astrophysics Data System (ADS)

    Hergt, Rudolf; Dutz, Silvio; Müller, Robert; Zeisberger, Matthias

    2006-09-01

    Loss processes in magnetic nanoparticles are discussed with respect to optimization of the specific loss power (SLP) for application in tumour hyperthermia. Several types of magnetic iron oxide nanoparticles representative for different preparation methods (wet chemical precipitation, grinding, bacterial synthesis, magnetic size fractionation) are the subject of a comparative study of structural and magnetic properties. Since the specific loss power useful for hyperthermia is restricted by serious limitations of the alternating field amplitude and frequency, the effects of the latter are investigated experimentally in detail. The dependence of the SLP on the mean particle size is studied over a broad size range from superparamagnetic up to multidomain particles, and guidelines for achieving large SLP under the constraints valid for the field parameters are derived. Particles with the mean size of 18 nm having a narrow size distribution proved particularly useful. In particular, very high heating power may be delivered by bacterial magnetosomes, the best sample of which showed nearly 1 kW g-1 at 410 kHz and 10 kA m-1. This value may even be exceeded by metallic magnetic particles, as indicated by measurements on cobalt particles.

  12. Vital pulp therapy using calcium-enriched mixture: An evidence-based review

    PubMed Central

    Asgary, Saeed; Ahmadyar, Maryam

    2013-01-01

    Worldwide, casecontrol studies have revealed that the treatment outcomes of root canal therapy (RCT) are generally favorable; however, the overall epidemiological success rate of RCT in the general population is relatively low. On the other hand, vitality of dental pulp is a key factor in the long-term prognosis of permanent teeth; in recent years, vital pulp therapy (VPT) has received significant consideration as it has been revealed that the inflamed pulp has the potential to heal. In this review article, the current best evidence with regard to VPT using calcium-enriched mixture (CEM) cement in human permanent/primary teeth is discussed. A strategy based on a search using keywords for CEM cement as well as VPT was applied. PMID:23716958

  13. Preoperative Testosterone Therapy Prior to Surgical Correction of Hypospadias: A Review of the Literature

    PubMed Central

    Chagani, Sean; Rohl, Austin J

    2016-01-01

    Hypospadias is a congenital anomaly of the male urethra that causes significant morbidity in the pediatric male population. The mainstay of treatment is hypospadias repair surgery. However, given the common co-occurrence of microphallus in these patients, surgery remains difficult without adequate tissue for proper reconstruction of the urethra. The use of preoperative testosterone therapy, parenterally or topically, has been a topic of study for several years in urologic literature. This literature review aims to summarize the different studies that have been conducted to address whether preoperative testosterone therapy is beneficial, inconsequential, or detrimental to the surgical and cosmetic outcomes of hypospadias repair as well as to address the differences in routes of administration. PMID:27551655

  14. Preoperative Testosterone Therapy Prior to Surgical Correction of Hypospadias: A Review of the Literature.

    PubMed

    Krishnan, Arvind; Chagani, Sean; Rohl, Austin J

    2016-01-01

    Hypospadias is a congenital anomaly of the male urethra that causes significant morbidity in the pediatric male population. The mainstay of treatment is hypospadias repair surgery. However, given the common co-occurrence of microphallus in these patients, surgery remains difficult without adequate tissue for proper reconstruction of the urethra. The use of preoperative testosterone therapy, parenterally or topically, has been a topic of study for several years in urologic literature. This literature review aims to summarize the different studies that have been conducted to address whether preoperative testosterone therapy is beneficial, inconsequential, or detrimental to the surgical and cosmetic outcomes of hypospadias repair as well as to address the differences in routes of administration. PMID:27551655

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

    NASA Astrophysics Data System (ADS)

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

    2010-02-01

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

  16. Iatrogenic Cushing's syndrome and topical steroid therapy: case series and review of the literature.

    PubMed

    Decani, Sem; Federighi, Veronica; Baruzzi, Elisa; Sardella, Andrea; Lodi, Giovanni

    2014-12-01

    Topical corticosteroids are considered first-line therapy in patients with chronic inflammatory oral mucosal diseases; among them, clobetasol propionate is one of the most widely used in oral medicine. Under physiological conditions, the transmucosal application is characterized by a significantly greater absorption than the skin application. Contrary to many publications about the side effects of topical corticosteroids in dermatology, few studies have investigated the systemic effects due to local application of these drugs on oral mucosa. Although topical steroid therapy for the management of oral diseases is generally associated with local adverse effects (candidiasis, stomatopyrosis, and hypogeusia), these drugs can also lead to systemic side effects, such as suppression of the hypothalamic-pituitary-adrenal axis and Cushing's syndrome. This review reports five cases of systemic adverse effects caused by clobetasol propionate topical treatment. PMID:23210698

  17. [Gene therapy and stem cells for the inner ear: a review].

    PubMed

    Breinbauer, H A; Praetorius, M

    2014-02-01

    Within the field of otolaryngology, the inner ear is perhaps the most important target for which stem cell and gene therapy may comprise elements of primary intervention strategies in the future. As it has done in the past, sensorineural hearing loss still represents a major therapeutic challenge-and it will continue to do so in the future. Current management strategies are not cause-orientated. Since the first experiments aimed at developing a middle ear-specific gene-based therapy by Fujiyoshi in 1994, several new discoveries have been made. In the laboratory, advances in the fields of genetics, molecular signalling, stem cell biology and hair cell development and regeneration have been made. Through these advances, the potential roll of cellular and intracellular tools for the future treatment of hearing loss has been recognized. This paper comprises a review of the current status of important areas of research. PMID:24549508

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

    PubMed Central

    Sawadkar, Prasad; Mudera, Vivek

    2014-01-01

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

  19. Complications associated with molding helmet therapy for positional plagiocephaly: a review.

    PubMed

    Gump, William C; Mutchnick, Ian S; Moriarty, Thomas M

    2013-10-01

    Molding helmet therapy is a widely accepted treatment for positional plagiocephaly that is generally considered to be low risk. Multiple large outcome studies have shown good results, but adverse events are rarely reported. The literature on helmet therapy was reviewed to clarify the clinical experience with associated complications. Although significant complications were extremely rare, there was a large degree of variability in detection of lesser problems such as minor skin irritation. Patients with a primarily brachycephalic morphology may be at higher risk for poorly fitting orthoses. Most reported complications are minor and self-limited. Maintenance of good helmet hygiene appears to be the most effective strategy for reducing or eliminating complications. PMID:24079782

