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1

Particle therapy  

SciTech Connect

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.

Raju, M.R.

1993-09-01

2

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

PubMed Central

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.

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

3

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

SciTech Connect

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.

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

2013-05-01

4

Charged particle radiation therapy for uveal melanoma: a systematic review and meta-analysis.  

PubMed

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. PMID:23040219

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

2013-05-01

5

Review of Particle Physics  

Microsoft Academic Search

This biennial Review summarizes much of particle physics. Using data from previous editions, plus 2158 new measurements from 551 papers, we list, evaluate, and average measured properties of gauge bosons, leptons, quarks, mesons, and baryons. We also summarize searches for hypothetical particles such as Higgs bosons, heavy neutrinos, and supersymmetric particles. All the particle properties and search limits are listed

K. Nakamura

2010-01-01

6

Review of Particle Physics  

Microsoft Academic Search

This biennial review summarizes much of Particle Physics. Using data from previous editions, plus 1900 new measurements from 700 papers, we list, evaluate, and average measured properties of gauge bosons, leptons, quarks, mesons, and baryons. We also summarize searches for hypothetical particles such as Higgs bosons, heavy neutrinos, and supersymmetric particles. All the particle properties and search limits are listed

R. M. Barnett; C. D. Carone; D. E. Groom; T. G. Trippe; C. G. Wohl; B. Armstrong; P. S. Gee; G. S. Wagman; F. James; M. Mangano; K. Mönig; L. Montanet; J. L. Feng; H. Murayama; J. J. Hernández; A. Manohar; M. Aguilar-Benitez; C. Caso; R. L. Crawford; M. Roos; N. A. Törnqvist; K. G. Hayes; K. Hagiwara; K. Nakamura; M. Tanabashi; K. Olive; K. Honscheid; P. R. Burchat; R. E. Shrock; S. Eidelman; R. H. Schindler; A. Gurtu; K. Hikasa; G. Conforto; R. L. Workman; C. Grab; C. Amsler

1996-01-01

7

Review of particle properties  

Microsoft Academic Search

This biennial review summarizes much of Particle Physics. Using data from previous editions, plus 2300 new measurements from 700 papers, we list evaluate, and average measured properties of gauge bosons, leptons, quarks, mesons, and baryons. We also summarize searches for hypothetical particles such as Higgs bosons, heavy neutrinos, monopoles, and supersymmetric particles. All the particle properties and search limits are

L. Montanet; K. Gieselmann; R. M. Barnett; D. E. Groom; T. G. Trippe; C. G. Wohl; B. Armstrong; G. S. Wagman; H. Murayama; J. Stone; J. J. Hernandez; F. C. Porter; R. J. Morrison; A. Manohar; M. Aguilar-Benitez; C. Caso; P. Lantero; R. L. Crawford; M. Roos; N. A. Törnqvist; K. G. Hayes; G. Höhler; S. Kawabata; D. M. Manley; K. Olive; R. E. Shrock; S. Eidelman; R. H. Schindler; A. Gurtu; K. Hikasa; G. Conforto; R. L. Workman; C. Grab

1994-01-01

8

Review of Particle Physics  

Microsoft Academic Search

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

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

2006-01-01

9

Gene therapy review.  

PubMed

The use of genes to treat disease, more commonly known as gene therapy, is a valid and promising tool to manage and treat diseases that conventional drug therapies cannot cure. Gene therapy holds the potential to control a wide range of diseases, including cystic fibrosis, heart disease, diabetes, cancer, and blood diseases. This review assesses the current status of gene therapy, highlighting therapeutic methodologies and applications, terminology, and imaging strategies. This article presents an overview of roadblocks associated with each therapeutic methodology, along with some of the scientific, social, and ethical issues associated with gene therapy. PMID:25391667

Moss, Joseph Anthony

2014-11-01

10

Basics of particle therapy I: physics  

PubMed Central

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

Park, Seo Hyun

2011-01-01

11

Indoor Particles: A Review  

Microsoft Academic Search

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

Lance Wallace

1996-01-01

12

Comparison of particle-radiation-therapy modalities  

SciTech Connect

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.

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

1981-01-01

13

Review of Particle Physics  

NASA Astrophysics Data System (ADS)

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

Olive, K. A.; Particle Data Group

2014-08-01

14

The Review of Particle Physics  

NSDL National Science Digital Library

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

1995-01-01

15

Play Therapy: A Review  

ERIC Educational Resources Information Center

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…

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

2009-01-01

16

Radiation therapy for arteriovenous malformations: a review.  

PubMed

There have been numerous case reports and series of patients treated with partial brain irradiation, linear accelerator-based radiosurgery, gamma knife radiosurgery, and Bragg peak therapy for inoperable arteriovenous malformations (AVMs). These cases are summarized and compared. There is convincing evidence that radiation therapy does have a role in obliterating carefully chosen inoperable lesions. The changes that occur in vessel walls after radiation are reviewed. Data about x-ray and gamma radiation are mostly historical and difficult to evaluate because of the techniques of partial brain irradiation. There is a lack of data about the volume of AVM treated and the minimum dose delivered to the AVM nidus. For gamma knife, heavy particle, and linear accelerator therapy, more complete data are available. The incidence of hemorrhage during the first 2 years after treatment, when radiation-induced vascular changes are proposed to occur, is approximately 2.6% per year for gamma knife therapy, 2% per year for proton beam therapy, 2.3% per year for helium beam therapy, and 2.3% per year for linear accelerator therapy. These rates are similar to the recurrence rate for hemorrhage of 2.2 to 3% per year expected based on the natural history of untreated AVMs. If AVM obliteration after therapy is not achieved, the incidence of recurrent hemorrhage remains between 2% per year after treatment with gamma knife therapy. The incidence of hemorrhage for all patients treated was reported as 0.15% per year in one study and 20% over 8 years in a follow-up study using proton beam therapy. Mortality from hemorrhage after treatment was 0.6% after gamma knife therapy, 2.3% after helium beam therapy, and 2 to 5% after proton beam therapy. These figures for mortality are all lower than the 11% observed for the natural history of untreated AVMs. Permanent neurological deficits experienced as a complication of radiation occurred in 2 to 3% of patients treated with gamma knife therapy, 4% of patients treated with helium beam therapy, 1.7% of patients treated with proton beam therapy, and 3% of patients treated with stereotactic linear accelerator therapy. Proton beam therapy has been used for both small and large lesions. The majority of lesions in patients treated with gamma knife, helium beam, and linear accelerator therapy have been small (usually less than 3.0 cm average diameter) lesions. In these patients with small inoperable lesions treated with accurately directed fields of isocentric radiation, the greatest incidence of AVM obliteration has been observed on follow-up angiograms.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2191236

Ogilvy, C S

1990-05-01

17

Gantry for medical particle therapy facility  

DOEpatents

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.

Trbojevic, Dejan (Wading River, NY)

2012-05-08

18

Gantry for medical particle therapy facility  

DOEpatents

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.

Trbojevic, Dejan

2013-04-23

19

[Proton therapy and particle accelerators].  

PubMed

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

Fukumoto, Sadayoshi

2012-01-01

20

Life Review: Implementation, Theory, Research, and Therapy  

ERIC Educational Resources Information Center

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…

Haber, David

2006-01-01

21

Magnetic particle hyperthermia—a promising tumour therapy?  

NASA Astrophysics Data System (ADS)

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.

Dutz, Silvio; Hergt, Rudolf

2014-11-01

22

Magnetic particle hyperthermia-a promising tumour therapy?  

PubMed

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. PMID:25337919

Dutz, Silvio; Hergt, Rudolf

2014-11-14

23

Review of Particle Physics, 1996-1997  

E-print Network

This biennial review summarizes much of Particle Physics. Using data from previous editions, plus 1900 new measurements from 700 papers, we list, evaluate, and average measured properties of gauge bosons, leptons, quarks, mesons, and baryons. We also summarize searches for hypothetical particles such as Higgs bosons, heavy neutrinos, and supersymmetric particles. All the particle properties and search limits are listed in Summary Tables. We also give numerous tables, figures, formulae, and reviews of topics such as the Standard Model, particle detectors, probability, and statistics. A booklet is available containing the Summary Tables and abbreviated versions of some of the other sections of this full Review.

Particle Data Group. Berkeley; Carone, Cristopher D; Groom, Donald E; Trippe, Thomas G; Wohl, Charles G; Armstrong, Betty; Gee, Paul S; Wagman, Gary S; James, Fred; Mangano, Michelangelo L; Mönig, Klaus; Montanet, Lucien; Feng, Jonathan L; Murayama, Hitoshi; Hernández, Juan José; Manohar, Aneesh Vasant; Aguilar-Benítez, M; Caso, Carlo; Crawford, Ronald L; Roos, Matts; Törnqvist, N A; Hayes, Kenneth G; Hagiwara, Kaoru; Nakamura, Kenzo; Tanabashi, Masaharu; Olive, Keith A; Honscheid, Klaus; Burchat, Patricia R; Shrock, Robert E; Eidelman, Simon; Schindler, Rafe H; Gurtu, Atul; Hikasa, Ken Ichi; Conforto, Gianni; Workman, Ronald L; Grab, C; Amsler, Claude

1996-01-01

24

Nanoscale particle therapies for wounds and ulcers.  

PubMed

'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

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

2010-06-01

25

Molecular Pathways: Targeted ?-Particle Radiation Therapy  

PubMed Central

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

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

2012-01-01

26

Respiratory motion management in particle therapy  

SciTech Connect

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

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

2010-02-15

27

Hepatocellular carcinoma radiation therapy: review of evidence and future opportunities.  

PubMed

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. PMID:23219567

Klein, Jonathan; Dawson, Laura A

2013-09-01

28

Hepatocellular Carcinoma Radiation Therapy: Review of Evidence and Future Opportunities  

SciTech Connect

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.

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

2013-09-01

29

Review: Model particles in atmospheric optics  

NASA Astrophysics Data System (ADS)

This review paper provides an overview over model geometries for computing light scattering by small particles. The emphasis is on atmospheric optics, although much of this review will also be relevant to neighbouring fields, in particular to astronomy. Various morphological particle properties are discussed, such as overall nonsphericity, pristine shapes, aggregation, and different forms of inhomogeneity, e.g. porous and compact inhomogeneous morphologies, as well as encapsulated aggregates. Models employed to reproduce the optical properties of complex particles range from strongly simplified to highly realistic and morphologically sophisticated model geometries. Besides reviewing the most recent literature, we discuss the idea behind models of varying degree of complexity with regard to the intended use of the models. Applications range from fundamental studies of light scattering processes to routine applications of particle optics look-up tables in operational modelling systems.

Kahnert, Michael; Nousiainen, Timo; Lindqvist, Hannakaisa

2014-10-01

30

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

PubMed Central

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

Fukumitsu, Nobuyoshi

2012-01-01

31

Ozone therapy: A clinical review  

PubMed Central

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

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

2011-01-01

32

Patients' perspectives on electroconvulsive therapy: systematic review  

PubMed Central

Objective To ascertain patients' views on the benefits of and possible memory loss from electroconvulsive therapy. Design Descriptive systematic review. Data sources Psychinfo, Medline, Web of Science, and Social Science Citation Index databases, and bibliographies. Study selection Articles with patients' views after treatment with electroconvulsive therapy. Data extraction 26 studies carried out by clinicians and nine reports of work undertaken by patients or with the collaboration of patients were identified; 16 studies investigated the perceived benefit of electroconvulsive therapy and seven met criteria for investigating memory loss. Data synthesis The studies showed heterogeneity. The methods used were associated with levels of perceived benefit. At least one third of patients reported persistent memory loss. Conclusions The current statement for patients from the Royal College of Psychiatrists that over 80% of patients are satisfied with electroconvulsive therapy and that memory loss is not clinically important is unfounded. PMID:12816822

Rose, Diana; Fleischmann, Pete; Wykes, Til; Leese, Morven; Bindman, Jonathan

2003-01-01

33

A Comprehensive Review of Retinal Gene Therapy  

PubMed Central

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

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

2013-01-01

34

STFC 2012 PARTICLE PHYSICS REVIEW -EXPERIMENTS AND EXPERIMENTAL CONSOLIDATED GRANTS  

E-print Network

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

35

Courseware Review: CONDUIT: Scatter--Particle Scattering.  

ERIC Educational Resources Information Center

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

Risley, John S.; Grabel, Lisa

1983-01-01

36

Clinical review: Timing of renal replacement therapy  

PubMed Central

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

2011-01-01

37

Particle beam therapy (hadrontherapy): basis for interest and clinical experience.  

PubMed

The particle or hadron beams deployed in radiotherapy (protons, neutrons and helium, carbon, oxygen and neon ions) have physical and radiobiological characteristics which differ from those of conventional radiotherapy beams (photons) and which offer a number of theoretical advantages over conventional radiotherapy. After briefly describing the properties of hadron beams in comparison to photons, this review discusses the indications for hadrontherapy and analyses accumulated experience on the use of this modality to treat mainly neoplastic lesions, as published by the relatively few hadrontherapy centres operating around the world. The analysis indicates that for selected patients and tumours (particularly uveal melanomas and base of skull/spinal chordomas and chondrosarcomas), hadrontherapy produces greater disease-free survival. The advantages of hadrontherapy are most promisingly realised when used in conjunction with modern patient positioning, radiation delivery and focusing techniques (e.g. on-line imaging, three-dimensional conformal radiotherapy) developed to improve the efficacy of photon therapy. Although the construction and running costs of hadrontherapy units are considerably greater than those of conventional facilities, a comprehensive analysis that considers all the costs, particularly those resulting from the failure of less effective conventional radiotherapy, might indicate that hadrontherapy could be cost effective. In conclusion, the growing interest in this form of treatment seems to be fully justified by the results obtained to date, although more efficacy and dosing studies are required. PMID:9713294

Orecchia, R; Zurlo, A; Loasses, A; Krengli, M; Tosi, G; Zurrida, S; Zucali, P; Veronesi, U

1998-03-01

38

Alopecia: A review of laser and light therapies  

E-print Network

A review of laser and light therapies Sophia Rangwala AB,intense pulsed light hair removal therapy. J Dermatologtherapy Since approval by the Food and Drug Administration (FDA) in 1996, lasers and intense pulsed light (

Rangwala, Sophia; Rashid, Rashid M

2012-01-01

39

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

PubMed Central

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

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

2013-01-01

40

A Review of Qigong Therapy for Cancer Treatment  

Microsoft Academic Search

Research studies of Qigong therapy for cancer for the past 20 years in China were reviewed from three different categories: clinical study on human cancer patients, in-vitro study of cancer cells, and in-vivo study of cancer with Qigong therapy, in an attempt to understand the role Qigong therapy plays in cancer treatment. There is a lot of evidence suggesting that

Kevin CHEN; Raphael YEUNG

41

MINI REVIEW MODIFIED ADENOVIRUSES FOR CANCER GENE THERAPY  

E-print Network

MINI REVIEW MODIFIED ADENOVIRUSES FOR CANCER GENE THERAPY Anna KANERVA 1­3 and Akseli HEMMINKI 1,2 * 1 Cancer Gene Therapy Group, Rational Drug Design, Biomedicum Helsinki, University of Helsinki of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland Adenoviral gene therapy

Hemminki, Akseli

42

Glycolic acid peel therapy - a current review  

PubMed Central

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

Sharad, Jaishree

2013-01-01

43

The History of Couple Therapy: A Millennial Review  

Microsoft Academic Search

In this article, we review the major con- ceptual and clinical influences and trends in the history of couple therapy to date, and also chronicle the history of research on couple therapy. The evolving patterns in theory and practice are reviewed as having progressed through four distinc- tive phases: Phase I—Atheoretical Mar- riage Counseling Formation (1930 -1963); Phase II—Psychoanalytic Experimenta-

Alan S. Gurman; Peter Fraenkel

2002-01-01

44

STFC 2009 PARTICLE PHYSICS REVIEW -EXPERIMENTS AND EXPERIMENTAL ROLLING GRANTS  

E-print Network

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

45

Accelerators for charged particle therapy: PAMELA and related issues  

NASA Astrophysics Data System (ADS)

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

Peach, Ken

2014-05-01

46

Concise Review: Cell Therapy and Tissue Engineering for Cardiovascular Disease  

PubMed Central

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

Haraguchi, Yuji; Shimizu, Tatsuya; Yamato, Masayuki

2012-01-01

47

Occupational therapy for community dwelling elderly people: a systematic review  

Microsoft Academic Search

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

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

48

REVIEWS OF TOPICAL PROBLEMS: The search for dark matter particles  

NASA Astrophysics Data System (ADS)

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

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

2008-11-01

49

The shape of loess particles reviewed  

NASA Astrophysics Data System (ADS)

An important property of loess is a tendency to collapse on loading and wetting (hydroconsolidation) which can have serious consequences worldwide for civil engineering projects. This paper describes the use of Monte Carlo and other analytical techniques to predict the shape of naturally occurring loess particles. Randomly generated particles are classified according to Zingg shape categories: disc, sphere, blade and rod. By assuming a uniform distribution for the basic particle, average relative dimensions are calculated for the blade category, into which most loess particles have been shown to fall.

Howarth, John J.

2010-03-01

50

Can you trust systematic reviews of complementary and alternative therapies?  

Microsoft Academic Search

Systematic reviews have considerable impact on the discussion of complementary therapies in the scientific community, in the media and on healthcare decision making, because they are considered to be the most reliable tool to summarize and assess the evidence available on a defined question. This article aims to discuss some of the most relevant problems of systematic reviews, both in

Klaus Linde

2009-01-01

51

Subject Review Targeting Mdm2 and Mdmx in Cancer Therapy  

E-print Network

Subject Review Targeting Mdm2 and Mdmx in Cancer Therapy: Better Living through Medicinal Chemistry, or elevated expression of the p53 regulators Mdm2 and Mdmx. This review discusses current models of p53 regulation by Mdm2 and Mdmx and presents the rationale for design of future Mdmx-specific therapeutics based

Wahl, Geoffrey M.

52

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...