  20. Systematic Review and Meta-Analysis of Psychological Therapies for Children With Chronic Pain

    PubMed Central

    Heathcote, Lauren; Palermo, Tonya M.; de C Williams, Amanda C; Lau, Jennifer; Eccleston, Christopher

    2014-01-01

    Objectives This systematic review and meta-analysis examined the effects of psychological therapies for management of chronic pain in children. Methods Randomized controlled trials of psychological interventions treating children (<18 years) with chronic pain conditions including headache, abdominal, musculoskeletal, or neuropathic pain were searched for. Pain symptoms, disability, depression, anxiety, and sleep outcomes were extracted. Risk of bias was assessed and quality of the evidence was rated using GRADE. Results 35 included studies revealed that across all chronic pain conditions, psychological interventions reduced pain symptoms and disability posttreatment. Individual pain conditions were analyzed separately. Sleep outcomes were not reported in any trials. Optimal dose of treatment was explored. For headache pain, higher treatment dose led to greater reductions in pain. No effect of dosage was found for other chronic pain conditions. Conclusions Evidence for psychological therapies treating chronic pain is promising. Recommendations for clinical practice and research are presented. PMID:24602890

  1. Effectiveness of acupuncture and related therapies for palliative care of cancer: overview of systematic reviews

    PubMed Central

    Wu, Xinyin; Chung, Vincent CH; Hui, Edwin P; Ziea, Eric TC; Ng, Bacon FL; Ho, Robin ST; Tsoi, Kelvin KF; Wong, Samuel YS; Wu, Justin CY

    2015-01-01

    Acupuncture and related therapies such as moxibustion and transcutaneous electrical nerve stimulation are often used to manage cancer-related symptoms, but their effectiveness and safety are controversial. We conducted this overview to summarise the evidence on acupuncture for palliative care of cancer. Our systematic review synthesised the results from clinical trials of patients with any type of cancer. The methodological quality of the 23 systematic reviews in this overview, assessed using the Methodological Quality of Systematic Reviews Instrument, was found to be satisfactory. There is evidence for the therapeutic effects of acupuncture for the management of cancer-related fatigue, chemotherapy-induced nausea and vomiting and leucopenia in patients with cancer. There is conflicting evidence regarding the treatment of cancer-related pain, hot flashes and hiccups, and improving patients’ quality of life. The available evidence is currently insufficient to support or refute the potential of acupuncture and related therapies in the management of xerostomia, dyspnea and lymphedema and in the improvement of psychological well-being. No serious adverse effects were reported in any study. Because acupuncture appears to be relatively safe, it could be considered as a complementary form of palliative care for cancer, especially for clinical problems for which conventional care options are limited. PMID:26608664

  2. Effectiveness of laser therapy and topical desensitising agents in treating dentine hypersensitivity: a systematic review.

    PubMed

    He, S; Wang, Y; Li, X; Hu, D

    2011-05-01

    The aim of this systematic review was to compare the effectiveness of laser therapy with that of topical desensitising agents in treating dentine hypersensitivity. A secondary objective was to determine the safety of laser application according to the relevant studies. A systematic search was performed in the MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the National Research Register, the Cochrane Oral Health Group's Trials Register database to retrieve all articles that were about randomised controlled trials involving the application of laser desensitising procedures and topical desensitising agents in the treatment of dentine hypersensitivity. A total of eight trials that met all inclusion criteria involving 234 participants were reviewed. Based upon the 'quality' of evidence, one study was classified as A level, five as B level and two as C level. Owing to the heterogeneity of the studies, a meta-analysis was not performed. Half of the included studies compared GaALAS laser with topical desensitising agents, but the findings were conflicting. The remaining studies involved Nd:YAG laser, Er:YAG laser and CO2 laser, and all showed that the three types of lasers were superior to topical desensitising agents, but the superiority was slight. A systematic review of the literature indicates the likelihood that laser therapy has a slight clinical advantage over topical medicaments in the treatment of dentine hypersensitivity. More large sample-sized, long-term, high-quality randomised controlled clinical trials are needed before definitive conclusions were made. PMID:21223353

  3. Interventions for Enhancing Adherence to Antiretroviral Therapy (ART): A Systematic Review of High Quality Studies

    PubMed Central

    Sivaramalingam, Bhairavi; Navarro, Tamara; Hobson, Nicholas; Keepanasseril, Arun; Wilczynski, Nancy J.; Haynes, R. Brian

    2015-01-01

    Abstract We sought to review the effectiveness of interventions designed to improve adherence to antiretroviral therapy (ART) from studies included in a recent Cochrane review that reported a clinical and an adherence outcome, with at least 80% follow-up for 6 months or more. Data were extracted independently and in duplicate, with an adjudicator for disagreements. Risk of bias was assessed using the Cochrane Risk of Bias tool. Of 182 relevant studies in the Cochrane review, 49 were related to ART. Statistical pooling was not warranted due to heterogeneity in interventions, participants, treatments, adherence measures and outcomes. Many studies had high risk of bias in elements of design and outcome ascertainment. Only 10 studies improved both adherence and clinical outcomes. These used the following interventions: adherence counselling (two studies); a once-daily regimen (compared to twice daily); text messaging; web-based cognitive behavioral intervention; face-to-face multi-session intensive behavioral interventions (two studies); contingency management; modified directly observed therapy; and nurse-delivered home visits combined with telephone calls. Patient-related adherence interventions were the most frequently tested. Uniform adherence measures and higher quality studies of younger populations are encouraged. PMID:25825938