53

BOOK REVIEW: The Dynamics of Fluidized Particles  

Microsoft Academic Search

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

Roy Jackson

2001-01-01

54

Combination therapy for erectile dysfunction: an update review  

PubMed Central

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, ?-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

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

2011-01-01

55

Hyperbaric Oxygen Therapy for Malignancy: A Review  

Microsoft Academic Search

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

Jurstine Daruwalla; Chris Christophi

2006-01-01

56

Review of particle properties. 25th anniversary edition  

SciTech Connect

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

Not Available

1982-04-01

57

A Systematic Review of Psychological Therapies for Nonulcer Dyspepsia  

Microsoft Academic Search

OBJECTIVES:We conducted a systematic review to determine the effectiveness of psychological interventions including psychodrama, cognitive behavioral therapy, relaxation therapy, guided imagery, or hypnosis in the improvement of dyspepsia symptoms in patients with nonulcer dyspepsia (NUD).DESIGN:Trials were identified through electronic searches of the Cochrane Controlled Trials Register (CCTR), MEDLINE, EMBASE, CINAHL, and PsycLIT, using appropriate subject headings and text words and

Shelly Soo; David Forman; Brendan C. Delaney; Paul Moayyedi

2004-01-01

58

Stem cell therapy in stroke: a review literature.  

PubMed

Stroke is an important cause of death in the world and disability world-wide especially in developed countries. Following acute phase of stroke, some procedures and medical treatment such as thrombolytic agents has been recommended; nevertheless many patients have enduring deficits. Thus, there is a realistic need to develop treatment strategies for reducing neurological deficits. However, the stem cell (SC) therapy could arrange an alternative intervention for disease modifying therapy. In this article, we present a brief review of different methods of SC therapy in stroke patients and discuss the results with different cell types and routes of administration. PMID:23776716

Meamar, Rokhsareh; Dehghani, Leila; Ghasemi, Majid; Khorvash, Fariborz; Shaygannejad, Vahid

2013-05-01

59

Stem Cell Therapy in Stroke: A Review Literature  

PubMed Central

Stroke is an important cause of death in the world and disability world-wide especially in developed countries. Following acute phase of stroke, some procedures and medical treatment such as thrombolytic agents has been recommended; nevertheless many patients have enduring deficits. Thus, there is a realistic need to develop treatment strategies for reducing neurological deficits. However, the stem cell (SC) therapy could arrange an alternative intervention for disease modifying therapy. In this article, we present a brief review of different methods of SC therapy in stroke patients and discuss the results with different cell types and routes of administration. PMID:23776716

Meamar, Rokhsareh; Dehghani, Leila; Ghasemi, Majid; Khorvash, Fariborz; Shaygannejad, Vahid

2013-01-01

60

Medicinal leech therapy in pain syndromes: a narrative review.  

PubMed

Medicinal leech therapy is used in a variety of conditions; most of which have pain as a major symptom. Its mode of action relies on the injection of leech saliva into patients' tissues during the process of blood withdrawal. Leech saliva contains active ingredients with anti-inflammatory, thrombolytic, anti-coagulant and blood- and lymph-circulation enhancing properties. A specific analgesic substance within the leech saliva is yet to be identified. Pain relief from leech therapy is rapid, effective and long-lasting in many conditions. This review compiles studies and case reports that provide clinical evidence for leech therapy's analgesic effects. PMID:24081747

Koeppen, Detlev; Aurich, Michael; Rampp, Thomas

2014-03-01

61

Particle Physics Summary : a digest of the 1996 Review of Particle Physics  

E-print Network

This report summarizes the highlights of the 1996 Review of Particle Physics (Phys, Rev. D54, 1 (1996)). Using data from previous editions, plus 1900 new measurements from 700 papers, we list, evaluate, and average, measured properties of gauge bosons, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as Higgs bosons, heavy neutrinos, and supersymmetric particles. We also give numerous reviews, tables, figures, and formulae. The present edition marks the apparent completion of the table of Standard Model quarks with the discovery of the top. A booklet is available containing the Summary Tables and abbreviated versions of some of the other sections of the full Review..

Particle Data Group. Berkeley; Carone, Cristopher D; Groom, Donald E; Trippe, Thomas G; Wohl, Charles G; Armstrong, Betty; Gee, Paul S; Wagman, Gary S; James, Fred; Mangano, Michelangelo L; Mönig, Klaus; Montanet, Lucien; Feng, Jonathan L; Murayama, Hitoshi; Hernández, Juan José; Manohar, Aneesh Vasant; Aguilar-Benítez, M; Caso, Carlo; Crawford, Ronald L; Roos, Matts; Törnqvist, N A; Hayes, Kenneth G; Hagiwara, Kaoru; Nakamura, Kenzo; Tanabashi, Masaharu; Olive, Keith A; Honscheid, Klaus; Burchat, Patricia R; Shrock, Robert E; Eidelman, Simon; Schindler, Rafe H; Gurtu, Atul; Hikasa, Ken Ichi; Conforto, Gianni; Workman, Ronald L; Grab, C; Amsler, C

1996-01-01

62

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

PubMed Central

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

Jabbari, Keyvan

2011-01-01

63

Therapy gloves for patients with rheumatoid arthritis: a review  

PubMed Central

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

Troynikov, Olga; Massy-Westropp, Nicola

2014-01-01

64

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

Microsoft Academic Search

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

Sarah C. Slayton; Jeanne DArcher; Frances Kaplan

2010-01-01

65

Helicobacter pylori eradication therapy: A review of current trends.  

PubMed

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

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

2013-01-01

66

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

E-print Network

review© The American Society of Gene Therapy Molecular Therapy vol. 17 no. 7, 1125­1135 july 2009, a direct, targeted attack or via gene therapy in which foreign genes are expressed therapeutically and release infectious virus. In gene therapy, expression of therapeu- tic foreign gene products either

Cai, Long

67

TRAIL combinations: The new 'trail' for cancer therapy (Review)  

PubMed Central

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) therapy is anticipated to be one of the most effective cancer treatments. However, resistance to TRAIL therapy remains a challenge facing the development of anticancer strategies. To circumvent this problem, TRAIL combinations have been experimented with for over ten years to induce synergism or sensitize resistant cancer cells. By analyzing the signaling pathways triggered by these combinations, this review has defined a set of core targets for novel combinatorial treatments. The review suggests specific pathways to be targeted together with TRAIL for more efficient treatment, including cellular FLICE inhibitory protein and its downstream survival factors, the Bcl-2 family and other prominent targets. The suggested pathways provide new avenues for more effective TRAIL-based cancer therapy. PMID:24765133

REFAAT, ALAA; ABD-RABOU, AHMED; REDA, ASMAA

2014-01-01

68

Occupational therapy for children with cerebral palsy: a systematic review  

Microsoft Academic Search

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

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

2004-01-01

69

Online Video Game Therapy for Mental Health Concerns: A Review  

Microsoft Academic Search

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

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

2008-01-01

70

Analgesic Therapy in Postherpetic Neuralgia: A Quantitative Systematic Review  

Microsoft Academic Search

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

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

2005-01-01

71

Review of Breast Conservation Therapy: Then and Now  

PubMed Central

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

Hoover, Susan; Bloom, Elizabeth; Patel, Sunil

2011-01-01

72

Complementary Spiritist Therapy: Systematic Review of Scientific Evidence  

PubMed Central

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

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

2011-01-01

73

Precise On-line Position Measurement for Particle Therapy  

E-print Network

An on-line beam position monitoring and regular beam stability tests are of utmost importance for the Quality Assurance (QA) of the patient treatment at any particle therapy facility. The Gantry${0.5 mm}2$ at the Paul Scherrer Institute uses a strip ionization chamber for the on-line beam position verification. The design of the strip chamber placed in the beam in front of the patient allows for a small beam penumbra in order to achieve a high-quality lateral beam delivery. The detector granularity and the low noise allow the reconstruction of the signals offered by Gantry${0.5 mm}2$ with a precision of about 0.1 mm. The frond-end electronics and the whole data processing sequence have been optimized for minimizing the dead time between the beam applications to about 2 ms: the charge collection is performed in about 1 ms, read-out takes place in 100 $\\mu$s while data verification and logging are completed in less than 1 ms. The sub-millimeter precision of the lateral reconstruction allows the dose inhomogenei...

Actis, O; König, S

2014-01-01

74

Zinc therapy in dermatology: a review.  

PubMed

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

Gupta, Mrinal; Mahajan, Vikram K; Mehta, Karaninder S; Chauhan, Pushpinder S

2014-01-01

75

Zinc Therapy in Dermatology: A Review  

PubMed Central

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

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

2014-01-01

76

Review - numerical models for dilute gas-particle flows  

Microsoft Academic Search

The significant nondimensional parameters relating to dilute gas-particle flows are defined, and a review of the essential features of gas-particle flows from the point of view of model development is presented. Also, the various models that have appeared for one-dimensional and two-dimensional flows are examined, and the advantages and disadvantages of the trajectory and two-fluid models are considered. It is

C. T. Crowe

1982-01-01

77

Mind-body Therapies for Menopausal Symptoms: A Systematic Review  

PubMed Central

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

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

2010-01-01

78

Concise Review: Stem Cell Therapy for Muscular Dystrophies  

PubMed Central

Muscular dystrophy comprises a group of genetic diseases that cause progressive weakness and degeneration of skeletal muscle resulting from defective proteins critical to muscle structure and function. This leads to premature exhaustion of the muscle stem cell pool that maintains muscle integrity during normal use and exercise. Stem cell therapy holds promise as a treatment for muscular dystrophy by providing cells that can both deliver functional muscle proteins and replenish the stem cell pool. Here, we review the current state of research on myogenic stem cells and identify the important challenges that must be addressed as stem cell therapy is brought to the clinic. PMID:23197695

Wilschut, Karlijn J.; Ling, Vivian B.

2012-01-01

79

Manual therapies in myofascial trigger point treatment: a systematic review  

Microsoft Academic Search

Abstract Background,and,purpose: Myofascial pain syndrome,(MPS) is thought,by some,authors,the main,cause of headache,and,neck,pain. MPS is characterized,by Myofascial Trigger Points (MTrPs). However, there are not many controlled studies that have,analyzed,the effects of the manual,therapies,in their treatment.,The aim of this systematic,review,is to establish whether,manual,therapies,have,specific efficacy in the management of MPS, based on published studies. Methods: Data sources: PubMed (from 1975), Ovid MEDLINE (from 1975),

Juan Carlos Miangolarra Page; Avenida de Atenas

80

Proton beam therapy for locally advanced lung cancer: A review  

PubMed Central

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.

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

2014-01-01

81

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

PubMed

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

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

2014-10-10

82

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

PubMed

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

Purdy, James A

2008-11-01

83

Ridge filter design for a particle therapy line  

NASA Astrophysics Data System (ADS)

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.

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

84

Efficacy of light therapy for perinatal depression: a review  

PubMed Central

Perinatal depression is an important public health problem affecting 10% to 20% of childbearing women. Perinatal depression is associated with significant morbidity, and has enormous consequences for the wellbeing of the mother and child. During the perinatal period, treatment of depression, which could affect the mother and child during pregnancy and lactation, poses a complex problem for both mother and clinician. Bright light therapy may be an attractive treatment for perinatal depression because it is low cost, home-based, and has a much lower side effect profile than pharmacotherapy. The antidepressant effects of bright light are well established, and there are several rationales for expecting that bright light might also be efficacious for perinatal depression. This review describes these rationales, summarizes the available evidence on the efficacy of bright light therapy for perinatal depression, and discusses future directions for investigation of bright light therapy as a treatment for perinatal depression. PMID:22738716

2012-01-01

85

Oral complications of targeted cancer therapies: a narrative literature review.  

PubMed

The aim of the present study was to investigate the available literature regarding the oral side effects or adverse events associated with targeted cancer therapy. Common oral toxicities include the terms mucositis, stomatitis, dysphagia, xerostomia, pharyngitis, and taste alterations. Aims of treatment included molecules and pathways involved in carcinogenesis reported in the literature were EGFRI, VEGF, mTOR, mAbs, TKIs, and multi-kinase inhibitors. Common targeted therapies used in clinical practice or under-investigation included cetuximab, panitumumab, erlotinib, sorafenib, sunitinib malate, imatinib mesylate, bevacizumab, trastuzumab, lapatinib, and mTORs. One hundred and forty-three articles were considered relevant and included in this review. The majority of studies did not specifically address oral toxicities or include an oral clinical exam, which may lead to underreported and under-investigated oral toxicities. Further investigation is necessary to determine if the initial impression that targeted therapy produces milder oral toxicities than conventional cancer treatment is accurate. PMID:21514211

Watters, A L; Epstein, J B; Agulnik, M

2011-06-01

86

A Review of Progress in Clinical Photodynamic Therapy  

PubMed Central

Photodynamic therapy (PDT) has received increased attention since the regulatory approvals have been granted to several photosensitizing drugs and light applicators world-wide. Much progress has been seen in basic sciences and clinical photodynamics in recent years. This review will focus on new developments of clinical investigation and discuss the usefulness of various forms of PDT techniques for curative or palliative treatment of malignant and non-malignant diseases. PMID:15896084

Huang, Zheng

2005-01-01

87

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

E-print Network

review© The American Society of Gene & Cell Therapy Molecular Therapy vol. 19 no. 8, 1407­1415 aug. 2011 1407 IntroductIon Gene therapy has shown increasing promise in clinical trials for disorders in the development of gene delivery systems must continue to build upon the recent successes in the field and further

Schaffer, David V.

88

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

Microsoft Academic Search

Radionuclides of rare earth elements are gaining importance as emerging therapeutic agents in nuclear medicine. ?\\u000a \\u000a ?\\u000a -particle emitter 142Pr [T\\u000a 1\\/2 = 19.12 h, E\\u000a ?? = 2.162 MeV (96.3%), E? = 1575 keV (3.7%)] is one of the praseodymium-141 (100% abundant) radioisotopes. Production routes and therapy aspects of\\u000a 142Pr will be reviewed in this paper. However, 142Pr produces via 141Pr(n, ?)142Pr reaction by irradiation in a low-fluence

Mohamadreza K. Bakht; Mahdi Sadeghi

89

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

PubMed

Chordoma is a rare, slow-growing, locally aggressive, primary bone tumor that arises from the skull base region in approximately 25-35% of cases. The therapeutic approach to chordoma has traditionally been surgery, followed by radiation therapy. The advent of charged particle radiotherapy has let us consider protons as the postoperative treatment of choice, but no controlled studies have yet confirmed the superiority of protons over photons. During January 2008, two independent researchers conducted a systematic review of the current data on the treatment of base of the skull chordoma C with proton therapy (PT) and, for comparison, with other irradiation techniques (conventional radiation therapy, ion therapy, fractionated stereotactic radiation therapy, and radiosurgery). Two hundred and ten reports in total were retrieved (81 concerning PT). According to the inclusion criteria, 47 articles were considered in the analysis. There were no prospective trials (randomized or nonrandomized) but just seven uncontrolled single-arm studies for PT, providing clinical outcomes for 416 patients in total; these reports were mainly related to advanced inoperable or incompletely resected tumors. The therapeutic approach to chordoma of the base of the skull has traditionally relied on surgical control. Radiation therapy has demonstrated to be a valuable modality for local control in the postoperative setting, particularly with the advent of charged particle radiotherapy. The use of protons has shown better results in comparison to the use of conventional photon irradiation, resulting in the best long-term (10 years) outcome for this tumor with relatively few significant complications considering the high doses delivered with this therapeutic modality. PMID:19319583

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

2009-10-01

90

Review Article: Celiac Disease, New Approaches to Therapy  

PubMed Central

STRUCTURED SUMMARY Background Celiac disease is managed by life-long gluten withdrawal from the diet. However strict adherence to a gluten-free diet is difficult and is not always effective. Novel therapeutic approaches are needed to supplement or even replace the dietary treatment. Aims To review recent advances in new therapeutic options for celiac disease. Methods A literature search was performed on MEDLINE, EMBASE, Web of Science, Scopus, DDW.org and ClinicalTrial.gov for English articles and abstracts. The search terms used include but not limited to “Celiac disease”, “new”, “novel”, Advances”, “alternatives” and “Drug therapy”. The cited articles were selected based on the relevancy to the review objective. Results Several new therapeutic approaches for celiac disease are currently under development by targeting its underlying pathogenesis. Alternative therapies range from reproduction of harmless wheat strains to immunomodulatory approaches. Some of these therapies such as enzymatic cleavage of gluten and permeability inhibitors have shown promise in clinical studies. Conclusion Gluten-free diet is still the only practical treatment for patients with celiac disease. Novel strategies provide promise of alternative adjunctive approaches to diet restriction alone for patients with this disorder. PMID:22324389

Rashtak, Shahrooz; Murray, Joseph A

2014-01-01

91

TOPICAL REVIEW: Stem cells engineering for cell-based therapy  

NASA Astrophysics Data System (ADS)

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.

Taupin, Philippe

2007-09-01

92

Oxaliplatin: a review in the era of molecularly targeted therapy  

PubMed Central

Objective To review preclinical and clinical data for oxaliplatin in the current context of molecularly targeted therapy. Methods of Study Selection We searched the PubMed and PubChem databases by combining the search terms “oxaliplatin” or “platinum” or both, with “clinical trials,” “pharmacokinetics,” and “pharmacodynamics.” Data Extraction and Synthesis Oxaliplatin has a complicated pharmacokinetic profile, with activity against digestive cancers in particular. It has several mechanisms of action, but cancer cells can develop resistance. Real or potential synergism has been observed when oxaliplatin is combined with other cytotoxic agents or molecularly targeted agents. Peripheral neuropathy is a prominent toxic effect. Conclusions Oxaliplatin lends itself to further clinical research in combination with molecularly targeted therapy. PMID:21331278

Alcindor, T.; Beauger, N.

2011-01-01

93

Using antimicrobial adjuvant therapy in cancer treatment: a review  

PubMed Central

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

2012-01-01

94

Current and emerging therapies in multiple sclerosis: a systematic review  

PubMed Central

Multiple sclerosis (MS) is a potentially disabling chronic autoimmune neurological disease that mainly affects young adults. Our understanding of the pathophysiology of MS has significantly advanced in the past quarter of a century. This has led to the development of many disease-modifying therapies (DMTs) that prevent exacerbations and new lesions in patients with relapsing remitting MS (RRMS). So far there is no drug available that can completely halt the neurodegenerative changes associated with the disease. It is the purpose of this review to provide concise information regarding mechanism of action, indications, side effects and safety of Food and Drug Administration and European Medicines Agency approved agents for MS, emerging therapies, and drugs that can be considered for off-label use in MS. PMID:22783370

Graves, Donna; Frohman, Teresa C.; Flores, Angela Bates; Hardeman, Paula; Logan, Diana; Orchard, Megan; Greenberg, Benjamin; Frohman, Elliot M.

2012-01-01

95

Acanthamoeba encephalitis: A Case Report and Review of Therapy  

PubMed Central

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

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

2014-01-01

96

Review and uses of stereotactic body radiation therapy for oligometastases.  

PubMed

In patients with proven distant metastases from solid tumors, it has been a notion that the condition is incurable, warranting palliative care only. The term "oligometastases" was coined to refer to isolated sites of metastasis, whereby the entire burden of disease can be recognized as a finite number of discrete lesions that can be potentially cured with local therapies. Stereotactic body radiation therapy (SBRT) is a novel treatment modality in radiation oncology that delivers a very high dose of radiation to the tumor target with high precision using single or a small number of fractions. SBRT is the result of technological advances in patient and tumor immobilization, image guidance, and treatment planning and delivery. A number of studies, both retrospective and prospective, showed promising results in terms of local tumor control and, in a limited subset of patients, of survival. This article reviews the radiobiologic, technical, and clinical aspects of SBRT for various anatomical sites. PMID:22723509

Alongi, Filippo; Arcangeli, Stefano; Filippi, Andrea Riccardo; Ricardi, Umberto; Scorsetti, Marta

2012-01-01

97

Deterministic lateral displacement for particle separation: a review.  

PubMed

Deterministic lateral displacement (DLD), a hydrodynamic, microfluidic technology, was first reported by Huang et al. in 2004 to separate particles on the basis of size in continuous flow with a resolution of down to 10 nm. For 10 years, DLD has been extensively studied, employed and modified by researchers in terms of theory, design, microfabrication and application to develop newer, faster and more efficient tools for separation of millimetre, micrometre and even sub-micrometre sized particles. To extend the range of potential applications, the specific arrangement of geometric features in DLD has also been adapted and/or coupled with external forces (e.g. acoustic, electric, gravitational) to separate particles on the basis of other properties than size such as the shape, deformability and dielectric properties of particles. Furthermore, investigations into DLD performance where inertial and non-Newtonian effects are present have been conducted. However, the evolvement and application of DLD has not yet been reviewed. In this paper, we collate many interesting publications to provide a comprehensive review of the development and diversity of this technology but also provide scope for future direction and detail the fundamentals for those wishing to design such devices for the first time. PMID:25212386

McGrath, J; Jimenez, M; Bridle, H

2014-09-30

98

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

Microsoft Academic Search

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

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

2010-01-01

99

ROLE OF PARTICLE HYGROSCOPICITY IN AEROSOL THERAPY AND INHALATION TOXICOLOGY  

EPA Science Inventory

The extrathoracic compartment of the human respiratory tract (i.e., the naso- and oropharyngeal regions) effectively conditions inhaled air by warming and humidifying processes even in extreme ambient environments. When airborne particles are inhaled, the effectiveness of interac...

100

Art Therapy for Young Children: A Review of the Research and Literature.  

ERIC Educational Resources Information Center

Through a review of the literature on art therapy, a discussion of the strengths and limitations of the arts and art therapy for young children, and a survey of various techniques and uses of art therapy, this paper examines how children translate their perceptual world into their drawings. The paper notes that art therapy is, primarily, a means…

Moss, Deborah L.

101

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

ERIC Educational Resources Information Center

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.…

Yeaw, John David Andrew

102

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

Microsoft Academic Search

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 through the music therapy treatment process are provided.

Michael J. Silverman

2008-01-01

103

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

PubMed Central

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

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

2011-01-01

104

Hyperbaric Oxygen Therapy in Acute Ischemic Stroke: A Review  

PubMed Central

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

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

2014-01-01

105

Hyperbaric oxygen therapy in acute ischemic stroke: a review.  

PubMed

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

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

2014-08-01

106

Spinal manual therapy interventions for pediatric patients: a systematic review  

PubMed Central

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

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

2012-01-01

107

Insulin therapy and quality of life. A review.  

PubMed

Three central goals in the treatment of diabetes mellitus are (1) the avoidance of hyperglycaemia to prevent the development or progression of diabetes complications over time, (2) the avoidance of hypoglycaemia and (3) the maintenance or achievement of good quality of life. Insulin is the most powerful agent that can be used to control blood glucose levels. This article reviews the studies that have investigated the effects of different types of insulin and insulin delivery techniques on quality of life of patients with type 1 or type 2 diabetes. First, the concept of 'quality of life' (QoL) is defined and different ways of measuring QoL are explained. Secondly, the effects of different aspects of insulin therapy on QoL are reviewed: (1) the phenomenon of 'psychological insulin resistance'; (2) the effects of different types of insulin: regular insulin versus short-acting insulin analogues, long-acting insulin analogues or biphasic mixtures; (3) multiple daily injections versus pump therapy. Having multiple complications of diabetes is clearly associated with decreased QoL. Results from large studies such as the Diabetes Control and Complications Trial (DCCT) and United Kingdom Prospective Diabetes Study (UKPDS) suggest that intensive treatment itself does not impair QoL. Recent findings further suggest that pump therapy, compared to multiple daily injections, has beneficial effects on QoL. The fact that multiple tools are used to assess QoL makes it difficult to draw conclusions regarding the effects of different types of insulin on QoL. More work on the standardization of the assessment of QoL in diabetes is urgently needed. PMID:19662621

Pouwer, François; Hermanns, Norbert

2009-09-01

108

Review of lattice results concerning low energy particle physics  

E-print Network

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.

Sinya Aoki; Yasumichi Aoki; Claude Bernard; Tom Blum; Gilberto Colangelo; Michele Della Morte; Stephan Dürr; Aida X. El Khadra; Hidenori Fukaya; Roger Horsley; Andreas Jüttner; Takeshi Kaneko; Jack Laiho; Laurent Lellouch; Heinrich Leutwyler; Vittorio Lubicz; Enrico Lunghi; Silvia Necco; Tetsuya Onogi; Carlos Pena; Christopher T. Sachrajda; Stephen R. Sharpe; Silvano Simula; Rainer Sommer; Ruth S. Van de Water; Anastassios Vladikas; Urs Wenger; Hartmut Wittig

2013-10-31

109

Life-review therapy with computer supplements for depression in the elderly: A randomized controlled trial  

Microsoft Academic Search

Life-review therapy has been recognized as an effective therapeutic approach for depression in older adults. Additionally, the use of new media is becoming increasingly common in psychological interventions. The aim of this study was to investigate a life-review therapy in a face-to-face setting with additional computer use. This study explored whether a six-week life-review therapy with computer supplements from the

Barbara Preschl; Andreas Maercker; Birgit Wagner; Simon Forstmeier; Rosa M. Baños; Mariano Alcañiz; Diana Castilla; Cristina Botella

2012-01-01

110

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

SciTech Connect

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.

Redondo, Antonio [Los Alamos National Laboratory

2010-01-01

111

A review of anti-hypertension therapies in diabetic patients.  

PubMed

The objective of this study was to review published articles on the issues surrounding tight blood pressure control in hypertensive diabetics. Relevant medical subject headings (MeSH) terms and keywords to review scientific literatures were developed. These MeSH terms were used to generate MEDLINE searches that focused on English-language, peer-reviewed scientific literature. In reviewing the exceptionally large body of research literature in anti-hypertension therapies in diabetic patients , the review focused on outcomes of importance to patients and effects of sufficient magnitude to warrant changes in medical practice ("patient oriented evidence that matters" [POEMs]). Patient-oriented outcomes include not only mortality but also other outcomes that affect patients' lives and well-being. Studies of physiological end points (diseaseoriented evidence [DOEs]) were used to address questions where POEMs were not available Treatment of hypertension in diabetic patients provides dramatic beneficial outcomes. Target diastolic BP of < 80 mmHg appears optimal; and systolic targets of 130 mmHg or less are also reasonable. Studies that compare drug classes do not suggest obviously superior agents. However, it is reasonable to conclude that ACEIs, thiazide diuretics and angiotension II receptor blockers may be the preferred first-line agents for treatment of hypertension in diabetes. ACEIs, ARBs and low dose thiazide diuretics may be the first line treatments although other agents are usually necessary and goals may not be achieved even with three or four agents. Aggressive blood pressure control may be the most important factor in preventing adverse outcomes in hypertensive patients with diabetes. PMID:24825981

Ogochukwu, Adibe Maxwell; Victoria, Ukwe Chinwe

2010-06-01

112

Accelerators for heavy-charged-particle radiation therapy.  

PubMed

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

Coutrakon, George B

2007-08-01

113

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

PubMed Central

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

2012-01-01

114

Review of lattice results concerning low energy particle physics  

E-print Network

We review lattice results relevant for pion and kaon physics with the aim of making them easily accessible to the particle physics community. Specifically, we review the determination of the light-quark masses, the form factor f_+(0), relevant for the semileptonic K -> pi transition at zero momentum transfer as well as the ratio f_K/f_pi of decay constants and discuss the consequences for the elements V_{us} and V_{ud} of the CKM matrix. 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 B_K parameter of neutral kaon mixing. We introduce quality criteria and use these when forming averages. Although subjective and imperfect, these criteria may help the reader to judge different aspects of current lattice computations. Our main results are summarized in section 1.2, but we stress the importance of the detailed discussion that underlies these results and constitutes the bulk of the present review.

Gilberto Colangelo; Stephan Durr; Andreas Juttner; Laurent Lellouch; Heinrich Leutwyler; Vittorio Lubicz; Silvia Necco; Christopher T. Sachrajda; Silvano Simula; Anastassios Vladikas; Urs Wenger; Hartmut Wittig

2010-11-19

115

Corneal Neovascularization: An Anti-VEGF Therapy Review  

PubMed Central

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

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

2013-01-01

116

Mini-review: bmx kinase inhibitors for cancer therapy.  

PubMed

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

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

2013-09-01

117

Beta-blocking agents during electroconvulsive therapy: a review.  

PubMed

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

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

2014-07-01

118

The benefits and risks of testosterone replacement therapy: a review  

PubMed Central

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

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

2009-01-01

119

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

PubMed Central

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

Cianchetti, Marco; Amichetti, Maurizio

2012-01-01

120

Systematic review of psychological therapies for cancer patients: overview and recommendations for future research  

Microsoft Academic Search

Many cancer patients use psychological therapies because they expect them to cure their cancer or to improve their recovery. Despite these high expectations, both patients and oncologists report being moderately to very satisfied with the results of psychological therapies. Previous reviews of the literature have concluded that psychological therapies may help cancer patients in various ways, ranging from reducing the

Sallie Anne Newell; Rob William Sanson-Fisher; Nina Johanna Savolainen

2002-01-01

121

A review of gene and stem cell therapy in cutaneous wound healing  

Microsoft Academic Search

Different therapies that effect wound repair have been proposed over the last few decades. This article reviews the emerging fields of gene and stem cell therapy in wound healing. Gene therapy, initially developed for treatment of congenital defects, is a new option for enhancing wound repair. In order to accelerate wound closure, genes encoding for growth factors or cytokines showed

Ludwik K. Branski; Gerd G. Gauglitz; David N. Herndon; Marc G. Jeschke

2009-01-01

122

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

ERIC Educational Resources Information Center

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…

Silverman, Michael J.

2008-01-01

123

Neurobiology of Cognitive Remediation Therapy for Schizophrenia: A Systematic Review  

PubMed Central

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

Thorsen, Anders Lillevik; Johansson, Kyrre; L?berg, Else-Marie

2014-01-01

124

Antipsychotic Therapy During Early and Late Pregnancy. A Systematic Review  

PubMed Central

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

Gentile, Salvatore

2010-01-01

125

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

PubMed Central

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

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

2013-01-01

126

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

ERIC Educational Resources Information Center

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

Burford, B.; Jahoda, A.

2012-01-01

127

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

SciTech Connect

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.

Lim, Young Kyung; Kwak, Jungwon; Kim, Dong Wook; Shin, Dongho; Yoon, Myonggeun [Proton Therapy Center, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of); Park, Soah [Department of Radiation Oncology, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Kim, Jin Sung; Ahn, Sung Hwan; Shin, Jungwook [Proton Therapy Center, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of); Lee, Se Byeong [Proton Therapy Center, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of)], E-mail: sblee@ncc.re.kr; Park, Sung Yong; Pyo, Hong Ryeol; Kim, Dae Yong M.D.; Cho, Kwan Ho [Proton Therapy Center, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of)

2009-08-01

128

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

Microsoft Academic Search

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

Arthur Jones; Brian H. Rowe

2000-01-01

129

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

Microsoft Academic Search

BACKGROUND: Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with acupuncture. Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles

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

2001-01-01

130

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

Microsoft Academic Search

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

Tian P. S. Oei; Michael L. Free

1995-01-01

131

Updating a systematic review – what difference did it make? Case study of nicotine replacement therapy  

Microsoft Academic Search

AIMS: To examine the effect of updating a systematic review of nicotine replacement therapy on its contents and conclusions. METHODS: We examined the effects of regular updating of a systematic review of nicotine replacement therapy for smoking cessation. We considered two outcomes. First, we assessed the effect of adding new data to meta-analyses, comparing results in 2000 with the results

Lindsay F Stead; Tim Lancaster; Chris A Silagy

2001-01-01

132

Systematic review of the effectiveness of mirror therapy in upper extremity function  

Microsoft Academic Search

Purpose. This review gives an overview of the current state of research regarding the effectiveness of mirror therapy in upper extremity function. Method. A systematic literature search was performed to identify studies concerning mirror therapy in upper extremity. The included journal articles were reviewed according to a structured diagram and the methodological quality was assessed. Results. Fifteen studies were identified

Daniëlle Ezendam; Raoul M. Bongers; Michiel J. A. Jannink

2009-01-01

133

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

E-print Network

Particle Image Velocimetry measurement of indoor airflow field: A review of the technologies with point-wise anemometry. Therefore, using Particle Image Velocimetry (PIV) is a promising technique. "Particle image velocimetry measurement of indoor airflow field: A review of the technologies

Chen, Qingyan "Yan"

134

Dosimetric effects of energy spectrum uncertainties in radiation therapy with laser-driven particle beams.  

PubMed

Laser-driven particle acceleration is a potentially cost-efficient and compact new technology that might replace synchrotrons or cyclotrons for future proton or heavy-ion radiation therapy. Since the energy spectrum of laser-accelerated particles is rather wide, compared to the monoenergetic beams of conventional machines, studies have proposed the usage of broader spectra for the treatment of at least certain parts of the target volume to make the process more efficient. The thereby introduced additional uncertainty in the applied energy spectrum is analysed in this note. It is shown that the uncertainty can be categorized into a change of the total number of particles, and a change in the energy distribution of the particles. The former one can be monitored by a simple fluence detector and cancels for a high number of statistically fluctuating shots. The latter one, the redistribution of a fixed number of particles to different energy bins in the window of transmitted energies of the energy selection system, only introduces smaller changes to the resulting depth dose curve. Therefore, it might not be necessary to monitor this uncertainty for all applied shots. These findings might enable an easier uncertainty management for particle therapy with broad energy spectra. PMID:22330752

Schell, S; Wilkens, J J

2012-03-01

135

Dosimetric effects of energy spectrum uncertainties in radiation therapy with laser-driven particle beams  

NASA Astrophysics Data System (ADS)

Laser-driven particle acceleration is a potentially cost-efficient and compact new technology that might replace synchrotrons or cyclotrons for future proton or heavy-ion radiation therapy. Since the energy spectrum of laser-accelerated particles is rather wide, compared to the monoenergetic beams of conventional machines, studies have proposed the usage of broader spectra for the treatment of at least certain parts of the target volume to make the process more efficient. The thereby introduced additional uncertainty in the applied energy spectrum is analysed in this note. It is shown that the uncertainty can be categorized into a change of the total number of particles, and a change in the energy distribution of the particles. The former one can be monitored by a simple fluence detector and cancels for a high number of statistically fluctuating shots. The latter one, the redistribution of a fixed number of particles to different energy bins in the window of transmitted energies of the energy selection system, only introduces smaller changes to the resulting depth dose curve. Therefore, it might not be necessary to monitor this uncertainty for all applied shots. These findings might enable an easier uncertainty management for particle therapy with broad energy spectra.

Schell, S.; Wilkens, J. J.

2012-03-01

136

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

PubMed

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

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

2014-02-01

137

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

NASA Astrophysics Data System (ADS)

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.

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

138

Systematic review of overactive bladder therapy in females.  

PubMed

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

Cardozo, Linda

2011-10-01

139

Biofield therapies and cancer-related symptoms: a review.  