  4. The Acceptability and Usefulness of Cognitive Stimulation Therapy for Older Adults with Dementia: A Narrative Review

    PubMed Central

    Toh, Hui Moon; Ghazali, Shazli Ezzat

    2016-01-01

    Cognitive stimulation therapy (CST) is an evidence-based therapy for individuals with mild-to-moderate dementia. Past reviews have only synthesized outcomes obtained through quantitative study which does not fully represent the understanding on the acceptability and usefulness of CST. Therefore, the present review aims to integrate outcomes obtained from both quantitative and qualitative studies to provide a deeper understanding on the acceptability and usefulness of CST for older adults with dementia. Findings of literature were retrieved from searches of computerized databases in relation to CST for people with dementia. Literatures were selected according to selection criteria outlined. Results obtained in previous studies pertaining to the effects of CST were discussed in relation to variables such as cognitive function, quality of life, and family caregivers' wellbeing. The review also explores the use of CST in different cultural context, the perception on its effectiveness, and individualized CST (iCST). There is considerable evidence obtained through quantitative and qualitative studies on the usefulness and acceptability of CST for older adults with dementia. Recommendations for future research are provided to strengthen the evidence of CST's effectiveness. PMID:27478677

  5. Is enhanced cognitive behavioral therapy an effective intervention in eating disorders? A review.

    PubMed

    Groff, Sara E

    2015-01-01

    In this study the author reviews the current empirical research regarding Enhanced Cognitive Behavioral Therapy (CBT-E) in the treatment of the full range of eating disorders (EDs): anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified. All peer-reviewed outcome studies identified through electronic bibliographic databases and manual searches of article reference lists are reviewed. A total of six studies (n = 6) were found. The author reports the results of these studies consisting of open-trials of CBT-E applied to different ED diagnoses, comparing two forms of CBT-E (focused and broad) to waitlist, and comparing CBT-E plus Motivation Focused Therapy. There is evidence to support the use of CBT-E for the treatment of EDs; however, this evidence is tentative as CBT-E is still in its early phases of empirical testing. No trials found CBT-E to be ineffective. Although these research designs are not randomized control trials, these results are promising for ED research. There are few efficacious treatments for EDs, especially for those with "chronic" EDs and adults with anorexia nervosa. CBT-E is one of the first interventions that focuses on particular symptomatic behaviors of EDs manifested in individual clients rather than treating ED diagnoses generically. PMID:25661898

  6. Game-Based Digital Interventions for Depression Therapy: A Systematic Review and Meta-Analysis

    PubMed Central

    Theng, Yin-Leng; Foo, Schubert

    2014-01-01

    Abstract 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

  7. Effectiveness of acupuncture and related therapies for palliative care of cancer: overview of systematic reviews.

    PubMed

    Wu, Xinyin; Chung, Vincent C H; Hui, Edwin P; Ziea, Eric T C; Ng, Bacon F L; Ho, Robin S T; Tsoi, Kelvin K F; Wong, Samuel Y S; Wu, Justin C Y

    2015-01-01

    Acupuncture and related therapies such as moxibustion and transcutaneous electrical nerve stimulation are often used to manage cancer-related symptoms, but their effectiveness and safety are controversial. We conducted this overview to summarise the evidence on acupuncture for palliative care of cancer. Our systematic review synthesised the results from clinical trials of patients with any type of cancer. The methodological quality of the 23 systematic reviews in this overview, assessed using the Methodological Quality of Systematic Reviews Instrument, was found to be satisfactory. There is evidence for the therapeutic effects of acupuncture for the management of cancer-related fatigue, chemotherapy-induced nausea and vomiting and leucopenia in patients with cancer. There is conflicting evidence regarding the treatment of cancer-related pain, hot flashes and hiccups, and improving patients' quality of life. The available evidence is currently insufficient to support or refute the potential of acupuncture and related therapies in the management of xerostomia, dyspnea and lymphedema and in the improvement of psychological well-being. No serious adverse effects were reported in any study. Because acupuncture appears to be relatively safe, it could be considered as a complementary form of palliative care for cancer, especially for clinical problems for which conventional care options are limited. PMID:26608664

  8. 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.

  9. Calculation of radiation therapy dose using all particle Monte Carlo transport

    DOEpatents

    Chandler, William P.; Hartmann-Siantar, Christine L.; Rathkopf, James A.

    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.

  10. Reduction-sensitive polymeric nanocarriers in cancer therapy: a comprehensive review

    NASA Astrophysics Data System (ADS)

    Deng, Bing; Ma, Ping; Xie, Yan

    2015-07-01

    Redox potential is regarded as a significant signal to distinguish between the extra-cellular and intra-cellular environments, as well as between tumor and normal tissues. Taking advantage of this physiological differentiation, various reduction-sensitive polymeric nanocarriers (RSPNs) have been designed and explored to demonstrate excellent stability during blood circulation but rapidly degrade and effectively trigger drug release in tumor cells. Therefore, this smart RSPN delivery system has attracted much attention in recent years, as it represents one of the most promising drug delivery strategies in cancer therapy. In this review, we will provide a comprehensive overview of RSPNs with various reducible linkages and functional groups up to date, including their design and synthetic strategies, preparation methods, drug release behavior, and their in vitro and in vivo efficacy in cancer therapy. In addition, dual- and triple-sensitive nanocarriers based on reducible disulfide bond-containing linkages will also be discussed.Redox potential is regarded as a significant signal to distinguish between the extra-cellular and intra-cellular environments, as well as between tumor and normal tissues. Taking advantage of this physiological differentiation, various reduction-sensitive polymeric nanocarriers (RSPNs) have been designed and explored to demonstrate excellent stability during blood circulation but rapidly degrade and effectively trigger drug release in tumor cells. Therefore, this smart RSPN delivery system has attracted much attention in recent years, as it represents one of the most promising drug delivery strategies in cancer therapy. In this review, we will provide a comprehensive overview of RSPNs with various reducible linkages and functional groups up to date, including their design and synthetic strategies, preparation methods, drug release behavior, and their in vitro and in vivo efficacy in cancer therapy. In addition, dual- and triple