PubMed

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

Gonella, Silvia; Garrino, Lorenza; Dimonte, Valerio

2014-10-01

140

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

PubMed

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

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

2011-12-01

141

Thermal modelling using discrete vasculature for thermal therapy: a review  

PubMed Central

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

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

2013-01-01

142

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

Microsoft Academic Search

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

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

2008-01-01

143

Particle bombardment effects on thin-film deposition: A review  

Microsoft Academic Search

In many atomistic film deposition processes, concurrent energetic particle bombardment (ions, atoms, molecules, atom clusters) may occur inadvertently and uncontrollably or bombardment may be used to deliberately modify film properties. These energetic particles can arise from (i) the acceleration of charged particles, (ii) high-energy neutrals from reflection from bombarded surfaces, or (iii) charge exchange processes. Particle bombardment effects that can

D. M. Mattox

1989-01-01

144

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

PubMed

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

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

2002-12-01

145

Rapid appearance of transient secondary adrenocortical insufficiency after alpha-particle radiation therapy for Cushing's disease  

Microsoft Academic Search

A 17-year-old woman received 12,000 rads of alpha-particle radiation for the treatment of Cushing's disease. One day after the completion of therapy, the patient developed nausea, vomiting, headache, and postural hypotension. Laboratory evaluation demonstrated a marked fall of the previously elevated urinary 17-hydroxycorticosteroids (17-OHCS) and undetectable plasma cortisols. The urinary 17-OHCS transiently returned to supranormal levels but over a 2¹\\/â-week

D. M. Cook; R. M. Jordan; J. W. Kendall; J. A. Linfoot

1976-01-01

146

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

ERIC Educational Resources Information Center

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

Swiderski, Michael J.; Mitten, Denise

1994-01-01

147

Concise Review: Cell Therapies: The Route to Widespread Adoption  

PubMed Central

We identify three dimensions with which to classify heuristically the routes to widespread adoption of cellular therapies. The first dimension is based on the relative involvement of clinicians and companies in a particular cellular therapy. The second dimension is based on cell type and consequent scale of manufacture. The third dimension classifies the therapeutic intervention as a procedure or product and has perhaps received less attention. We suggest that for those cellular therapies that require therapeutic procedures, close collaboration between companies and clinicians will reduce the time to widespread adoption. For selected cellular therapies we make predictions of the likely time to widespread adoption. PMID:23197823

Foley, Lucy

2012-01-01

148

Eurythmy Therapy in clinical studies: a systematic literature review  

Microsoft Academic Search

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,

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

2008-01-01

149

Contemporary Reviews in Cardiovascular Medicine Cardiac Resynchronization Therapy in Patients With New  

E-print Network

(Figure 1). Stage B indicates the presence of structural heart disease strongly associated of HF. Stage C corresponds to past or present symptomatic HF associated with structural heart diseaseContemporary Reviews in Cardiovascular Medicine Cardiac Resynchronization Therapy in Patients

Boyer, Edmond

150

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

Microsoft Academic Search

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

Belinda Bilney; Meg E. Morris; Alison Perry

2003-01-01

151

A systematic review of the research base on sexual reorientation therapies  

Microsoft Academic Search

In the past few years, members of the AAMFT, like members of other professional groups, have engaged in a discourse as to the necessity and effectiveness of sexual reorientation therapies. The purpose of this article is to review, critique, and synthesize the scientific rigor of the literature base underpinning sexual reorientation therapy research. Using a systematic narrative analysis approach, 28

Julianne M. Serovich; Shonda M. Craft; Paula Toviessi; Rashmi Gangamma; Tiffany McDowell; Erika E. Grafsky

2008-01-01

152

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

Microsoft Academic Search

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

Richard Harrington; Jane Whittaker; Philip Shoebridge; Fiona Campbell

1998-01-01

153

Testosterone therapy in hypogonadal men and potential prostate cancer risk: a systematic review  

Microsoft Academic Search

This paper provides a systematic review of the literature about prostate cancer risk associated with testosterone therapy for hypogonadism. A comprehensive search of MEDLINE, EMBASE and other resources was conducted to identify articles that highlight occurrences of prostate cancer in men receiving testosterone therapy for hypogonadism treatment. Articles that met study inclusion criteria were assessed for causality between testosterone treatment

R Shabsigh; E D Crawford; A Nehra; K M Slawin

2009-01-01

154

Serious adverse effects of unconventional therapies for children and adolescents: a systematic review of recent evidence  

Microsoft Academic Search

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

Edzard Ernst

2003-01-01

155

Injection therapy for subacute and chronic low back pain: an updated Cochrane review  

Microsoft Academic Search

STUDY DESIGN: A systematic review of randomized controlled trials (RCTs). OBJECTIVE: To determine if injection therapy is more effective than placebo or other treatments for patients with subacute or chronic low back pain. SUMMARY OF BACKGROUND DATA: The effectiveness of injection therapy for low back pain is still debatable. Heterogeneity of target tissue, pharmacological agent, and dosage, generally found in

J Bart Staal; Rob A. de Bie; Henrica C. W. de Vet; Jan Hildebrandt; Patty Nelemans

2009-01-01

156

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

Microsoft Academic Search

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

Iva Kosutic; Teresa McDowell

2008-01-01

157

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

Microsoft Academic Search

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

Sally M Gainsbury; Alex Blaszczynski

2011-01-01

158

Relaxation therapies for the management of primary hypertension in adults: a Cochrane review  

Microsoft Academic Search

The objective of this review was to evaluate the effectiveness of relaxation to lower high blood pressure. We searched electronic bibliographic databases and grey literature to identify randomized controlled trials comparing relaxation therapies with no active treatment or sham therapy, enrolling adult participants with raised systolic blood pressure (SBP) ?140 mm Hg or diastolic blood pressure (DBP) ?85 mm Hg

H O Dickinson; F Campbell; F R Beyer; D J Nicolson; J V Cook; G A Ford; J M Mason

2008-01-01

159

Speech and language therapy for dysarthria due to nonprogressive brain damage: a systematic Cochrane review  

Microsoft Academic Search

Background: Dysarthria is a common sequel of nonprogressive brain damage (typically stroke and traumatic brain damage). Impairment-based therapy and a wide variety of compensatory management strategies are undertaken by speech and language therapists with this patient population.Objective: To determine the efficacy of speech and language therapy interventions for adults with dysarthria following nonprogressive brain damage.Design: Systematic review.Search strategy: This review

Cameron Sellars; Thomas Hughes; Peter Langhorne

2002-01-01

160

Ablation therapies for pancreatic cancer: an updated review.  

PubMed

While impressive strides have been made in the detection and management of numerous somatic malignancies over the past two decades, safe and effective treatments for pancreatic cancer have remained elusive. However, a number of emerging new therapies hold the promise of improving survival and quality of life for those stricken with the disease. Ablative therapies in particular, including those utilizing radiofrequency waves, microwaves, thermal energy, photodynamic energy and focused ultrasound waves provide an opportunity to target neoplasms while sparing healthy surrounding tissue. Paired with endoscopic ultrasound, these therapies offer a safe, effective and minimally invasive means to care of patients with otherwise inoperable tumors. PMID:25215460

Salgado, S; Sharaiha, R; Gaidhane, M; Kahaleh, M

2014-12-01

161

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

SciTech Connect

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

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

2009-03-10

162

Contextual Behavior Therapies in the Treatment of PTSD A Review  

Microsoft Academic Search

Empirical evidence supports cognitive -behavioral interventions for the treatment Posttraumatic Stress Disorder (PTSD), with exposure therapy typically being the most frequently utilized. While the success of exposure treatments is well established there are factors which may hinder their use in \\

Patrick S. Mulick; Sara J. Landes; Jonathan W. Kanter

2005-01-01

163

Review of ion beam therapy: Present and Future  

SciTech Connect

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.

Alonso, Jose R.

2000-06-01

164

Physical therapy in the postoperative of proximal femur fracture in elderly. Literature review  

PubMed Central

The proximal femoral fracture in the elderly is a serious public health problem. Surgical treatment of this fracture is used to reduce morbidity, together with postoperative physical therapy. The objective was to conduct a systematic review of physical therapy protocols in postoperative for fractures of the proximal femur in elderly. We selected randomized controlled trials in elderly in the past 10 years, in Portuguese and English. There were 14 articles in the literature. Physical therapy has an important role in functional recovery of the elderly. Level of Evidence I, Systematic Review RCTs (Study results were homogenous). PMID:24453665

Carneiro, Mariana Barquet; Alves, Debora Pinheiro Ledio; Mercadante, Marcelo Tomanik

2013-01-01

165

Review Herbal Dewormers in Livestock - A Traditional Therapy  

Microsoft Academic Search

This review is a part of data being collected on the botanical anthelmintics being traditionally used in various parts of the world. Much of the review has been extracted from internet collections. Review presents some examples of herbal medicine used against helminths in livestock, and outlines potentials and limitations in the use of ethnomedicine, or ethnobotanical medicine - the utilization

ZAFAR IQBAL; MUHAMMAD SHOAIB AKHTAR; ZIA-UD-DIN SINDHU; M. NISAR KHAN; ABDUL JABBAR

166

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

E-print Network

In particle therapy, knowledge of the stopping-power ratios (STPRs) of the ion beam for air and water is necessary for accurate ionization chamber dosimetry. Earlier work has investigated the STPRs for pristine carbon ion beams, but here we expand the calculations to a range of ions (1 <= z <= 18) as well as spread out Bragg peaks (SOBPs) and provide a theoretical in-depth study with a special focus on the parameter regime relevant for particle therapy. The Monte Carlo transport code SHIELD-HIT is used to calculate complete particle-fluence spectra which are required for determining STPRs according to the recommendations of the International Atomic Energy Agency (IAEA). We confirm that the STPR depends primarily on the current energy of the ions rather than on their charge z or absolute position in the medium. However, STPRs for different sets of stopping-power data for water and air recommended by the International Commission on Radiation Units & Measurements (ICRU) are compared, including also the...

Lühr, Armin; Jäkel, Oliver; Sobolevsky, Nikolai; Bassler, Niels

2010-01-01

167

Does adherence therapy improve medication adherence among patients with schizophrenia? A systematic review.  

PubMed

Non-adherence to medication is highly prevalent in patients with schizophrenia. Adherence therapy aims to improve medication adherence of these patients by applying techniques of cognitive behavioural therapy, psycho-education, and motivational interviewing. Even though adherence therapy is frequently discussed and researched, its effectiveness is still uncertain. This paper aims to review the effectiveness of adherence therapy on the medication adherence of patients with schizophrenia. To this end, six electronic databases were systematically searched for randomized, controlled trials on adherence therapy from January 2002 to March 2013. Four trials met the inclusion criteria and were incorporated into the review. The findings suggest that adherence therapy does not improve patients' medication adherence in comparison to treatment as usual or a control intervention. However, all the studies reviewed showed high-adherence ratings at baseline. Thus, further well-designed studies that target adherence therapy to patients who are non-adherent to their medication are needed for a more profound understanding of its effectiveness. In addition, if adherence therapy is aimed not only at improving medication adherence, but also to reach an agreement whereby the patient's decision not to take his medication is accepted, the shared decision-making process needs to be assessed as well. PMID:25279684

Hegedüs, Anna; Kozel, Bernd

2014-12-01

168

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

NASA Astrophysics Data System (ADS)

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

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

1998-06-01

169

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

Microsoft Academic Search

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

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

2007-01-01

170

Particle Interaction Summary/Review Spring 2009 Compton Lecture Series  

E-print Network

the correct mass and properties to be the mediator for the nuclear force. · Conservation Laws determine what conservation law, it must occur. This means that a particle is only stable if it is protected by some conservation law. ­ the electron is stable because it is the lightest negatively charged particle, the proton

171

Ozone therapy in dentistry. A brief review for physicians.  

PubMed

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

Domb, William C

2014-10-31

172

Effect of reminiscence therapy on depression in older adults: a systematic review  

Microsoft Academic Search

The objective of this systematic review is to provide healthcare professionals with information to assist in their decision to utilize reminiscence therapy for depression reduction in older adults outside of the primary care setting. Nine reviewed studies that were randomized controlled trials not only varied in person, outcome measurement, control, and exposure\\/intervention, the results of these studies were also diverse.

Hsiu-Fang Hsieh; Jing-Jy Wang

2003-01-01

173

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

ERIC Educational Resources Information Center

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

Gellis, Zvi D.; Kenaley, Bonnie

2008-01-01

174

Occupational therapy for rheumatoid arthritis: A systematic review  

Microsoft Academic Search

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

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

2002-01-01

175

Proton therapy - A systematic review of clinical effectiveness  

Microsoft Academic Search

Background and purpose: Proton therapy is an emerging treatment modality for cancer that may have distinct advantages over conventional radiotherapy. This relates to its ability to confine the high-dose treatment area to the tumour volume and thus minimizing radiation dose to surrounding normal tissue. Several proton facilities are currently operating or under planning world-wide - in the United States, Asia

Dag Rune Olsen; Øyvind S. Bruland; Gunilla Frykholm; Inger Natvig Norderhaug

176

Maintenance electroconvulsive therapy in autistic catatonia: A case series review  

Microsoft Academic Search

The usage of electroconvulsive therapy for the acute resolution of catatonia in autistic children and adults is a novel area that has received increased attention over the past few years. Reported length of the acute ECT course varies among these patients, and there is no current literature on maintenance ECT in autism. The maintenance ECT courses of three patients with

Lee E. Wachtel; Adriana Hermida; Dirk M. Dhossche

2010-01-01

177

Review of Intrathecal Baclofen Therapy for Spastic and Rigidity Disorders  

ERIC Educational Resources Information Center

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…

Obringer, S. John; Coffey, Kenneth M.

2002-01-01

178

Contextual Behavior Therapies in the Treatment of PTSD: A Review  

ERIC Educational Resources Information Center

Empirical evidence supports cognitive-behavioral interventions for the treatment Posttraumatic Stress Disorder (PTSD), with exposure therapy typically being the most frequently utilized. While the success of exposure treatments is well established there are factors which may hinder their use in "real-world" settings (e.g., poor treatment…

Mulick, Patrick S.; Landers, Sara J.; Kanter, Jonathan W.

2005-01-01

179

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

Microsoft Academic Search

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

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

2005-01-01

180

A review of the numerical investigation on the scattering of Gaussian beam by complex particles  

NASA Astrophysics Data System (ADS)

The study of light scattering by various particles is an active and important subject of research with myriad practical applications. During the years the scattering of plane wave by various particles has been investigated extensively. In recent years, with the development of laser sources and the tremendous expansion of their application, there has been a growing interest in the study of light scattering by various particles illuminated by a focused Gaussian beam. Since the analytical methods are only suitable for the analysis of Gaussian beam scattering by some regular particles, for complex particles with arbitrary shape and structure, one has to resort to the numerical methods. In this article, we review the recent numerical investigation on the scattering of Gaussian beam by systems of complex particles, including arbitrarily shaped conducting particles, dielectric particles, composite particles with inclusions, as well as random discrete particles and fractal soot aggregates. The essential formulations of the proposed numerical methods are outlined and the numerical results for some complex particles are also presented. This review is expected to provide useful help for the study of the interaction between the laser beams and the complex particles.

Cui, Zhiwei; Han, Yiping

2014-05-01

181

Response to 'Position statement on ethics, equipoise and research on charged particle therapy'.  

PubMed

In August 2011, a group of medical doctors, ethicists, academic and medical physicists were asked to debate and reach consensus on the potential need for randomised control trials to test charged particle radiation therapy (CPRT) for treating tumours. The outcome of the meeting was a paper recently published in the Journal of Medical Ethics entitled "Position statement on ethics, equipoise and research on charged particle therapy" by Sheehan et al. However 6 of the 30 meeting participants withdrew from authorship of the 'position statement' because their views were not adequately represented. The 'position statement' did not state our reasons for withdrawing from the statement, which is a considerable omission. We had two principal objections: (1) the case for the benefits to patients and society of randomized trials to test CPRT was not adequately represented, and (2) the complexities and potential harms of CPRT were not clearly stated. In this response we explain and justify our objections. Patients, doctors and policymakers seeking to make independent judgments about whether equipoise exists for the relative benefits of CPRT should therefore read this document alongside the 'position' statement. PMID:24812333

Jones, Bleddyn; Howick, Jeremy; Hopewell, John; Liew, Su May

2014-08-01

182

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

NASA Astrophysics Data System (ADS)

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

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

2013-01-01

183

Virtual reality exposure therapy of anxiety disorders: a review.  

PubMed

Virtual reality exposure therapy (VRET) is an altered form of behavioral therapy and may be a possible alternative to standard in vivo exposure. Virtual reality integrates real-time computer graphics, body tracking devices, visual displays, and other sensory input devices to immerse patients in a computer-generated virtual environment. Research on this type of treatment for anxiety disorders is discussed in this article, and the mediating and moderating variables that influence VR treatment effectiveness as well. Evidence is found that VRET is effective for participants with fear of heights and of flying. For other phobias, research to date is not conclusive. More randomized clinical trials in which VRET is compared with standard exposure are required. Furthermore, studies are needed in which VRET is not just a component of the treatment package evaluated, but in which VRET should be assessed as a stand-alone treatment. PMID:15245832

Krijn, M; Emmelkamp, P M G; Olafsson, R P; Biemond, R

2004-07-01

184

Self-Management of Oral Anticoagulant Therapy: A Review  

Microsoft Academic Search

Patient self-management of oral anticoagulant therapy has over the last years gained increasing attention and widespread use. The method implies self-testing using a coagulometer (point-of-care device) and self-dosaging of coumarin. The method entails advantages for selected patients, who do not need to go to the hospital or family doctor for blood specimen and drug dosage adjustment. In contrast to patients

Thomas D. Christensen

2004-01-01

185

Silicone-Based Scar Therapy: A Review of the Literature  

Microsoft Academic Search

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

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

2010-01-01

186

Ocular Surface Alterations and Topical Antiglaucomatous Therapy: A Review  

PubMed Central

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

Actis, Alessandro G; Rolle, Teresa

2014-01-01

187

Prevention of and Therapies for Nipple Pain: A Systematic Review  

Microsoft Academic Search

Objective: To review the literature on nipple pain and to delineate effective strategies for the pre- vention and treatment of nipple pain in breastfeeding mothers. Data Sources: Computerized searches on MED- LINE, Pre-MEDLINE, CINAHL, and the Cochrane Library.

Kristine Morland-Schultz; Pamela D. Hill

188

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

PubMed Central

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

2013-01-01

189

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

NASA Astrophysics Data System (ADS)

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.