  11. A randomized controlled study of reviewer bias against an unconventional therapy.

    PubMed Central

    Resch, K I; Ernst, E; Garrow, J

    2000-01-01

    A study was designed to test the hypothesis that experts who review papers for publication are prejudiced against an unconventional form of therapy. Two versions were produced (A and B) of a 'short report' that related to treatments of obesity, identical except for the nature of the intervention. Version A related to an orthodox treatment, version B to an unconventional treatment. 398 reviewers were randomized to receive one or the other version for peer review. The primary outcomes were the reviewers' rating of 'importance' on a scale of 1-5 and their verdict regarding rejection or acceptance of the paper. Reviewers were unaware that they were taking part in a study. The overall response rate was 41.7%, and 141 assessment forms were suitable for statistical evaluation. After dichotomization of the rating scale, a significant difference in favour of the orthodox version with an odds ratio of 3.01 (95% confidence interval, 1.03 to 8.25), was found. This observation mirrored that of the visual analogue scale for which the respective medians and interquartile ranges were 67% (51% to 78.5%) for version A and 57% (29.7% to 72.6%) for version B. Reviewers showed a wide range of responses to both versions of the paper, with a significant bias in favour of the orthodox version. Authors of technically good unconventional papers may therefore be at a disadvantage in the peer review process. Yet the effect is probably too small to preclude publication of their work in peer-reviewed orthodox journals. PMID:10844878

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

    PubMed

    Okonta, Nkechi Rose

    2012-01-01

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

  13. Systematic review on antibiotic therapy for pneumonia in children between 2 and 59 months of age.

    PubMed

    Lassi, Zohra S; Das, Jai K; Haider, Syed Waqas; Salam, Rehana A; Qazi, Shamim A; Bhutta, Zulfiqar A

    2014-07-01

    Community-acquired pneumonia (CAP) remains a force to reckon with, as it accounts for 1.1 million of all deaths in children less than 5 years of age globally, with disproportionately higher mortality occurring in the low and middle income-countries (LMICs) of Southeast Asia and Africa. Existing strategies to curb pneumonia-related morbidity and mortality have not effectively translated into meaningful control of pneumonia-related burden. In the present systematic review, we conducted a meta-analysis of trials conducted in LMICs to determine the most suitable antibiotic therapy for treating pneumonia (very severe, severe and non-severe). While previous reviews, including the most recent review by Lodha et al, have focused either on single modality of antibiotic therapy (such as choice of antibiotic) or children under the age of 16 years, the current review updates evidence on the choice of drug, duration, route and combination of antibiotics in children specifically between 2 and 59 months of age. We included randomised controlled trials (RCTs) and quasi-RCTs that assessed the route, dose, combination and duration of antibiotics in the management of WHO-defined very severe/severe/non-severe CAP. Study participants included children between 2 and 59 months of age with CAP. All available titles and abstracts were screened for inclusion by two review authors independently. All data was entered and analysed using Review Manager 5 software. The review identified 8122 studies on initial search, of which 22 studies which enrolled 20,593 children were included in meta-analyses. Evidence from these trials showed a combination of penicillin/ampicillin and gentamicin to be effective for managing very severe pneumonia in children between 2 and 59 months of age, and oral amoxicillin to be equally efficacious, as other parenteral antibiotics for managing severe pneumonia in children of this particular age group. Oral amoxicillin was also found to be effective in non

  14. A review of microfabrication techniques and dielectrophoretic microdevices for particle manipulation and separation

    NASA Astrophysics Data System (ADS)

    Li, M.; Li, W. H.; Zhang, J.; Alici, G.; Wen, W.

    2014-02-01

    The development of lab-on-a-chip (LOC) devices over the past decade has attracted growing interest. LOC devices aim to achieve the miniaturization, integration, automation and parallelization of biological and chemical assays. One of the applications, the ability to effectively and accurately manipulate and separate micro- and nano-scale particles in an aqueous solution, is particularly appealing in biological, chemical and medical fields. Among the technologies that have been developed and implemented in microfluidic microsystems for particle manipulation and separation (such as mechanical, inertial, hydrodynamic, acoustic, optical, magnetic and electrical methodologies), dielectrophoresis (DEP) may prove to be the most popular because of its label-free nature, ability to manipulate neutral bioparticles, analyse with high selectivity and sensitivity, compatibility with LOC devices, and easy and direct interface with electronics. The required spatial electric non-uniformities for the DEP effect can be generated by patterning microelectrode arrays within microchannels, or placing insulating obstacles within a microchannel and curving the microchannels. A wide variety of electrode- and insulator-based DEP microdevices have been developed, fabricated, and successfully employed to manipulate and separate bioparticles (i.e. DNA, proteins, bacteria, viruses, mammalian and yeast cells). This review provides an overview of the state-of-the-art of microfabrication techniques and of the structures of dielectrophoretic microdevices aimed towards different applications. The techniques used for particle manipulation and separation based on microfluidics are provided in this paper. In addition, we also present the theoretical background of DEP.

  15. Potential of laser mass spectrometry for the analysis of environmental dust particles--a review.

    PubMed

    Aubriet, Frédéric; Carré, Vincent

    2010-02-01

    Laser-based aerosol mass spectrometry in both on-line and off-line modes has become an essential tool to analyze airborne and industrial dust particles. The versatility of laser desorption and/or ionization appears to be a powerful tool to obtain the global composition of environment particles. Laser mass spectrometry to analyze inorganic (elemental and molecular), organic and biological aerosol components without or with a restricted number of preparation steps in both on-line and off-line modes can be regarded as an ideal analytical machine. However, some limitations are associated to this range of mass spectrometry techniques. This review presents the fundamental aspects of laser-based mass spectrometry and the different kinds of analyses, which may be done. A selected number of applications are then given which allows the reader to consider both the capabilities and the drawbacks of laser mass spectrometry to analyze dust environmental particles. Critical discussion is focused on comparison and new trends of these aerosol analytical techniques. PMID:20103104

  16. Determination of chemical composition of individual airborne particles by SEM/EDX and micro-Raman spectrometry: A review

    NASA Astrophysics Data System (ADS)

    Stefaniak, E. A.; Buczynska, A.; Novakovic, V.; Kuduk, R.; Van Grieken, R.

    2009-04-01

    The strategies for sampling and analysis by SEM/EDX and micro-Raman spectrometry for individual airborne particles analysis as applied at the University of Antwerp (Belgium) by the MITAC group have been reviewed. Microbeam techniques provide detailed information concerning the origin, formation, transport, reactivity, transformation reactions and environmental impact of particulate matter. Moreover, some particles of certain chemical properties have been recognized as a threat for human health and cultural heritage objects. However, the small sizes of particles result in specific problems with respect to single particle analysis. Development of equipment and software for improvement of analysis and quantification are reported.

  17. Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy

    PubMed Central

    Gjeorgjievski, Mihajlo; Cappell, Mitchell S

    2016-01-01

    AIM: To describe the pathophysiology, clinical presentation, natural history, and therapy of portal hypertensive gastropathy (PHG) based on a systematic literature review. METHODS: Computerized search of the literature was performed via PubMed using the following medical subject headings or keywords: “portal” and “gastropathy”; or “portal” and “hypertensive”; or “congestive” and “gastropathy”; or “congestive” and “gastroenteropathy”. The following criteria were applied for study inclusion: Publication in peer-reviewed journals, and publication since 1980. Articles were independently evaluated by each author and selected for inclusion by consensus after discussion based on the following criteria: Well-designed, prospective trials; recent studies; large study populations; and study emphasis on PHG. RESULTS: PHG is diagnosed by characteristic endoscopic findings of small polygonal areas of variable erythema surrounded by a pale, reticular border in a mosaic pattern in the gastric fundus/body in a patient with cirrhotic or non-cirrhotic portal hypertension. Histologic findings include capillary and venule dilatation, congestion, and tortuosity, without vascular fibrin thrombi or inflammatory cells in gastric submucosa. PHG is differentiated from gastric antral vascular ectasia by a different endoscopic appearance. The etiology of PHG is inadequately understood. Portal hypertension is necessary but insufficient to develop PHG because many patients have portal hypertension without PHG. PHG increases in frequency with more severe portal hypertension, advanced liver disease, longer liver disease duration, presence of esophageal varices, and endoscopic variceal obliteration. PHG pathogenesis is related to a hyperdynamic circulation, induced by portal hypertension, characterized by increased intrahepatic resistance to flow, increased splanchnic flow, increased total gastric flow, and most likely decreased gastric mucosal flow. Gastric mucosa

  18. Systematic review of occupational therapy-related interventions for people with multiple sclerosis: part 1. Activity and participation.

    PubMed

    Yu, Chih-Huang; Mathiowetz, Virgil

    2014-01-01

    This article is the first part of a systematic review of studies on occupational therapy-related intervention for people with multiple sclerosis (MS). The objective of this systematic review was to critically appraise and synthesize the applicable findings to address the following focused question: What is the evidence for the effectiveness of interventions within the scope of occupational therapy practice for people with multiple sclerosis? This article focuses on occupational therapy interventions aimed at activity and participation, including programs (e.g., inpatient and outpatient rehabilitation) in which an occupational therapy practitioner was one member of the team. Part 2 (Yu & Mathiowetz, 2014) focuses on interventions within the scope of occupational therapy to remediate impairment (e.g., exercise, cognition, emotional regulation). PMID:24367952

  19. Efficacy of AZM therapy in patients with gingival overgrowth induced by Cyclosporine A: a systematic review

    PubMed Central

    Clementini, Marco; Vittorini, Gianluca; Crea, Alessandro; Gualano, Maria Rosaria; Macrì, Ludovica Antonella; Deli, Giorgio; La Torre, Giuseppe

    2008-01-01

    Background In daily clinical practice of a dental department it's common to find gingival overgrowth (GO) in periodontal patients under treatment with Cyclosporine A (CsA). The pathogenesis of GO and the mechanism of action of Azithromycin (AZM) are unclear. A systematic review was conducted in order to evaluate the efficacy of Azithromycin in patients with gingival overgrowth induced by assumption of Cyclosporine A. Methods A bibliographic search was performed using the online databases MEDLINE, EMBASE and Cochrane Central of Register Controlled Trials (CENTRAL) in the time period between 1966 and September 2008. Results The literature search retrieved 24 articles; only 5 were Randomised Controlled Trials (RCTs), published in English, fulfilled the inclusion criteria. A great heterogeneity between proposed treatments and outcomes was found, and this did not allow to conduct a quantitative meta-analysis. The systematic review revealed that a 5-day course of Azithromycin with Scaling and Root Planing reduces the degree of gingival overgrowth, while a 7-day course of metronidazole is only effective on concomitant bacterial over-infection. Conclusion Few RCTs on the efficacy of systemic antibiotic therapy in case of GO were found in the literature review. A systemic antibiotic therapy without plaque and calculus removal is not able to reduce gingival overgrowth. The great heterogeneity of diagnostic data and outcomes is due to the lack of precise diagnostic methods and protocols about GO. Future studies need to improve both diagnostic methods and tools and adequate classification aimed to determine a correct prognosis and an appropriate therapy for gingival overgrowth. PMID:19087331

  20. Adherence with drug therapy in the rheumatic diseases Part one: a review of adherence rates.

    PubMed

    Hill, Jackie

    2005-01-01

    Drug therapy plays a major role in the management of many rheumatic diseases and is particularly important in rheumatoid arthritis (RA) because of the significant rates of morbidity and mortality (Pincus, 1995). Understanding of the pathogenesis of RA has led to the development of new and more effective drugs (Emery et al., 1999), but the ultimate efficacy of any drug therapy depends upon the patient's decision to take it. There is widespread agreement that many people with rheumatic disease do not adhere to their medication regimens (Deyo et al., 1981; Belcon et al., 1984; Pullar et al., 1988; Hill et al., 2001). Research has demonstrated that 50% of women taking hormone replacement therapy for the prevention of osteoporosis discontinue treatment after a year (Fordham, 2000) and similar rates of discontinuation are found in other chronic diseases (Haynes et al., 1996, 2000). This is bewildering as, in asymptomatic illnesses such as hypertension and diabetes, the expectation is that levels of adherence would be lower than in diseases where pain and stiffness are present. The picture becomes even more confusing when we consider the findings from a recent multi-country study of RA, which found no association between adherence and disease severity, nor with the treatment prescribed (Viller et al., 1999). In chronic disease poor adherence is commonplace. The World Health Organization (WHO) recognizes this and has recently stated that 'poor adherence to treatment of chronic diseases is a worldwide problem of striking magnitude' and cites adherence to long-term therapy for chronic illnesses in developed countries averaging just 50% (WHO, 2003). The first part of this two part review focuses on adherence with drug therapy, and the second part discusses different methods of measuring it. PMID:17041995