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

2014-03-01

190

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

Microsoft Academic Search

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

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

2008-01-01

191

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

Microsoft Academic Search

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

E. Ernst

2002-01-01

192

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

PubMed Central

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

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

2013-01-01

193

A systematic review of orofacial pain in patients receiving cancer therapy  

Microsoft Academic Search

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

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

2010-01-01

194

Treatment of pediatric patients and young adults with particle therapy at the Heidelberg Ion Therapy Center (HIT): establishment of workflow and initial clinical data  

PubMed Central

Background To report on establishment of workflow and clinical results of particle therapy at the Heidelberg Ion Therapy Center. Materials and methods We treated 36 pediatric patients (aged 21 or younger) with particle therapy at HIT. Median age was 12 years (range 2-21 years), five patients (14%) were younger than 5 years of age. Indications included pilocytic astrocytoma, parameningeal and orbital rhabdomyosarcoma, skull base and cervical chordoma, osteosarcoma and adenoid-cystic carcinoma (ACC), as well as one patient with an angiofibroma of the nasopharynx. For the treatment of small children, an anesthesia unit at HIT was established in cooperation with the Department of Anesthesiology. Results Treatment concepts depended on tumor type, staging, age of the patient, as well as availability of specific study protocols. In all patients, particle radiotherapy was well tolerated and no interruptions due to toxicity had to be undertaken. During follow-up, only mild toxicites were observed. Only one patient died of tumor progression: Carbon ion radiotherapy was performed as an individual treatment approach in a child with a skull base recurrence of the previously irradiated rhabdomyosarcoma. Besides this patient, tumor recurrence was observed in two additional patients. Conclusion Clinical protocols have been generated to evaluate the real potential of particle therapy, also with respect to carbon ions in distinct pediatric patient populations. The strong cooperation between the pediatric department and the department of radiation oncology enable an interdisciplinary treatment and stream-lined workflow and acceptance of the treatment for the patients and their parents. PMID:23072718

2012-01-01

195

A review of TRISO-coated particle nuclear fuel performance models  

Microsoft Academic Search

The success of high temperature gas cooled reactor depends upon the safety and quality of the coated particle fuel. The understanding and evaluation of this fuel requires the development of an integrated mechanistic fuel performance model that fully describes the mechanical and physicochemical behavior of the fuel particle under irradiation. In this paper, a review of the analytical capability of

Bing LIU; Tongxiang LIANG; Chunhe TANG

2006-01-01

196

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

PubMed

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

DeBaun, Michael R

2014-12-01

197

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

PubMed

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

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

2014-01-01

198

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

PubMed

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

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

2014-03-01

199

Changes in Lipids and Lipoprotein Particle Concentrations After Interruption of Antiretroviral Therapy  

PubMed Central

Background The effect of interruption of antiretroviral therapy (ART) on lipoprotein particle subclasses has not been studied. We examined short-term changes in lipids and lipoprotein particles among 332 HIV-infected individuals randomized to interrupt or continue ART in the “Strategies for Management of Antiretroviral Therapy” trial. Methods Lipids and lipoprotein particles measured by nuclear magnetic resonance spectroscopy were compared between randomized groups at month 1; associations with inflammatory and coagulation markers (high sensitivity C-reactive protein; interleukin 6; amyloid A; amyloid P; D-dimer; prothrombin fragment 1 + 2) were assessed. Results Compared with continuation of ART, treatment interruption resulted in substantial declines in total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, and triglyceride, at month 1 but had little net effect on total/HDL cholesterol ratio [baseline-adjusted mean difference [95% confidence interval (CI)] interruption versus continuation arms: ?0.10 (?0.59 to 0.38); P = 0.67]. ART interruption resulted in declines in total, large, and medium very low density lipoprotein (VLDL) particle concentrations (VLDL-p) and total and medium HDL-p. However, there was no change in small HDL-p [baseline-adjusted percentage difference between arms: ?4.6% (?13.1%, +5.1% ); P = 0.35], small LDL-p [?5.0% (?16.9%, +8.6%); P = 0.45], or other LDL-p subclasses. Changes in lipid parameters on ART interruption did not differ according to baseline ART class (protease inhibitor versus non-nucleoside reverse transcriptase inhibitor) but were negatively associated both with changes in HIV viral load and with changes in inflammatory and coagulation markers, particularly D-dimer. Conclusions These results suggest that ART interruption does not favorably influence overall lipid profile: there was little net effect on total/HDL cholesterol ratio, and no change in small LDL-p or small HDL-p, the lipoprotein particle subclasses most consistently linked to coronary risk. Short-term declines in lipid parameters after ART interruption were not associated with class of ART and may be linked to increases in viral replication, inflammation and coagulation. PMID:20658749

Lampe, Fiona C.; Duprez, Daniel A.; Kuller, Lewis H.; Tracy, Russell; Otvos, James; Stroes, Erik; Cooper, David A.; Hoy, Jennifer; Paton, Nick I.; Friis-M?ller, Nina; Neuhaus, Jacquie; Liappis, Angelike P.; Phillips, Andrew N.

2011-01-01

200

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

PubMed Central

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

Naseri, Alireza; Mesbahi, Asghar

2010-01-01

201

Metastatic Crohn's disease: a review and approach to therapy.  

PubMed

Metastatic Crohn's disease (CD) is a rare cutaneous manifestation of CD that was first described nearly 50 years ago. Many subsequent reports have defined its most common clinical and histopathologic features. The pathogenesis underlying metastatic CD is unknown but various hypotheses exist. An established standard therapy is lacking. Owing to its rarity and nonspecific clinical presentation along with the diversity of inflammatory skin disorders that often complicate CD, the diagnosis of metastatic CD may be overlooked. This report highlights the salient features of this disorder to facilitate recognition and management of this rare dermatosis. PMID:24888520

Kurtzman, Drew J B; Jones, Trevor; Lian, Fangru; Peng, Lisan S

2014-10-01

202

Harm Reduction Therapy: A Practice-Friendly Review of Research  

PubMed Central

Harm reduction is an umbrella term for interventions aiming to reduce the problematic effects of behaviors. Although harm reduction was originally and most frequently associated with substance use, it is increasingly being applied to a multitude of other behavioral disorders. This article reviews the state of empirical research on harm reduction practices including alcohol interventions for youth, college students, and a variety of other adult interventions. We also review nicotine replacement and opioid substitution, as well as needle exchanges and safe injection sites for intravenous drug users. Dozens of peer-reviewed controlled trial publications provide support for the effectiveness of harm reduction for a multitude of clients and disorders without indications of iatrogenic effects. Harm reduction interventions provide additional tools for clinicians working with clients who, for whatever reason, may not be ready, willing, or able to pursue full abstinence as a goal. PMID:20049923

Logan, Diane E.; Marlatt, G. Alan

2014-01-01

203

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...

204

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

PubMed

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

Tucquet, Belinda; Leung, Maggie

2014-11-01

205

Adverse Events of Auricular Therapy: A Systematic Review  

PubMed Central

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.

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

2014-01-01

206

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

NASA Astrophysics Data System (ADS)

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

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

2013-09-01

207

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

PubMed Central

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

Kumar, Saravana; Beaton, Kate; Hughes, Tricia

2013-01-01

208

Usage of complementary therapies in rheumatology: A systematic review  

Microsoft Academic Search

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

E. Ernst

1998-01-01

209

Brief Review: Advances in Therapy with Antileukotriene Drugs  

Microsoft Academic Search

Evidence from clinical trials and experience derived from managing patients with asthma justify a broader role for leukotriene (LT) blockers in asthma management than that recommended by the National Asthma Education and Prevention Program and the NIH Heart, Lung and Blood Institute treatment guidelines. Many published clinical trials, reviews, and case reports have suggested important new applications of LT blockers

Graziano Riccioni; Carmine Di Ilio; Pio Conti; Theoharis C. Theoharides; Nicolantonio D'Orazio

210

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

PubMed Central

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

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

2013-01-01

211

Novel and emerging therapies safeguarding health of humans and their companion animals: a review.  

PubMed

Modern medicine has helped to a great extent to eradicate and cure several diseases of mankind and animals. But the existence of incurable diseases like cancer, Acquired Immunodeficiency Syndrome (AIDS), diabetes or rheumatoid arthritis, side effects of allopathic medicine, increasing trend of antibiotic resistance and chemicals and biopesticides causing dietary risk have made the situation more critical than ever before. Thus, it has become a matter of concern for the scientists and researchers to develop novel therapies. Bacteriophage therapy to treat pathogenic bacterial infections, virophage therapy for conservation of global system and avian egg yolk antibody therapy for designing prophylactic strategies against Gastrointestinal (GI) diseases are interesting approaches. Others include the use of cytokines as adjunctive immunomodulators, gene therapy focusing on diseases caused by single gene defects, RNAi technology to suppress specific gene of interest and apoptins for cancer treatment. Stem cell therapy against several diseases and ailments has also been discussed. The use of nanoparticles for better drug delivery, even though costly, has been given equal importance. Nevertheless, immunomodulation, be it through physiological, chemical or microbial products, or through essential micronutrients, probiotics, herbs or cow therapy prove to be cost-effective, causing minimum adverse reactions when compared to allopathy. Development in the field of molecular biology has created an enormous impact on vaccine development. The present review deals with all these novel and emerging therapies essential to safeguard the health of humans and companion animals. PMID:24171271

Dhama, Kuldeep; Chakraborty, Sandip; Mahima; Wani, Mohd Yaqoob; Verma, Amit Kumar; Deb, Rajib; Tiwari, Ruchi; Kapoor, Sanjay

2013-02-01

212

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

PubMed

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

Shibata, Takanori; Wada, Kazuyoshi

2011-01-01

213

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

NASA Technical Reports Server (NTRS)

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.

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

2010-01-01

214

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

PubMed Central

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

2013-01-01

215

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

PubMed

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

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

2014-10-01

216

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

PubMed

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

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

2014-01-01

217

Leech therapy for epidermoid cysts and review of the literature  

PubMed Central

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

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

2014-01-01

218

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

PubMed Central

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

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

2001-01-01

219

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

PubMed Central

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

2010-01-01

220

A systematic review of randomized controlled trials on curative and health enhancement effects of forest therapy  

PubMed Central

Objective To summarize the evidence for curative and health enhancement effects through forest therapy and to assess the quality of studies based on a review of randomized controlled trials (RCTs). Study design A systematic review based on RCTs. Methods Studies were eligible if they were RCTs. Studies included one treatment group in which forest therapy was applied. The following databases – from 1990 to November 9, 2010 – were searched: MEDLINE via PubMed, CINAHL, Web of Science, and Ichushi- Web. All Cochrane databases and Campbell Systematic Reviews were also searched up to November 9, 2010. Results Two trials met all inclusion criteria. No specific diseases were evaluated, and both studies reported significant effectiveness in one or more outcomes for health enhancement. However, the results of evaluations with the CONSORT (Consolidated Standards of Reporting Trials) 2010 and CLEAR NPT (A Checklist to Evaluate a Report of a Nonpharmacological Trial) checklists generally showed a remarkable lack of description in the studies. Furthermore, there was a problem of heterogeneity, thus a meta-analysis was unable to be performed. Conclusion Because there was insufficient evidence on forest therapy due to poor methodological and reporting quality and heterogeneity of RCTs, it was not possible to offer any conclusions about the effects of this intervention. However, it was possible to identify problems with current RCTs of forest therapy, and to propose a strategy for strengthening study quality and stressing the importance of study feasibility and original check items based on characteristics of forest therapy as a future research agenda. PMID:22888281

Kamioka, Hiroharu; Tsutani, Kiichiro; Mutoh, Yoshiteru; Honda, Takuya; Shiozawa, Nobuyoshi; Okada, Shinpei; Park, Sang-Jun; Kitayuguchi, Jun; Kamada, Masamitsu; Okuizumi, Hiroyasu; Handa, Shuichi

2012-01-01

221

Section1: A Review of Adherence to Oral Endocrine Therapy for Breast Cancer Section 2: Jenny Milata 1  

E-print Network

Section1: A Review of Adherence to Oral Endocrine Therapy for Breast Cancer Section 2: Jenny Milata persistence. Adherence to oral endocrine therapy post treatment for breast cancer is a complex phenomenon cancer. Endocrine therapies include Tamoxifen and the aromatase inhibitors, such as Anastrozole

Zhou, Yaoqi

222

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

PubMed Central

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

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

2014-01-01

223

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

PubMed

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

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

2014-10-10

224

A systematic review of vinpocetine therapy in acute ischaemic stroke  

Microsoft Academic Search

Objectives: To determine whether vinpocetine decreases short- and long-term case fatality and proportion of dependent survivors if administered\\u000a within 2?weeks of stroke onset.\\u000a \\u000a \\u000a \\u000a Methods: All published and unpublished trials were attempted to be identified using the standard search strategy of the Cochrane\\u000a Collaboration Stroke Review Group, using MEDLINE searches performed with all known manufacturer code names and trade names\\u000a of

D. Bereczki; I. Fekete

1999-01-01

225

Probiotic therapy for gastro-intestinal allergenic infants : A preliminary review  

Microsoft Academic Search

Purpose – This article seeks to review the incidence of food allergy or food sensitization in children which has increased during the past decade and can manifest urticaria or angioedema, anaphylaxis, atopic dermatitis, respiratory symptoms or gastro-intestinal disorders, and to looks closely at probiotic therapy, which appears to alleviate allergy inflammation. Design\\/methodology\\/approach – Literature related to probiotics and their exploitation

S. Sarkar

2007-01-01

226

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

Microsoft Academic Search

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

Alexander De Graeff; Mervyn Dean

2007-01-01

227

Hormone replacement therapy and cognitive performance in postmenopausal women—a review by cognitive domain  

Microsoft Academic Search

Laboratory, animal and neuroimaging evidences suggest that hormone replacement therapy (HRT) may be beneficial to human cognition. This systematic review includes 26 studies on the association between HRT and cognition and 17 studies on HRT and risk of dementia. It was hypothesised that HRT would have a positive association with cognitive speed and verbal memory and possibly visual memory but

Lee-Fay Low; Kaarin J. Anstey

2006-01-01

228

Off-Therapy Headaches in Pediatric Brain Tumor Patients: A Retrospective Review  

Microsoft Academic Search

To determine the incidence, timing, and characteristics of headaches in a population of off-therapy pediatric brain tumor patients, a retrospective chart review was conducted on 3 subpopulations of children followed in a multidisciplinary neuro-oncology clinic in the Southeastern United States. Data collected included tumor type and location, treatment, associated symptoms, and description and timing of headaches. In all, 81 charts

Ann H. Johnson; Cathy Jordan; Claire M. Mazewski

229

Androgen deprivation therapy for prostate cancer--review of indications in 2010  

PubMed Central

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

Quon, H.; Loblaw, D.A.

2010-01-01

230

Therapy of idiopathic sudden sensorineural hearing loss. A review of the literature.  

PubMed

The literature on therapy of Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) is reviewed. Clinical trails are judged on comparativeness, internal and external validity. It is concluded that steroids are only treatment available with a significant beneficial effect on ISSHL. Recommendations are made with regard to a well designed clinical trail on the treatment of ISSHL. PMID:8669277

Stokroos, R J; Albers, F W

1996-01-01

231

The feasibility of using cognitive behaviour therapy for depression associated with Parkinson's disease: A literature review  

Microsoft Academic Search

Clinicians and researchers have called for more information on how to treat depression in Parkinson's disease. Cognitive Behaviour Therapy (CBT) has been identified as the treatment of choice for a range of psychological disorders and is increasingly applied to depression associated with chronic medical conditions. The present paper will review the relevant literature on CBT treatment effectiveness and the nature

Kristina Cole; Frances L. Vaughan

2005-01-01

232

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

Microsoft Academic Search

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

Claude Villeneuve; Catherine LaRoche

1993-01-01

233

Probiotic therapy for the prevention and treatment of Clostridium difficile-associated diarrhea: a systematic review  

Microsoft Academic Search

Background: The recent increase in the number and severity of cases of nosocomial Clostridium difficile-associated diarrhea (CDAD) has prompted interest in the use of probiotics for the prevention and treatment of this disease. We performed a sys- tematic review of randomized controlled trials to assess the ef- fectiveness of probiotic therapy. Methods: We searched the PubMed, EMBASE, INAHTA, HEN and

Nandini Dendukuri; Vania Costa; Maurice McGregor; James M. Brophy

2005-01-01

234

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

Microsoft Academic Search

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

Deborah C. Bailey

2012-01-01

235

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

Cancer.gov

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

236

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

ERIC Educational Resources Information Center

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,…

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

2013-01-01

237

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

Microsoft Academic Search

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

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

2004-01-01

238

The role of music therapy in physical rehabilitation: a systematic literature review  

Microsoft Academic Search

Physiotherapists and occupational therapists provide physical rehabilitation to maximize independence of those with compromised function. Qualified music therapists have provided interventions to assist physical rehabilitation for over 20 years, however effectiveness of interventions are often questioned. This systematic literature review explores the effectiveness of music therapy (MT) in physical rehabilitation, the function of music and the role of the music

Claire M. Weller; Felicity A. Baker

2011-01-01

239

Conference Report Current limitations of antiepileptic drug therapy: a conference review  

Microsoft Academic Search

The current limitations of antiepileptic drug (AED) therapy were the topic of a discussion group meeting at the 5th European Congress on Epileptology, Madrid, 6-10 October 2002. This review contains four short papers covering the topics discussed by the speakers at this meeting and an account of the ensuing discussion with all participants. The meeting focused on four issues. (i)

C. L. P. Deckers; P. Genton; G. J. Sills; D. Schmidt

240

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

Microsoft Academic Search

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

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

2008-01-01

241

Histone deacetylase inhibitors: a novel target of anticancer therapy (review).  

PubMed

Accumulating evidence suggests that the acetylation and deacetylation of histones play significant roles in transcriptional regulation of eukaryotic cells. The balance between acetylation and deacetylation is an important factor in regulating gene expression and is thus linked to the control of cell fate. The histone deacetylase inhibitors (HDIs) including the hydroxamic acids, such as suberoylanilide hydroxamic acid and pyroxamide, the benzamides MS-275 and CI-994 and the butyrate derivative 4-PBA are a new class of anti-neoplastic agents currently being evaluated in clinical trials. Moreover, new synthetic HDIs have been used recently in phase I and II clinical trials. Over the next few years experts believe that as first generation HDIs produce clinical benefits and second generation inhibitors are rationally designed with improved specificity, this class of drugs will emerge as a new way of cancer treatment. The first clinical studies have shown that histone hyperacetylation can be achieved safely in humans and that treatment of cancer with such agents seems to become possible. The use of HDIs, probably in association with classical chemotherapy drugs or in combination with DNA-demethylating agents, could be promising for cancer patients. Further evaluation is needed to establish the clinical activity of combination therapy using HDIs with cytotoxic drugs or differentiation induced agents. PMID:16391874

Kouraklis, Gregory; Theocharis, Stamos

2006-02-01

242

First Exit Times of Harmonically Trapped Particles: A Didactic Review  

E-print Network

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

D. S. Grebenkov

2014-11-13

243

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

PubMed

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

Sliwi?ski, Pawe?; Chazan, Ryszarda; D?browiecki, Piotr; Jahnz-Ró?yk, Karina; Mróz, Robert; Piro?y?ski, Micha?

2014-01-01

244

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

PubMed Central

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

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

2013-01-01

245

Production of [211At]-Astatinated Radiopharmaceuticals and Applications in Targeted ?-Particle Therapy  

PubMed Central

Abstract 211At is a promising radionuclide for ?-particle therapy of cancers. Its physical characteristics make this radionuclide particularly interesting to consider when bound to cancer-targeting biomolecules for the treatment of microscopic tumors. 211At is produced by cyclotron irradiation of 209Bi with ?-particles accelerated at ?28?MeV and can be obtained in high radionuclidic purity after isolation from the target. Its chemistry resembles iodine, but there is also a tendency to behave as a metalloid. However, the chemical behavior of astatine has not yet been clearly established, primarily due to the lack of any stable isotopes of this element, which precludes the use of conventional analytical techniques for its characterization. There are also only a limited number of research centers that have been able to produce this element in sufficient amounts to carry out extensive investigations. Despite these difficulties, chemical reactions typically used with iodine can be performed, and a number of biomolecules of interest have been labeled with 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

Guerard, Francois; Gestin, Jean-Francois

2013-01-01

246

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

PubMed

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

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

2013-05-01

247

Massage as therapy for persons with intellectual disabilities: a review of the literature.  