  1. Association between susceptible genotypes to periodontitis and clinical outcomes of periodontal regenerative therapy: A systematic review

    PubMed Central

    Koidou, Vasiliki-Petros

    2016-01-01

    Background The aim of this review is to systematically investigate the effect of a susceptible genotype to periodontitis with the clinical outcomes of periodontal regeneration. Material and Methods Based on a focused question, an electronic search identified 155 unique citations. Three journals (Journal of Periodontology, Journal of Clinical Periodontology and Journal of Periodontal Research), references of relevant studies and review articles were hand-searched. Two independent reviewers implementing eligibility inclusion criteria selected the studies. Results Of the 155, four studies fulfilled the inclusion criteria. All studies were published between 2000 and 2004 and the samples’ size was 40 to 86 patients. Polymorphisms of Interleukin-1 (IL-1) gene were included in all. Three out of four studies failed to identify an association between susceptible genotypes to periodontitis and clinical outcomes of periodontal regeneration, while one found an association. The heterogeneity and small number of studies included prevented the conduct of a meta-analysis. No studies were identified evaluating the effect of other genotypes and as a result only IL-1 genotype studies were included. Conclusions Within the limits of the present review, no direct conclusion for the effect of a susceptible IL-1 genotype status to the clinical outcome after periodontal regeneration could be drawn. The need of more qualitative studies to explore a possible association emerges. Key words:Periodontitis, genotype, periodontal therapy, regeneration, susceptibility, systematic review. PMID:26946210

  2. 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

  3. Review of intravesical therapies for bladder pain syndrome/interstitial cystitis

    PubMed Central

    Rosamilia, Anna

    2015-01-01

    Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic pain condition characterised by urinary frequency, urgency and pain or discomfort which the patient attributes to the bladder. It is a complex condition to manage and treat and requires a multi-disciplinary and multi-modal approach. As well as lifestyle and behavioural modifications, physical therapy and oral medications, intravesical treatments can be used in the treatment algorithm for BPS/IC. A number of intravesical agents are reviewed in this paper along with the available evidence for their use. PMID:26816864

  4. Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis

    PubMed Central

    Camacho, Macario; Certal, Victor; Abdullatif, Jose; Zaghi, Soroush; Ruoff, Chad M.; Capasso, Robson; Kushida, Clete A.

    2015-01-01

    Objective: To systematically review the literature for articles evaluating myofunctional therapy (MT) as treatment for obstructive sleep apnea (OSA) in children and adults and to perform a meta-analysis on the polysomnographic, snoring, and sleepiness data. Data Sources: Web of Science, Scopus, MEDLINE, and The Cochrane Library. Review Methods: The searches were performed through June 18, 2014. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was followed. Results: Nine adult studies (120 patients) reported polysomnography, snoring, and/or sleepiness outcomes. The pre- and post-MT apneahypopnea indices (AHI) decreased from a mean ± standard deviation (M ± SD) of 24.5 ± 14.3/h to 12.3 ± 11.8/h, mean difference (MD) −14.26 [95% confidence interval (CI) −20.98, −7.54], P < 0.0001. Lowest oxygen saturations improved from 83.9 ± 6.0% to 86.6 ± 7.3%, MD 4.19 (95% CI 1.85, 6.54), P = 0.0005. Polysomnography snoring decreased from 14.05 ± 4.89% to 3.87 ± 4.12% of total sleep time, P < 0.001, and snoring decreased in all three studies reporting subjective outcomes. Epworth Sleepiness Scale decreased from 14.8 ± 3.5 to 8.2 ± 4.1. Two pediatric studies (25 patients) reported outcomes. In the first study of 14 children, the AHI decreased from 4.87 ± 3.0/h to 1.84 ± 3.2/h, P = 0.004. The second study evaluated children who were cured of OSA after adenotonsillectomy and palatal expansion, and found that 11 patients who continued MT remained cured (AHI 0.5 ± 0.4/h), whereas 13 controls had recurrent OSA (AHI 5.3 ± 1.5/h) after 4 y. Conclusion: Current literature demonstrates that myofunctional therapy decreases apnea-hypopnea index by approximately 50% in adults and 62% in children. Lowest oxygen saturations, snoring, and sleepiness outcomes improve in adults. Myofunctional therapy could serve as an adjunct to other obstructive sleep apnea treatments. Citation: Camacho M, Certal V, Abdullatif J, Zaghi S, Ruoff CM

  5. TOPICAL REVIEW: Multifunctional nanoassemblies of block copolymers for future cancer therapy

    NASA Astrophysics Data System (ADS)

    Cabral, Horacio; Kataoka, Kazunori

    2010-02-01

    Nanoassemblies from amphiphilic block copolymers are promising nanomedicine platforms for cancer diagnosis and therapy due to their relatively small size, high loading capacity of drugs, controlled drug release, in vivo stability and prolonged blood circulation. Recent clinical trials with self-assembled polymeric micelles incorporating anticancer drugs have shown improved antitumor activity and decreased side effects encouraging the further development of nanoassemblies for drug delivery. This review summarizes recent approaches considering stimuli-responsive, multifunctionality and more advanced architectures, such as vesicles or worm-like micelles, for tumor-specific drug and gene delivery.

  6. Antiapoptotic Bcl-2 protein as a potential target for cancer therapy: A mini review.

    PubMed

    Jagani, Hitesh; Kasinathan, Narayanan; Meka, Sreenivasa Reddy; Josyula, Venkata Rao

    2016-08-01

    Bcl-2, an antiapoptotic protein, is considered as a potential target in cancer treatment since its oncogenic potential has been proven and is well documented. Antisense technology and RNA interference (RNAi) have been used to reduce the expression of the Bcl-2 gene in many types of cancer cells and are effective as adjuvant therapy along with the chemotherapeutic agents. The lack of appropriate delivery systems is considered to be the main hurdle associated with the RNAi. In this review, we discuss the antiapoptotic Bcl-2 protein, its oncogenic potential, and various approaches utilized to target Bcl-2 including suitable delivery systems employed for successful delivery of siRNA. PMID:25801037

  7. Evaluation of cytotoxicity and radiation enhancement using 1.9 nm gold particles: potential application for cancer therapy

    NASA Astrophysics Data System (ADS)

    Butterworth, K. T.; Coulter, J. A.; Jain, S.; Forker, J.; McMahon, S. J.; Schettino, G.; Prise, K. M.; Currell, F. J.; Hirst, D. G.