PubMed

Persons with intellectual disabilities record a higher incidence of challenging behaviours than the general population. Massage therapy has frequently been applied to such persons to induce relaxation. The aim of this review was to evaluate the effectiveness of massage therapy on relaxation and reduction of challenging behaviours. A literature search was conducted through various electronic databases; a total of 64 articles was generated but only seven met all inclusion criteria. These studies were evaluated in terms of (a) number of participants, (b) study setting, (c) methodology, (d) intervention pattern, (e) outcome measure of the intervention, and (f) major results. Evidence-based literature demonstrating the effectiveness of massage therapy in supporting clinical practice is extremely limited. Case study designs, large amounts of qualitative data and small sample sizes meant that the therapeutic effect of massage therapy could not be substantiated. Hence, future studies with randomized clinical trials or of experimental design are recommended. PMID:21576215

Chan, Jenny Sau-Lai; Tse, Sonny Hing-Min

2011-03-01

248

Impact of quality scales on levels of evidence inferred from a systematic review of exercise therapy and low back pain  

Microsoft Academic Search

Colle F, Rannou F, Revel M, Fermanian J, Poiraudeau S. Impact of quality scales on levels of evidence inferred from a systematic review of exercise therapy and low back pain. Arch Phys Med Rehabil 2002;83:1745-52. Objective: To assess whether the scale used affects levels of evidence inferred from a systematic review of studies on exercise therapy and chronic low back

Florence Colle; Michel Revel; Jacques Fermanian; Serge Poiraudeau

2002-01-01

249

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

PubMed Central

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

2012-01-01

250

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

NASA Astrophysics Data System (ADS)

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

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

2014-03-01

251

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

PubMed Central

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

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

2014-01-01

252

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

Microsoft Academic Search

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

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

2009-01-01

253

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

PubMed Central

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

2012-01-01

254

Adipose stem cell therapy in cancer reconstruction: a critical review.  

PubMed

Found in most mesenchymally derived organs, mesenchymal stem cells are undifferentiated cells capable of developing into many cell types. Adipose stem cells are a type of mesenchymal stem cell easily extracted from lipoaspirate, often readily available, and are conformable to the tissue defect. Their ability for self-renewal, unlimited proliferation and proangiogenic, and immunomodulatory properties have made them attractive adjuncts in plastic surgery. Since the discovery of pluripotent cells in adipose tissue, plastic surgeons have applied the technology toward improving wound healing, soft tissue augmentation, and tissue engineering. More recently, some surgeons have used adipose stem cells in cancer reconstruction. By mixing lipoaspirate with concentrated fractions of adipose stem cells through a technique termed cell-assisted lipotransfer, plastic surgeons have claimed improved aesthetic results. Promising early results have been tempered by in vitro and animal studies demonstrating increased tumor proliferation and metastasis rates with the use of adipose and other mesenchymal stem cells. This review provides a succinct yet comprehensive overview of the current literature evaluating the oncologic risks associated with adipose stem cell use in cancer. PMID:25003407

Alperovich, Michael; Lee, Z-Hye; Friedlander, Paul L; Rowan, Brian G; Gimble, Jeffrey M; Chiu, Ernest S

2014-09-01

255

Autophagy: A potential target for thyroid cancer therapy (Review)  

PubMed Central

The sharply increasing incidence of thyroid cancer has attracted considerable attention over the last few years. The combination of surgery, radioiodine ablation and thyroid-stimulating hormone suppression is usually efficient for the majority of thyroid tumors. However, advanced thyroid cancer that is recurrent, metastatic and 131I-refractory, or medullary thyroid cancer, pose a therapeutic challenge. Autophagy is a process that metabolizes damaged cytoplasmic organelles and long-lived proteins in order to recycle cellular materials and maintain homeostasis. It has been confirmed that autophagy plays a dual role during cancer development, progression and treatment, mainly depending on the type and stage of the tumor. Autophagy modulation has become a potential therapeutic target for diverse diseases. The mechanism of thyroid tumorigenesis and cancer progression was largely demonstrated to be correlated with the dysregulation of the Ras/Raf/mitogen-activated protein kinase kinase/extracellular signal-regulated kinase and the phosphoinositide 3-kinase/Akt/mammalian target of rapamycin pathways, as well as with abnormal epigenetic modifications. Those mechanisms are associated with autophagy regulation and may be beneficial for the treatment of advanced thyroid cancer. However, the number of available studies on the role of autophagy in thyroid cancer development, progression and treatment outcome, is currently limited. The aim of this review was to elaborate on the relevant knowledge and future prospectives of autophagy in the treatment of thyroid cancer. PMID:25054028

YI, HEQING; LONG, BIN; YE, XUEMEI; ZHANG, LIJUN; LIU, XIAODONG; ZHANG, CHUNYAN

2014-01-01

256

Clinical review: Therapy for refractory intracranial hypertension in ischaemic stroke  

PubMed Central

The treatment of patients with large hemispheric ischaemic stroke accompanied by massive space-occupying oedema represents one of the major unsolved problems in neurocritical care medicine. Despite maximum intensive care, the prognosis of these patients is poor, with case fatality rates as high as 80%. Therefore, the term 'malignant brain infarction' was coined. Because conservative treatment strategies to limit brain tissue shift almost consistently fail, these massive infarctions often are regarded as an untreatable disease. The introduction of decompressive surgery (hemicraniectomy) has completely changed this point of view, suggesting that mortality rates may be reduced to approximately 20%. However, critics have always argued that the reduction in mortality may be outweighed by an accompanying increase in severe disability. Due to the lack of conclusive evidence of efficacy from randomised trials, controversy over the benefit of these treatment strategies remained, leading to large regional differences in the application of this procedure. Meanwhile, data from randomised trials confirm the results of former observational studies, demonstrating that hemicraniectomy not only significantly reduces mortality but also significantly improves clinical outcome without increasing the number of completely dependent patients. Hypothermia is another promising treatment option but still needs evidence of efficacy from randomised controlled trials before it may be recommended for clinical routine use. This review gives the reader an integrated view of the current status of treatment options in massive hemispheric brain infarction, based on the available data of clinical trials, including the most recent data from randomised trials published in 2007. PMID:18001491

Juttler, Eric; Schellinger, Peter D; Aschoff, Alfred; Zweckberger, Klaus; Unterberg, Andreas; Hacke, Werner

2007-01-01

257

A review of over-the-counter drug therapy.  

PubMed

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

Esmay, J B; Wertheimer, A I

1979-01-01

258

Clinical applications of bovine colostrum therapy: a systematic review.  

PubMed

Bovine colostrum, the first milk that cows produce after parturition, contains high levels of growth factors and immunomodulatory components. Some healthy and diseased individuals may gain health benefits by consuming bovine colostrum as a food supplement. This review provides a systematic, critical evaluation of the current state of knowledge in this area. Fifty-one eligible studies were identified from the following databases: Medline, Embase, Global Health, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature. Studies were heterogeneous with regard to populations, outcomes, and methodological quality, as judged by the Jadad assessment tool. Many studies used surrogate markers to study the effects of bovine colostrum. Studies suggesting clinical benefits of colostrum supplementation were generally of poor methodological quality, and results could not be confirmed by other investigators. Bovine colostrum may provide gastrointestinal and immunological benefits, but further studies are required before recommendations can be made for clinical application. Animal models may help researchers to better understand the mechanisms of bovine colostrum supplementation, the dosage regimens required to obtain clinical benefits, and the optimal methods for testing these effects in humans. PMID:24571383

Rathe, Mathias; Müller, Klaus; Sangild, Per Torp; Husby, Steffen

2014-04-01

259

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

PubMed Central

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

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

2014-01-01

260

A systematic review of dental disease in patients undergoing cancer therapy  

PubMed Central

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

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

261

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

NASA Astrophysics Data System (ADS)

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

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

2013-02-01

262

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

PubMed

Particle therapy positron emission tomography (PT-PET) allows for an in vivo and in situ verification of applied dose distributions in ion beam therapy. Since the dose distribution cannot be extracted directly from the ?(+)-activity distribution gained from the PET scan the validation is done by means of a comparison between the reconstructed ?(+)-activity distributions from a PT-PET measurement and from a PT-PET simulation. Thus, the simulation software for generating PET data predicted from the treatment planning is an essential part of the dose verification routine. For the dose monitoring of intra-fractionally moving target volumes the PET data simulation needs to be upgraded by using time resolved (4D) algorithms to account correctly for the motion dependent displacement of the positron emitters. Moreover, it has to consider the time dependent relative movement between target volume and scanned beam to simulate the accurate positron emitter distribution generated during irradiation. Such a simulation program is presented which properly proceeds with motion compensated dose delivery by scanned ion beams to intra-fractionally moving targets. By means of a preclinical phantom study it is demonstrated that even the sophisticated motion-mitigated beam delivery technique of range compensated target tracking can be handled correctly by this simulation code. The new program is widely based on the 3D PT-PET simulation program which had been developed at the Helmholtz-Zentrum Dresden-Rossendorf, Germany (HZDR) for application within a pilot project to simulate in-beam PET data for about 440 patients with static tumor entities irradiated at the former treatment facility of the GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (GSI). A simulation example for a phantom geometry irradiated with a tracked (12)C-ion beam is presented for demonstrating the proper functionality of the program. PMID:23306167

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

2013-02-01

263

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

PubMed

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

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

2014-09-01

264

Clinical review: Use of renal replacement therapies in special groups of ICU patients  

PubMed Central

Acute kidney injury (AKI) in ICU patients is typically associated with other severe conditions that require special attention when renal replacement therapy (RRT) is performed. RRT includes a wide range of techniques, each with specific characteristics and implications for use in ICU patients. In the present review we discuss a wide range of conditions that can occur in ICU patients who have AKI, and the implications this has for RRT. Patients at increased risk for bleeding should be treated without anticoagulation or with regional citrate anticoagulation. In patients who are haemodynamically unstable, continuous therapies are most often employed. These therapies allow slow removal of volume and guarantee a stable blood pH. In patients with cerebral oedema, continuous therapy is recommended in order to prevent decreased cerebral blood flow, which will lead to cerebral ischemia. Continuous therapy will also prevent sudden change in serum osmolality with aggravation of cerebral oedema. Patients with hyponatraemia, as in liver failure or decompensated heart failure, require extra attention because a rapid increase of serum sodium concentration can lead to irreversible brain damage through osmotic myelinolysis. Finally, in patients with severe lactic acidosis, RRT can be used as a bridging therapy, awaiting correction of the underlying cause. Especially in ICU patients who have severe AKI, treatment with RRT requires balancing the pros and cons of different options and modalities. Exact and specific guidelines for RRT in these patients are not available for most clinical situations. In the present article we provide an update on the existing evidence. PMID:22264279

2012-01-01

265

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

PubMed

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

Sun, Yongda

2014-01-01

266

Conservative therapy for plantar fasciitis: a narrative review of randomized controlled trials  

PubMed Central

A narrative literature review of RCTs only, was conducted to ascertain which conservative treatments provide the best results for plantar fasciitis patients. Stretching, prefabricated and custom-made orthotics and night splints have all been scrutinized in numerous studies with mixed results. Chiropractic manipulative therapy has been examined in one study, with favorable results. Therapeutic ultrasound and low intensity laser therapy have been examined in one study apiece with unsatisfactory results. Based on the trials reviewed a trial of therapy beginning with low-cost, patient-centered treatments is recommended, particularly stretching, over-the-counter orthotics, and patient education. Several (but not all) of the reviewed articles indicated that custom-made orthoses are more beneficial for plantar fasciitis than over-the-counter orthotics. In the event these treatments do not provide satisfactory results, use of night splints should be considered. Based on this review, there is no support for the use of magnetic insoles for plantar fasciitis. Most of the studies were found to have at least one methodological flaw, including inadequate sample sizes, high drop-out rates, comparing multiple interventions to multiple interventions (thus making it difficult to determine the effect of each individual intervention) and lack of long-term follow-up. Outcome measure use between studies was inconsistent. PMID:17549177

Stuber, Kent; Kristmanson, Kevyn

2006-01-01

267

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

NASA Astrophysics Data System (ADS)

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

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

2014-10-01

268

A Review of Potential Adverse Effects of Long-Term Opioid Therapy: A Practitioner's Guide  

PubMed Central

Objective:Review, synthesize, and summarize recent evidence on adverse effects of long-term opioid treatment for noncancer pain and present an organ system–based guide for primary care physicians in initiating and monitoring patients receiving chronic opioid therapy. Data Sources:A search for studies published in peer-reviewed journals from 2005 to 2011 was conducted using MEDLINE, Agency for Healthcare Research and Quality Clinical Guidelines and Evidence Reports, and the Cochrane Database of Systematic Reviews. Related citations and expert recommendations were included. Data Extraction:Studies were selected if the search terms opioid and the organ system of interest were in the article’s title, abstract, or text. Systems considered were gastrointestinal, respiratory, cardiovascular, central nervous, musculoskeletal, endocrine, and immune. Of 1,974 initially reviewed articles, 74 were selected for evidence regarding effects of chronic opioid use on that organ system. Of these articles, 43 were included on the basis of direct relevance to opioid prescriptions in the primary care setting. Data Synthesis:A qualitative review was performed because the number of articles pertaining to specific adverse effects of opioids was typically small, and the diversity of adverse effects across systems precluded a quantitative analysis. Results:Through a variety of mechanisms, opioids cause adverse events in several organ systems. Evidence shows that chronic opioid therapy is associated with constipation, sleep-disordered breathing, fractures, hypothalamic-pituitary-adrenal dysregulation, and overdose. However, significant gaps remain regarding the spectrum of potentially opioid-related adverse effects. Opioid-related adverse effects can cause significant declines in health-related quality of life and increased health care costs. Conclusions:The diverse adverse effects potentially caused by chronic opioid therapy support recommendations for judicious and selective opioid prescribing for chronic noncancer pain by primary care physicians. Additional research clarifying the risks and management of potential adverse effects of chronic opioid therapy is needed to guide clinical practice. PMID:23106029

Von Korff, Michael

2012-01-01

269

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

PubMed Central

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

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

2014-01-01

270

Quality of life issues in men undergoing androgen deprivation therapy: a review  

PubMed Central

Androgen deprivation therapy (ADT) has been an essential treatment option for treating prostate cancer (PCa). The role for hormonal treatment initially was restricted to men with metastatic and inoperable, locally advanced disease. Now it has been extended to neoadjuvant or adjuvant therapy for surgery and radiotherapy, for biochemical relapse after surgery or radiation, and even as primary therapy for non-metastatic disease. Fifty percent of PCa patients treated will receive ADT at some point. There is growing concern about the adverse effects and costs associated with more widespread ADT use. The adverse effects on quality of life (QoL), including physical, social and psychological well-being when men are androgen-deprived, may be considerable. This review examines the QoL issues in the following areas: body feminisation, sexual changes, relationship changes, cognitive and affective symptoms, fatigue, sleep disturbance, depression and physical effects. Further suggestions for therapeutic approaches to reduce these alterations are suggested. PMID:22231296

Casey, Rowan G; Corcoran, Niall M; Larry Goldenberg, S

2012-01-01

271

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

PubMed Central

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

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

2014-01-01

272

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

PubMed Central

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

Norred, Sarah E.; Johnson, Jacqueline Anne

2014-01-01

273

Progress in low-LET heavy particle therapy: intracranial and paracranial tumors and uveal melanomas.  

PubMed

The Harvard Cyclotron Laboratory in collaboration with the Department of Radiation Medicine of the Massachusetts General Hospital and the Retina Service of the Massachusetts Eye and Ear Infirmary provides low-LET heavy particle therapy with 160 MeV protons. The improved dose distribution of protons results from their physical characteristics. A total of 965 patients have been treated as of December 31, 1984. Dose is expressed in units of cobalt gray equivalent (CGE) which is the dose in Gy multiplied by the RBE (1.1) for modulated protons relative to 60Co radiation. Sixty-seven patients with chordomas or low-grade chondrosarcomas of the base of skull or cervical spine have received proton treatment. Forty-three of these patients have been followed for at least 8 months with a median follow-up of 27 months. The median dose is 69 CGE. The 3-year actuarial local control rate is 89%. Seven patients with gliomas, eight with craniopharyngiomas, and six with meningiomas have also received proton radiation treatments. A total of 615 patients with uveal melanomas have received a median dose of 70 CGE in five fractions. Tumor regression has been seen in 94% with 66% having vision of 20/100 or better. PMID:3003784

Austin-Seymour, M; Munzenrider, J E; Goitein, M; Gentry, R; Gragoudas, E; Koehler, A M; McNulty, P; Osborne, E; Ryugo, D K; Seddon, J

1985-01-01

274

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

PubMed Central

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

Baus, Oliver; Bouchard, Stephane

2014-01-01

275

A systematic review into the effectiveness of hand exercise therapy in the treatment of rheumatoid arthritis.  

PubMed

Hand exercises are often part of the treatment of hand rheumatoid arthritis; however, it is still unclear whether and what type of exercises is effective in the treatment of this condition. Therefore, a systematic review into the effectiveness of hand exercises in the treatment of hand rheumatoid arthritis has been performed. Studies were identified in the literature databases by predefined search criteria. The eight included studies are peer-reviewed studies published between 2000 and 2014. Hand exercises differed between studies, but always included resistance and/or active range of motion exercises. Grip strength in various grip types (power grip, key pinch, precision pinch and tripod pinch) was found to improve by hand exercise therapy without having adverse effects on pain or disease activity. Adaptations in the range of motion in response to hand exercise therapy were less pronounced. There appears to be some transfer from the improvements on the body functioning level to the level of daily functioning, with the largest improvements found on grip ability. With regard to the intervention content, there was some evidence in favour of a longer therapy duration and a higher therapy intensity. No conclusions could be drawn on the effectiveness of the different types of exercises. Collectively, the studies indicate that hand exercises may have positive effects on strength and some aspects of daily functioning without aggravating disease activity or pain, although caution should be taken for subjects in the exacerbation period. PMID:24952308

Bergstra, S A; Murgia, A; Te Velde, A F; Caljouw, S R

2014-11-01

276

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

PubMed Central

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

Srinivasan, Sudha M.; Bhat, Anjana N.

2013-01-01

277

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

PubMed

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

Srinivasan, Sudha M; Bhat, Anjana N

2013-01-01

278

REVIEWS OF TOPICAL PROBLEMS: Electron cooling and new possibilities in elementary particle physics  

Microsoft Academic Search

This review is devoted to a new method in experimental physics---electron cooling, which opens the possibility of storing intense and highly monochromatic beams of heavy particles and carrying out a wide range of experiments with high luminosity and resolution. The method is based on the cooling of beams by an accompanying electron flux as the result of Coulomb collisions of

G. I. Budker; Aleksandr N. Skrinskii

1978-01-01

279

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...

280

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

PubMed Central

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

Habermehl, Daniel; Henkner, Katrin; Ecker, Swantje; Jakel, Oliver; Debus, Jurgen; Combs, Stephanie E.

2013-01-01

281

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

Microsoft Academic Search

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

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

2011-01-01

282

Continuation and Maintenance Electroconvulsive Therapy for Mood Disorders: Review of the Literature  

Microsoft Academic Search

Background: Electroconvulsive therapy (ECT) is a highly effective treatment for mood disorders. Continuation ECT (C-ECT) and maintenance ECT (M-ECT) are required for many patients suffering from severe and recurrent forms of mood disorders. This is a review of the literature regarding C- and M-ECT. Methods: We conducted a computerized search using the words continuation ECT, maintenance ECT, depression, mania, bipolar

Georgios Petrides; Kristen G. Tobias; Charles H. Kellner; Matthew V. Rudorfer

2011-01-01

283

Combination therapy for scalp angiosarcoma using bevacizumab and chemotherapy: a case report and review of literature  

PubMed Central

Bevacizumab, an angiogenesis inhibitor, is a recombined humanized monoclonal antibody against vascular endothelial growth factor and a promising therapeutic option for angiosarcoma management. This is a case report and review of the literature using bevacizumab and combination chemotherapy for angiosarcoma. The understanding of the effectiveness of combined therapy of bevacizumab and chemotherapy agents is still limited. The benefits of bevacizumab treatment for angiosarcoma will need to be weighed against the risks of venous thromboembolism in this population. PMID:23825914

Zhu, Qi; Jiang, Fuqiang

2013-01-01

284

Patient Retention in Antiretroviral Therapy Programs in Sub-Saharan Africa: A Systematic Review  

Microsoft Academic Search

BackgroundLong-term retention of patients in Africa's rapidly expanding antiretroviral therapy (ART) programs for HIV\\/AIDS is essential for these programs' success but has received relatively little attention. In this paper we present a systematic review of patient retention in ART programs in sub-Saharan Africa.Methods and FindingsWe searched Medline, other literature databases, conference abstracts, publications archives, and the “gray literature” (project reports

Sydney Rosen; Matthew P Fox; Christopher J Gill

2007-01-01

285

Needling therapies in the management of myofascial trigger point pain: A systematic review  

Microsoft Academic Search

Cummings TM, White AR. Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil 2001;82:986-92. Objective: To establish whether there is evidence for or against the efficacy of needling as a treatment approach for myofascial trigger point pain. Data Sources: PubMed, Ovid MEDLINE, Ovid EMBASE, the Cochrane Library, AMED, and CISCOM databases, searched

T. Michael Cummings; Adrian R. White

2001-01-01

286

Impact of growth hormone therapy on adult height of children with idiopathic short stature: systematic review  

Microsoft Academic Search

Objective To systematically determine the impact of growth hormone therapy on adult height of children with idiopathic short stature.Design Systematic review.Data sources Cochrane Central Register of Controlled Trials, Medline, and the bibliographic references from retrieved articles of randomised and non-randomised controlled trials from 1985 to April 2010.Data extraction Height in adulthood (standard deviation score) and overall gain in height (SD

Annalisa Deodati; Stefano Cianfarani

2011-01-01

287

Auditory integration training and other sound therapies for autism spectrum disorders: a systematic review  

Microsoft Academic Search

Objectives: To determine the effectiveness of auditory integration training (AIT) or other methods of sound therapy in people with autism spectrum disorders (ASD).Study design: A systematic review was carried out of randomised controlled trials (RCTs) of adults or children with ASD. Meta-analysis was attempted.Results: Six RCTs of AIT, including one crossover trial, were identified, with a total of 171 participants

Y Sinha; N Silove; D Wheeler; K Williams

2006-01-01

288

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

Microsoft Academic Search

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

Susan Carson; Marian McDonagh; Barry Russman; Mark Helfand

2005-01-01

289

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

Microsoft Academic Search

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

Robert D. Adams; Lawrence B. Marks; Todd Pawlicki; James Hayman; Jessica Church

2010-01-01

290

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

PubMed Central

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

Prazeres, Angelica M; Nascimento, Antonio L; Fontenelle, Leonardo F

2013-01-01

291

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

PubMed Central

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

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

2012-01-01

292

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

PubMed Central

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

Zhang, Liping; Wang, Sa A

2014-01-01

293

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

PubMed Central

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

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

2014-01-01

294

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

PubMed Central

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

Hollon, Steven D.; Ponniah, Kathryn

2010-01-01

295

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

PubMed Central

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

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

2014-01-01

296

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

PubMed Central

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

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

2013-01-01

297

Combination therapy with GLP-1 receptor agonists and basal insulin: a systematic review of the literature  

PubMed Central

Treatment algorithms for type 2 diabetes call for intensification of therapy over time as the disease progresses and glycaemic control worsens. If diet, exercise and oral antihyperglycaemic medications (OAMs) fail to maintain glycaemic control then basal insulin is added and ultimately prandial insulin may be required. However, such an intensification strategy carries risk of increased hypoglycaemia and weight gain, both of which are associated with worse long-term outcomes. An alternative strategy is to intensify therapy by the addition of a short-acting glucagon-like peptide-1 receptor agonist (GLP-1 RA) rather than prandial insulin. Short-acting GLP-1 RAs such as exenatide twice daily are particularly effective at reducing postprandial glucose while basal insulin has a greater effect on fasting glucose, providing a physiological rationale for this complementary approach. This review analyzes the latest randomized controlled clinical trials of insulin/GLP-1 RA combination therapy and examines results from ‘real-world’ use of the combinations as reported through observational and clinical practice studies. The most common finding across all types of studies was that combination therapy improved glycaemic control without weight gain or an increased risk of hypoglycaemia. Many studies reported weight loss and a reduction in insulin use when a GLP-1 RA was added to existing insulin therapy. Overall, the relative degree of benefit to glycaemic control and weight was influenced by the insulin titration employed in conjunction with the GLP-1 RA. The greatest glycaemic benefits were observed in studies with structured titration of insulin to glycaemic targets while the greatest weight benefits were observed in studies with a protocol-specified focus on insulin sparing. The adverse event profile of GLP-1 RAs in the reviewed trials was similar to that reported with GLP-1 RAs as monotherapy or in combination with OAMs with gastrointestinal events being the most commonly reported. PMID:23061470

Balena, R; Hensley, I E; Miller, S; Barnett, A H

2013-01-01

298

Sequential Therapy or Triple Therapy for Helicobacter pylori Infection: Systematic Review and Meta-Analysis of Randomized Controlled Trials in Adults and Children  

Microsoft Academic Search

OBJECTIVES:Eradication rates with triple therapy (TT) for Helicobacter pylori infection have declined to unacceptable levels. Sequential therapy (ST) is a novel treatment that has shown promise in several controlled trials. Our aim was to assess the efficacy of ST in adults and children compared with that of TT by performing a systematic review and meta-analysis.METHODS:We performed an electronic search of

Luigi Gatta; Nimish Vakil; Gioacchino Leandro; Francesco Di Mario; Dino Vaira

2009-01-01

299

REVIEW OF SCIENTIFIC INSTRUMENTS 82, 053707 (2011) Errors in particle tracking velocimetry with high-speed cameras  

E-print Network

REVIEW OF SCIENTIFIC INSTRUMENTS 82, 053707 (2011) Errors in particle tracking velocimetry online 20 May 2011) Velocity errors in particle tracking velocimetry (PTV) are studied. When using high. [doi:10.1063/1.3589267] I. INTRODUCTION Particle tracking velocimetry (PTV) is a method to measure

Goree, John

300

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

Microsoft Academic Search

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

Patricia B Neumann; Karen A Grimmer; Yamini Deenadayalan

2006-01-01

301

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

SciTech Connect

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

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

2010-01-01

302

The new radiation therapy clinical practice: the emerging role of clinical peer review for radiation therapists and medical dosimetrists.  

PubMed

The concept of peer review for radiation therapists and medical dosimetrists has been studied very little in radiation oncology practice. The purpose of this manuscript is to analyze the concept of peer review in the clinical setting for both radiation therapists and medical dosimetrists. The literature reviewed both the percentages and causes of radiation therapy deviations. The results indicate that peer review can be both implemented and evaluated into both the radiation therapist and medical dosimetrist clinical practice patterns. PMID:21055612

Adams, Robert D; Marks, Lawrence B; Pawlicki, Todd; Hayman, James; Church, Jessica

2010-01-01

303

A review of biomass burning emissions, part II: Intensive physical properties of biomass burning particles  

NASA Astrophysics Data System (ADS)

The last decade has seen tremendous advances in atmospheric aerosol particle research that is often performed in the context of climate and global change science. Biomass burning, one of the largest sources of accumulation mode particles globally, has been closely studied for its radiative, geochemical, and dynamic impacts. These studies have taken many forms including laboratory burns, in situ experiments, remote sensing, and modeling. While the differing perspectives of these studies have ultimately improved our qualitative understanding of biomass burning issues, the varied nature of the work make inter-comparisons and resolutions of some specific issues difficult. In short, the literature base has become a milieu of small pieces of the biomass-burning puzzle. This manuscript, the second part of four, examines the properties of biomass-burning particle emissions. Here we review and discuss the literature concerning the measurement of smoke particle size, chemistry, thermodynamic properties, and emission factors. Where appropriate, critiques of measurement techniques are presented. We show that very large differences in measured particle properties have appeared in the literature, in particular with regards to particle carbon budgets. We investigate emissions uncertainties using scale analyses, which shows that while emission factors for grass and brush are relatively well known, very large uncertainties still exist in emission factors of boreal, temperate and some tropical forests. Based on an uncertainty analysis of the community data set of biomass burning measurements, we present simplified models for particle size and emission factors. We close this review paper with a discussion of the community experimental data, point to lapses in the data set, and prioritize future research topics.

Reid, J. S.; Koppmann, R.; Eck, T. F.; Eleuterio, D. P.

2004-09-01

304

A review of biomass burning emissions part II: intensive physical properties of biomass burning particles  

NASA Astrophysics Data System (ADS)

The last decade has seen tremendous advances in atmospheric aerosol particle research that is often performed in the context of climate and global change science. Biomass burning, one of the largest sources of accumulation mode particles globally, has been closely studied for its radiative, geochemical, and dynamic impacts. These studies have taken many forms including laboratory burns, in situ experiments, remote sensing, and modeling. While the differing perspectives of these studies have ultimately improved our qualitative understanding of biomass-burning issues, the varied nature of the work make inter-comparisons and resolutions of some specific issues difficult. In short, the literature base has become a milieu of small pieces of the biomass-burning puzzle. This manuscript, the second part of four, examines the properties of biomass-burning particle emissions. Here we review and discuss the literature concerning the measurement of smoke particle size, chemistry, thermodynamic properties, and emission factors. Where appropriate, critiques of measurement techniques are presented. We show that very large differences in measured particle properties have appeared in the literature, in particular with regards to particle carbon budgets. We investigate emissions uncertainties using scale analyses, which shows that while emission factors for grass and brush are relatively well known, very large uncertainties still exist in emission factors of boreal, temperate and some tropical forests. Based on an uncertainty analysis of the community data set of biomass burning measurements, we present simplified models for particle size and emission factors. We close this review paper with a discussion of the community experimental data, point to lapses in the data set, and prioritize future research topics.

Reid, J. S.; Koppmann, R.; Eck, T. F.; Eleuterio, D. P.

2005-03-01

305

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

PubMed

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

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

2014-10-01

306

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

PubMed Central

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

2007-01-01

307

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

PubMed Central

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

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

308

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

PubMed Central

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

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

2014-01-01

309

Insulin Pump Therapy in the Perioperative Period: A Review of Care after Implementation of Institutional Guidelines  

PubMed Central

Background An institutional policy was previously established for patients with diabetes on insulin pump therapy undergoing elective surgical procedures. Method Electronic medical records were reviewed to assess documentation of insulin pump status and glucose monitoring during preoperative, intraoperative, and postanesthesia care unit (PACU) phases of care. Results Twenty patients with insulin pumps underwent 23 procedures from March 1 to December 31, 2011. Mean (standard deviation) age was 58 (13) years, mean diabetes duration was 28 (17) years, and mean duration of insulin pump therapy was 7 (6) years. Nearly all cases (86%) during the preoperative phase had the presence of the device documented—an improvement over the 64% noted in data collected before the policy. Intraoperatively, 13 cases (61%) had the presence of the pump documented, which was higher than the 28% before implementation of the policy. However, documentation of pump status was found in only 38% in the PACU and was actually less than the 60% documented previously. Over 90% of cases had glucose checked in the preoperative area and the PACU, and only 60% had it checked intraoperatively, which was nearly identical to the percentages seen before policy implementation. No adverse events occurred when insulin pump therapy was continued. Conclusions Although some processes still require improvement, preliminary data suggest that the policy for perioperative management of insulin pumps has provided useful structure for care of these cases. The data thus far indicate that insulin pump therapy can be continued safely during the perioperative period. PMID:23063026

Boyle, Mary E.; Seifert, Karen M.; Beer, Karen A.; Mackey, Patricia; Schlinkert, Richard T.; Stearns, Joshua D.; Cook, Curtiss B.

2012-01-01

310

Concise review: genetically engineered stem cell therapy targeting angiogenesis and tumor stroma in gastrointestinal malignancy.  

PubMed

Cell-based gene therapy holds considerable promise for the treatment of human malignancy. Genetically engineered cells if delivered to sites of disease could alleviate symptoms or even cure cancer through expression of therapeutic or suicide transgene products. Mesenchymal stem cells (MSCs), nonhematopoietic multipotent cells found primarily in bone marrow, have garnered particular interest as potential tumor-targeting vehicles due to their innate tumortropic homing properties. However, recent strategies go further than simply using MSCs as vehicles and use the stem cell-specific genetic make-up to restrict transgene expression to tumorigenic environments using tumor-tissue specific promoters. This addresses one of the concerns with this novel therapy that nonselective stem cell-based therapy could induce cancer rather than treat it. Even minimal off-target effects can be deleterious, motivating recent strategies to not only enhance MSC homing but also engineer them to make their antitumor effect selective to sites of malignancy. This review will summarize the advances made in the past decade toward developing novel cell-based cancer therapies using genetically engineered MSCs with a focus on strategies to achieve and enhance tumor specificity and their application to targeting gastrointestinal malignancies such as hepatocellular carcinoma and pancreatic adenocarcinoma. PMID:23132810

Keung, Emily Z; Nelson, Peter J; Conrad, Claudius

2013-02-01

311

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

PubMed Central

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

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

2014-01-01

312

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

NASA Astrophysics Data System (ADS)

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

Lennox, Arlene J.

1991-05-01

313

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

PubMed Central

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

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

2011-01-01

314

Vital pulp therapy using calcium-enriched mixture: An evidence-based review  

PubMed Central

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

Asgary, Saeed; Ahmadyar, Maryam

2013-01-01

315

A balanced review of the status T cell-based therapy against cancer  

PubMed Central

A recent commentary stirred intense controversy over the status of anti-cancer immunotherapy. The commentary suggested moving beyond current anti-cancer vaccines since active-specific immunization failed to match expectations toward a more aggressive approach involving the adoptive transfer of in vitro expanded tumor antigen-specific T cells. Although the same authors clarified their position in response to others' rebuttal more discussion needs to be devoted to the current status of T cell-based anti-cancer therapy. The accompanying publications review the status of adoptive transfer of cancer vaccines on one hand and active-specific immunization on the other. Hopefully, reading these articles will offer a balanced view of the current status of antigen-specific ant-cancer therapies and suggest future strategies to foster unified efforts to complement either approach with the other according to specific biological principles. PMID:15831096

Marincola, Francesco M

2005-01-01

316

Iatrogenic Cushing's syndrome and topical steroid therapy: case series and review of the literature.  

PubMed

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

Decani, Sem; Federighi, Veronica; Baruzzi, Elisa; Sardella, Andrea; Lodi, Giovanni

2014-12-01

317

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

PubMed Central

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

Sawadkar, Prasad; Mudera, Vivek

2014-01-01

318

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

PubMed

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

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

2014-08-01

319

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

PubMed Central

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

Romano, Michele; Negrini, Stefano

2008-01-01

320

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

Microsoft Academic Search

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

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

2012-01-01

321

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

Microsoft Academic Search

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

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

2012-01-01

322

Prospects For and Progress Towards Laser-Driven Particle Therapy Accelerators  

SciTech Connect

Recent advances in laser-ion acceleration have motivated research towards laser-driven compact accelerators for medical therapy. Realizing laser-ion acceleration for medical therapy will require adapting the medical requirements to the foreseeable laser constraints, as well as advances in laser-acceleration physics, beam manipulation and delivery, real-time dosimetry, treatment planning and translational research into a clinical setting.

Cowan, T. E.; Schramm, U.; Burris-Mog, T.; Fiedler, F.; Kraft, S. D.; Zeil, K.; Bussmann, M.; Gaillard, S.; Herrmannsdoerfer, T.; Kluge, T.; Schmidt, B.; Sobiella, M.; Sauerbrey, R. [Forschungszentrum Dresden-Rossendorf, POB 510119, D-01314 Dresden (Germany); Baumann, M. [OncoRay- Center for Radiation Research in Oncology, TU Dresden, Fetscherstr. 74, D-01307 Dresden (Germany); Klinik fuer Strahlentherapie und Radioonkologie, TU Dresden, Fetscherstr. 74, D-01307 Dresden (Germany); Enghardt, W.; Pawelke, J. [OncoRay- Center for Radiation Research in Oncology, TU Dresden, Fetscherstr. 74, D-01307 Dresden (Germany); Flippo, K. [Los Alamos National Laboratory, POB 1663, Los Alamos, NM 87545 (United States); Harres, K.; Nuernberg, F.; Roth, M. [Technische Universitaet Darmstadt, D-64289 Darmstadt (Germany)

2010-11-04

323

Systematic review on antibiotic therapy for pneumonia in children between 2 and 59 months of age.  