    2010-07-01

    High atomic number (Z) materials such as gold preferentially absorb kilovoltage x-rays compared to soft tissue and may be used to achieve local dose enhancement in tumours during treatment with ionizing radiation. Gold nanoparticles have been demonstrated as radiation dose enhancing agents in vivo and in vitro. In the present study, we used multiple endpoints to characterize the cellular cytotoxic response of a range of cell lines to 1.9 nm gold particles and measured dose modifying effects following transient exposure at low concentrations. Gold nanoparticles caused significant levels of cell type specific cytotoxicity, apoptosis and increased oxidative stress. When used as dose modifying agents, dose enhancement factors varied between the cell lines investigated with the highest enhancement being 1.9 in AGO-1522B cells at a nanoparticle concentration of 100 µg ml - 1. This study shows exposure to 1.9 nm gold particles to induce a range of cell line specific responses including decreased clonogenic survival, increased apoptosis and induction of DNA damage which may be mediated through the production of reactive oxygen species. This is the first study involving 1.9 nm nanometre sized particles to report multiple cellular responses which impact on the radiation dose modifying effect. The findings highlight the need for extensive characterization of responses to gold nanoparticles when assessing dose enhancing potential in cancer therapy.

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

    ERIC Educational Resources Information Center

    Harpell, Jody V.; Andrews, Jac

    2006-01-01

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

  9. Particle-in-cell simulations of whistler turbulence: A review (Invited)

    NASA Astrophysics Data System (ADS)

    Gary, S. P.; Chang, O.; Hughes, R. S.; Wang, J.

    2013-12-01

    Measurements of broadband magnetic fluctuations in the solar wind at wavelengths shorter than the ion inertial length indicate that the primary constituent of such turbulence is kinetic Alfven waves at frequencies well below the proton cyclotron frequency. Nevertheless, it is possible that much higher frequency whistler fluctuations also contribute to this short-wavelength turbulence. To better understand such potential contributions to solar wind turbulence, we have carried out a series of three-dimensional (3D) particle-in-cell (PIC) simulations of whistler turbulence in a collisionless, homogeneous, magnetized plasma [Chang et al., 2011, 2013; Gary et al., 2012]. We here review the properties of these simulations, which address turbulence driven by both an initial ensemble of whistler waves and by the whistler anisotropy instability. Our results include the consequences due to both forward and inverse cascades, to variations in the amplitudes of the initial fluctuations and to variations in βe. We describe the magnetic fluctuation spectral properties as well as dissipation on the electrons, which are heated primarily in directions parallel and antiparallel to the background magnetic field. Magnetic fluctuation energy spectra exhibit a break to steeper slopes which scales as the inverse electron inertial length. The simulation results are consistent with the interpretation that the forward cascade is due to nonlinear three-wave interactions. Chang, O., S. P. Gary, and J. Wang (2011), Whistler turbulence forward cascade: Three-dimensional particle-in-cell simulations, Geophys. Res. Lett., 38, L22102. Chang, O., S. P. Gary, and J. Wang (2013), Whistler turbulence at variable electron beta: Three-dimensional particle-in-cell simulations, J. Geophys. Res., 118, 2824. Gary, S. P., O. Chang, and J. Wang (2012), Forward cascade of whistler turbulence: Three-dimensional particle-in-cell simulations, Ap. J., 755, 142.

  10. Advanced pancreatic adenocarcinoma: a review of current treatment strategies and developing therapies

    PubMed Central

    Teague, Andrea; Lim, Kian-Huat

    2015-01-01

    Pancreatic adenocarcinoma is one of the deadliest solid malignancies. A large proportion of patients are diagnosed with locally advanced or metastatic disease at the time of presentation and, unfortunately, this severely limits the number of patients who can undergo surgical resection, which offers the only chance for cure. Recent therapeutic advances for patients with advanced pancreatic cancer have extended overall survival, but prognosis still remains grim. Given that traditional chemotherapy is ineffective in curing advanced pancreatic adenocarcinoma, current research is taking a multidirectional approach in the hopes of developing more effective treatments. This article reviews the major clinical trial data that is the basis for the current chemotherapy regimens used as first- and second-line treatments for advanced pancreatic adenocarcinoma. We also review the current ongoing clinical trials, which include the use of agents targeting the oncogenic network signaling of K-Ras, agents targeting the extracellular matrix, and immune therapies. PMID:25755680

  11. 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

  12. 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

  13. Reiki--review of a biofield therapy history, theory, practice, and research.

    PubMed

    Miles, Pamela; True, Gala

    2003-01-01

    Reiki is a vibrational, or subtle energy, therapy most commonly facilitated by light touch, which is believed to balance the biofield and strengthen the body's ability to heal itself. Although systematic study of efficacy is scant thus far, Reiki is increasingly used as an adjunct to conventional medical care, both in and out of hospital settings. This article will describe the practice and review the history and theory of Reiki, giving readers a context for the growing popularity of this healing modality. Programs that incorporate Reiki into the clinical setting will be discussed, as well as important considerations in setting up such a program. Finally, the research literature to date on Reiki will be reviewed and evaluated, and directions for future Reiki research will be suggested. PMID:12652885

  14. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis

    PubMed Central

    Pitance, Laurent; Singh, Vandana; Neto, Francisco; Thie, Norman; Michelotti, Ambra

    2016-01-01

    Background Manual therapy (MT) and exercise have been extensively used to treat people with musculoskeletal conditions such as temporomandibular disorders (TMD). The evidence regarding their effectiveness provided by early systematic reviews is outdated. Purpose The aim of this study was to summarize evidence from and evaluate the methodological quality of randomized controlled trials that examined the effectiveness of MT and therapeutic exercise interventions compared with other active interventions or standard care for treatment of TMD. Data Sources Electronic data searches of 6 databases were performed, in addition to a manual search. Study Selection Randomized controlled trials involving adults with TMD that compared any type of MT intervention (eg, mobilization, manipulation) or exercise therapy with a placebo intervention, controlled comparison intervention, or standard care were included. The main outcomes of this systematic review were pain, range of motion, and oral function. Forty-eight studies met the inclusion criteria and were analyzed. Data Extraction Data were extracted in duplicate on specific study characteristics. Data Synthesis The overall evidence for this systematic review was considered low. The trials included in this review had unclear or high risk of bias. Thus, the evidence was generally downgraded based on assessments of risk of bias. Most of the effect sizes were low to moderate, with no clear indication of superiority of exercises versus other conservative treatments for TMD. However, MT alone or in combination with exercises at the jaw or cervical level showed promising effects. Limitations Quality of the evidence and heterogeneity of the studies were limitations of the study. Conclusions No high-quality evidence was found, indicating that there is great uncertainty about the effectiveness of exercise and MT for treatment of TMD. PMID:26294683

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

    PubMed Central

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

    2014-01-01

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

  16. A review: Different methods producing different particles size and distribution in synthesis of calcium carbonate nano particles

    NASA Astrophysics Data System (ADS)

    Sulimai, N. H.; Rusop, M.; Alrokayan, Salman A. H.; Khan, Haseeb A.

    2016-07-01

    Carbonates exist as 73 percent of world crust carbon. Abundance and bioavailability of Calcium Carbonates offer reliable resources, costs saving and environmental friendly potentials in its applications. Studies proven nano-sized Calcium Cabonate (nCC) employs a more significant characteristics compared to larger sizes. Properties of nCC is affected by the dispersion of the particles in which agglomeration occurs. It is important to gain more understanding of the conditions contributing or stunting the agglomeration to gain more control of the particles morphology and dynamic. A few recent studies with different methods to prepare calcium carbonate nanoparticles were listed in Table 1 .Particle size and dispersity of calcium carbonate are affected by different conditions of its preparation. Other factors such as mechanical aggression, concentration of solution, temperature of precipitation, pH of reaction are all contributing factors towards particle sizes and distribution.

  17. Androgen-deprivation therapy and bone loss in prostate cancer patients: a clinical review

    PubMed Central

    Bienz, Marc; Saad, Fred

    2015-01-01

    Androgen-deprivation therapy (ADT) has become a standard of care in the management of advanced prostate cancer or as an adjunct therapy. However, ADT is associated with a well-known deleterious effect on bone health, resulting in a decrease in bone-mass density (BMD) and increased risk for fracture. With the longer life expectancy of prostate cancer patients, improvement of the quality of life has become increasingly important. Therefore, adequate screening, prevention and treatment of BMD loss is paramount. Zoledronic acid and denosumab have shown promising results in recent studies, which has led to the Food and Drug Administration approval of these treatment options in various settings throughout the course of the disease, including the prevention of ADT-associated bone loss. This review focuses on the various parameters that impact BMD loss in men initiating ADT, on the specific effect of ADT on bone health and on various lifestyle modifications and treatment options such as bisphosphonates, osteoclast-targeted therapy and selective estrogen-receptor modulators that have shown promising results in recent studies. PMID:26131363

  18. Light-based therapy on wound healing : a review

    NASA Astrophysics Data System (ADS)

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

    2014-08-01

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

  19. The Effect of Massage Therapy on Children’s Learning Process: A Review

    PubMed Central

    Emtiazy, Majid; Abrishamkar, Mahboobeh

    2016-01-01

    Background: Massage therapy is the scientific manipulation of the soft tissues of the body for normalizing those tissues and consists of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body. There are more than 1500 massage training centers or schools in the United States. Several studies evaluated the effect of massage on elevating child health and to treat various disorders. Methods: In this review, keywords related to the subject were searched in ScienceDirect, Google, Google Scholar, PubMed, and Cochrane library. The data were classified, analyzed, and interpreted. Results: Studies showed massage in pupils could increase blood circulation in the body, make breathing better, better growth, increased concentration and IQ, improved immune system, reduction in stress, pain, anger, and aggressiveness as well as allowing restful sleep. All these together would elevate their learning ability. In addition, massage therapy is studied on a variety of disorders such as blood pressure, rheumatoid arthritis, autism, cystic fibrosis, back pain, nervous pain, muscle and joints pain and headache. Conclusion: To promote health in pupils, it I proposed to introduce the concept of “classmates massage during break” program. Such groups massage therapy, next to its health benefits, would contribute to their peace, tranquility, and teamwork. A similar program is running in Australia as well as few other countries under the codename “massage in schools program (MISP)”. This program has had a tangible effect on children’s capabilities. PMID:26722148

  20. Efficacy of Stem Cell Therapy in Amyotrophic Lateral Sclerosis: A Systematic Review and Meta-Analysis

    PubMed Central

    Moura, Mirian Conceicao; Novaes, Maria Rita Carvalho Garbi; Zago, Yuri S. S. P.; Eduardo, Emanoel Junio; Casulari, Luiz Augusto

    2016-01-01

    Background Published studies seeking to improve survival in amyotrophic lateral sclerosis (ALS) have poor results in humans, although there are several studies in animal models with positive results. Methods We conducted a systematic review and meta-analysis of studies that were published between March 2009 and March 2015 on stem cell therapy and survival in animal models and patients with ALS. A total of 714 articles were identified, and from these, we selected preclinical in vivo studies and retrospective clinical studies. Results and conclusions A meta-analysis confirmed the efficacy of stem cell therapy in improving survival in preclinical trials, where a mean difference of 9.79 days (95% confidence interval: 4.45 - 15.14) in lifespan favored stem cell therapy. In contrast, the number of clinical studies is still insufficient to assess their effectiveness, and these studies only demonstrate the absence of serious adverse events. However, even this conclusion should be interpreted with caution because clinical studies are retrospective and heterogeneous and have an unsatisfactory quality. PMID:26985252