PubMed

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-severe pneumonia as well. The review further found a short 3 day course of antibiotics to be equally beneficial as 5 day course for managing non-severe pneumonia in children between 2 and 59 months of age. This review updates evidence on the general spectrum of antibiotic recommendation for CAP in children between 2 and 59 months of age, which is an age group that warrants special focus owing to its high disease and mortality burden. Evidence derived from the review found oral amoxicillin to be equally effective as parenteral antibiotics for severe pneumonia in the 2-59 month age group, which holds important implications for LMICs where parenteral drug administration is an issue. Also, the review's finding that 3 day course of antibiotic is equally effective as 5 day course for non-severe pneumonia for 2-59 months of age is again beneficial for LMICs, as a shorter therapy will be associated with a lower cost. The review addresses some research gaps in antibiotic treatment for CAP as well, and this crucial information is presented with the aim of providing a targeted cure for the middle and low income setting. PMID:24431417

Lassi, Zohra S; Das, Jai K; Haider, Syed Waqas; Salam, Rehana A; Qazi, Shamim A; Bhutta, Zulfiqar A

2014-07-01

324

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

PubMed Central

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

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

2011-01-01

325

Reviews  

NASA Astrophysics Data System (ADS)

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

2003-01-01

326

Efficacy of exposure versus cognitive therapy in anxiety disorders: systematic review and meta-analysis  

PubMed Central

Background There is growing evidence of the effectiveness of Cognitive Behavioural Therapy (CBT) for a wide range of psychological disorders. There is a continued controversy about whether challenging maladaptive thoughts rather than use of behavioural interventions alone is associated with the greatest efficacy. However little is known about the relative efficacy of various components of CBT. This review aims to compare the relative efficacy of Cognitive Therapy (CT) versus Exposure (E) for a range of anxiety disorders using the most clinically relevant outcome measures and estimating the summary relative efficacy by combining the studies in a meta-analysis. Methods Psych INFO, MEDLINE and EMBASE were searched from the first available year to May 2010. All randomised controlled studies comparing the efficacy of exposure with cognitive therapy were included. Odds ratios (OR) or standardised means' differences (Hedges' g) for the most clinically relevant primary outcomes were calculated. Outcomes of the studies were grouped according to specific disorders and were combined in meta-analyses exploring short-term and long-term outcomes. Results 20 Randomised Controlled Trials with (n = 1,308) directly comparing the efficacy of CT and E in anxiety disorders were included in the meta-analysis. No statistically significant difference in the relative efficacy of CT and E was revealed in Post Traumatic Stress Disorder (PTSD), in Obsessive Compulsive Disorder (OCD) and in Panic Disorder (PD). There was a statistically significant difference favouring CT versus E in Social Phobia both in the short-term (Z = 3.72, p = 0.0002) and the long-term (Z = 3.28, p = 0.001) outcomes. Conclusions On the basis of extant literature, there appears to be no evidence of differential efficacy between cognitive therapy and exposure in PD, PTSD and OCD and strong evidence of superior efficacy of cognitive therapy in social phobia PMID:22185596

2011-01-01

327

Hyperbaric Oxygen Therapy: Solution for Difficult to Heal Acute Wounds? Systematic Review  

Microsoft Academic Search

Background  Hyperbaric oxygen therapy (HBOT) is used to treat various wound types. However, the possible beneficial and harmful effects\\u000a of HBOT for acute wounds are unclear.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We undertook a systematic review to evaluate the effectiveness of HBOT compared to other interventions on wound healing and\\u000a adverse effects in patients with acute wounds. To detect all available randomized controlled trials (RCTs) we

Anne M. Eskes; Dirk T. Ubbink; Maarten J. Lubbers; Cees Lucas; Hester Vermeulen

2011-01-01

328

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

PubMed

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

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

2014-11-01

329

Redefining relative biological effectiveness in the context of the EQDX formalism: implications for alpha-particle emitter therapy.  

PubMed

Alpha-particle radiopharmaceutical therapy (?RPT) is currently enjoying increasing attention as a viable alternative to chemotherapy for targeting of disseminated micrometastatic disease. In theory, ?RPT can be personalized through pre-therapeutic imaging and dosimetry. However, in practice, given the particularities of ?-particle emissions, a dosimetric methodology that accurately predicts the thresholds for organ toxicity has not been reported. This is in part due to the fact that the biological effects caused by ?-particle radiation differ markedly from the effects caused by traditional external beam (photon or electron) radiation or ?-particle emitting radiopharmaceuticals. The concept of relative biological effectiveness (RBE) is used to quantify the ratio of absorbed doses required to achieve a given biological response with alpha particles versus a reference radiation (typically a beta emitter or external beam radiation). However, as conventionally defined, the RBE varies as a function of absorbed dose and therefore a single RBE value is limited in its utility because it cannot be used to predict response over a wide range of absorbed doses. Therefore, efforts are underway to standardize bioeffect modeling for different fractionation schemes and dose rates for both nuclear medicine and external beam radiotherapy. Given the preponderant use of external beams of radiation compared to nuclear medicine in cancer therapy, the more clinically relevant quantity, the 2 Gy equieffective dose, EQD2(?/?), has recently been proposed by the ICRU. In concert with EQD2(?/?), we introduce a new, redefined RBE quantity, named RBE2(?/?), as the ratio of the two linear coefficients that characterize the ? particle absorbed dose-response curve and the low-LET megavoltage photon 2 Gy fraction equieffective dose-response curve. The theoretical framework for the proposed new formalism is presented along with its application to experimental data obtained from irradiation of a breast cancer cell line. Radiobiological parameters are obtained using the linear quadratic model to fit cell survival data for MDA-MB-231 human breast cancer cells that were irradiated with either ? particles or a single fraction of low-LET (137)Cs ? rays. From these, the linear coefficient for both the biologically effective dose (BED) and the EQD2(?/?) response lines were derived for fractionated irradiation. The standard RBE calculation, using the traditional single fraction reference radiation, gave RBE values that ranged from 2.4 for a surviving fraction of 0.82-6.0 for a surviving fraction of 0.02, while the dose-independent RBE2(4.6) value was 4.5 for all surviving fraction values. Furthermore, bioeffect modeling with RBE2(?/?) and EQD2(?/?) demonstrated the capacity to predict the surviving fraction of cells irradiated with acute and fractionated low-LET radiation, ? particles and chronic exponentially decreasing dose rates of low-LET radiation. RBE2(?/?) is independent of absorbed dose for ?-particle emitters and it provides a more logical framework for data reporting and conversion to equieffective dose than the conventional dose-dependent definition of RBE. Moreover, it provides a much needed foundation for the ongoing development of an ?-particle dosimetry paradigm and will facilitate the use of tolerance dose data available from external beam radiation therapy, thereby helping to develop ?RPT as a single modality as well as for combination therapies. PMID:24502376

Hobbs, Robert F; Howell, Roger W; Song, Hong; Baechler, Sébastien; Sgouros, George

2014-01-01

330

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

Microsoft Academic Search

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

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

331

The Role of Cytotoxic Therapy with Hematopoietic Stem Cell Transplantation in the Therapy of Acute Lymphoblastic Leukemia in Children: An Evidence-Based Review  

Microsoft Academic Search

Evidence supporting the role of hematopoietic stem cell transplantation (SCT) in the therapy of acute lymphoblastic leukemia (ALL) in children is presented and critically evaluated in this systematic evidence-based review. Specific criteria were used for searching the published literature and for grading the quality and strength of the evidence and the strength of the treatment recommendations. Treatment recommendations based on

Theresa Hahn; Donna Wall; Bruce Camitta; Stella Davies; Hildy Dillon; Paul Gaynon; Richard A. Larson; Susan Parsons; Jerome Seidenfeld; Daniel Weisdorf; Philip L. McCarthy

2005-01-01

332

The Role of Cytotoxic Therapy with Hematopoietic Stem Cell Transplantation in the Therapy of Acute Lymphoblastic Leukemia in Adults: An Evidence-based Review  

Microsoft Academic Search

Evidence supporting the role of hematopoietic stem cell transplantation (SCT) in the therapy of acute lymphoblastic leukemia in adults (?15 years) is presented and critically evaluated in this systematic evidence-based review. Specific criteria were used for searching the published medical literature and for grading the quality and strength of the evidence, and the strength of the treatment recommendations. Treatment recommendations

Theresa Hahn; Donna Wall; Bruce Camitta; Stella Davies; Hildy Dillon; Paul Gaynon; Richard A. Larson; Susan Parsons; Jerome Seidenfeld; Daniel Weisdorf; Philip L. McCarthy

2006-01-01

333

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

PubMed Central

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

A, Shilpa Reddy; Reddy, Narender; Dinapadu, Sainath; Reddy, Manoranjan; Pasari, Srikanth

2013-01-01

334

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

PubMed Central

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

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

2014-01-01

335

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...

336

Biomarker-guided antibiotic therapy in adult critically ill patients: a critical review.  

PubMed

Biomarkers of infection, namely C-reactive protein and procalcitonin (PCT), are potentially useful in the diagnosis of infection as well as in the assessment of its response to antibiotic therapy. C-reactive protein variations overtime appears to have a good performance for the diagnosis of infection. Procalcitonin shows a better correlation with clinical severity. In addition, to overcome the worldwide problem of antibiotic overuse as well as misuse, biomarker guidance of antibiotic stewardship represents a promising new approach. In several randomized, controlled trials, including adult critically ill patients, PCT guidance was repeatedly associated with a decrease in the duration of antibiotic therapy. However, these trials present several limitations, namely high rate of patients' exclusion, high rate of algorithm overruling, long duration of antibiotic therapy in the control group, disregard the effect of renal failure on PCT level, and above all a possible higher mortality and higher late organ failure in the PCT arm. In addition, some infections (e.g., endocarditis) as well as frequent nosocomial bacteria (e.g., Pseudomonas aeruginosa) are not suitable to be assessed by PCT algorithms. Therefore, the true value of PCT-guided algorithm of antibiotic stewardship in assisting the clinical decision-making process at the bedside remains uncertain. Future studies should take into account the issues identified in the present review. PMID:22824162

Póvoa, Pedro; Salluh, Jorge I F

2012-01-01

337

A systematic review of the use of technology for reminiscence therapy.  

PubMed

As the segment of the population 65 years of age or older continues to grow, the number of individuals with dementia increases proportionally, highlighting the need to design therapies that meet the social and emotional needs of people with dementia. Information and communication technologies (ICT) are potential venues for supporting the delivery of such therapies, including reminiscence therapy (RT), which is a non-pharmacological intervention involving the prompting of past memories, often with artifacts such as old photographs or music for therapeutic benefits such as the facilitation of social interactions or the increase of self-esteem. This paper systematically examines the scientific literature on the use of ICT for facilitating RT to assess the current state of the evidence and identify future trends. We searched the PubMed (1966-2013), ACM (1954-2013), and PsycINFO (1908-2013) repositories using the keywords dementia and reminiscence. Three hundred eighty-six articles were retrieved, 44 of which met the inclusion and exclusion criteria. Findings of the systematic review include that there are benefits to using ICT for RT interventions. Some of these benefits are access to rich and engaging multimedia reminiscence materials, opportunities for people with dementia to participate in social interactions and take ownership of conversations, and a reduction of barriers due to motor deficits during interactions with media. Future studies should explore the types and content of media beneficial to individuals at different stages of dementia. PMID:25274711

Lazar, Amanda; Thompson, Hilaire; Demiris, George

2014-10-01

338

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

PubMed Central

Background To assess the effectiveness of physical therapy (PT) interventions on functioning in children with cerebral palsy (CP). Methods A search was made in Medline, Cinahl, PEDro and the Cochrane library for the period 1990 to February 2007. Only randomized controlled trials (RCTs) on PT interventions in children with diagnosed CP were included. Two reviewers independently assessed the methodological quality and extracted the data. The outcomes measured in the trials were classified using the International Classification of Functioning, Disability and Health (ICF). Results Twenty-two trials were identified. Eight intervention categories were distinguished. Four trials were of high methodological quality. Moderate evidence of effectiveness was established for two intervention categories: effectiveness of upper extremity treatments on attained goals and active supination, and of prehensile hand treatment and neurodevelopmental therapy (NDT) or NDT twice a week on developmental status, and of constraint-induced therapy on amount and quality of hand use. Moderate evidence of ineffectiveness was found of strength training on walking speed and stride length. Conflicting evidence was found for strength training on gross motor function. For the other intervention categories the evidence was limited due to low methodological quality and the statistically insignificant results of the studies. Conclusion Due to limitations in methodological quality and variations in population, interventions and outcomes, mostly limited evidence on the effectiveness of most PT interventions is available through RCTs. Moderate evidence was found for some effectiveness of upper extremity training. Well-designed trials are needed especially for focused PT interventions. PMID:18435840

Anttila, Heidi; Autti-Ramo, Ilona; Suoranta, Jutta; Makela, Marjukka; Malmivaara, Antti

2008-01-01

339

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

PubMed

This is to our knowledge the first systematic review regarding the efficacy of manual therapy randomized clinical trials (RCT) for primary chronic headaches. A comprehensive English literature search on CINHAL, Cochrane, Medline, Ovid and PubMed identified 6 RCTs all investigating chronic tension-type headache (CTTH). One study applied massage therapy and five studies applied physiotherapy. Four studies were considered to be of good methodological quality by the PEDro scale. All studies were pragmatic or used no treatment as a control group, and only two studies avoided co-intervention, which may lead to possible bias and makes interpretation of the results more difficult. The RCTs suggest that massage and physiotherapy are effective treatment options in the management of CTTH. One of the RCTs showed that physiotherapy reduced headache frequency and intensity statistical significant better than usual care by the general practitioner. The efficacy of physiotherapy at post-treatment and at 6 months follow-up equals the efficacy of tricyclic antidepressants. Effect size of physiotherapy was up to 0.62. Future manual therapy RCTs are requested addressing the efficacy in chronic migraine with and without medication overuse. Future RCTs on headache should adhere to the International Headache Society's guidelines for clinical trials, i.e., frequency as primary end-point, while duration and intensity should be secondary end-point, avoid co-intervention, includes sufficient sample size and follow-up period for at least 6 months. PMID:25278005

Chaibi, Aleksander; Russell, Michael Bjørn

2014-01-01

340

The Rise of Cell Therapy Trials for Stroke: Review of Published and Registered Studies  

PubMed Central

Stroke is the second leading cause of death and the third leading cause of disability worldwide. Approximately 16 million first-ever strokes occur each year, leading to nearly 6 million deaths. Nevertheless, currently, very few therapeutic options are available. Cell therapies have been applied successfully in different hematological diseases, and are currently being investigated for treating ischemic heart disease, with promising results. Recent preclinical studies have indicated that cell therapies may provide structural and functional benefits after stroke. However, the effects of these treatments are not yet fully understood and are the subject of continuing investigation. Meanwhile, different clinical trials for stroke, the majority of them small, nonrandomized, and uncontrolled, have been reported, and their results indicate that cell therapy seems safe and feasible in these conditions. In the last 2 years, the number of published and registered trials has dramatically increased. Here, we review the main findings available in the field, with emphasis on the clinical results. Moreover, we address some of the questions that have been raised to date, to improve future studies. PMID:23509917

Pimentel-Coelho, Pedro Moreno; Barbosa da Fonseca, Lea Mirian; de Freitas, Gabriel Rodriguez; Mendez-Otero, Rosalia

2013-01-01

341

Review: molecular pathology in adult high-grade gliomas: from molecular diagnostics to target therapies.  

PubMed

The classification of malignant gliomas is moving from a morphology-based guide to a system built on molecular criteria. The development of a genomic landscape for gliomas and a better understanding of its functional consequences have led to the development of internally consistent molecular classifiers. However, development of a biologically insightful classification to guide therapy is still a work in progress. Response to targeted treatments is based not only on the presence of drugable targets, but rather on the molecular circuitry of the cells. Further, tumours are heterogeneous and change and adapt in response to drugs. Therefore, the challenge of developing molecular classifiers that provide meaningful ways to stratify patients for therapy remains a major challenge for the field. In this review, we examine the potential role of MGMT methylation, IDH1/2 mutations, 1p/19q deletions, aberrant epidermal growth factor receptor and PI3K pathways, abnormal p53/Rb pathways, cancer stem-cell markers and microRNAs as prognostic and predictive molecular markers in the setting of adult high-grade gliomas and we outline the clinically relevant subtypes of glioblastoma with genomic, transcriptomic and proteomic integrated analyses. Furthermore, we describe how these advances, especially in epidermal growth factor receptor/PI3K/mTOR signalling pathway, affect our approaches towards targeted therapy, raising new challenges and identifying new leads. PMID:22098029

Masui, K; Cloughesy, T F; Mischel, P S

2012-06-01

342

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

PubMed Central

This is to our knowledge the first systematic review regarding the efficacy of manual therapy randomized clinical trials (RCT) for primary chronic headaches. A comprehensive English literature search on CINHAL, Cochrane, Medline, Ovid and PubMed identified 6 RCTs all investigating chronic tension-type headache (CTTH). One study applied massage therapy and five studies applied physiotherapy. Four studies were considered to be of good methodological quality by the PEDro scale. All studies were pragmatic or used no treatment as a control group, and only two studies avoided co-intervention, which may lead to possible bias and makes interpretation of the results more difficult. The RCTs suggest that massage and physiotherapy are effective treatment options in the management of CTTH. One of the RCTs showed that physiotherapy reduced headache frequency and intensity statistical significant better than usual care by the general practitioner. The efficacy of physiotherapy at post-treatment and at 6 months follow-up equals the efficacy of tricyclic antidepressants. Effect size of physiotherapy was up to 0.62. Future manual therapy RCTs are requested addressing the efficacy in chronic migraine with and without medication overuse. Future RCTs on headache should adhere to the International Headache Society’s guidelines for clinical trials, i.e. frequency as primary end-point, while duration and intensity should be secondary end-point, avoid co-intervention, includes sufficient sample size and follow-up period for at least 6 months. PMID:25278005

2014-01-01

343

The role of letrozole (Femara(R)) in breast cancer therapy: A clinical review.  

PubMed

Letrozole is a third-generation aromatase inhibitor for use in postmenopausal women with hormonal-sensitive breast cancer. This drug was found to reduce or effectively shrink tumors in a significant number of such patients. It exhibits antitumor activity at a relatively low daily dose, and is highly potent and selective and well tolerated. Results from recent phase III clinical studies have confirmed the efficacy and the key role of this drug in the therapy of advanced breast cancer in postmenopausal women. Moreover, letrozole demonstrated higher activity and lower toxicity compared to tamoxifen in the first-line therapy of postmenopausal women affected with advanced breast cancer. However, it also represents a valid option in second-line therapy after tamoxifen failure. New data on this agent in adjuvant or neoadjuvant treatment also suggest efficacy in the treatment of early breast cancer. This article reviews the clinical data on letrozole in all settings and its future potential in chemoprevention. (c) 2001 Prous Science. All rights reserved. PMID:12743635

Crucitta, Enrico; Locopo, Nathalia; Silvestris, Nicola; De Lena, Mario; Lorusso, Vito

2001-09-01

344

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

PubMed

Just 15 years ago, Liddle and Dakof (Journal of Marital and Family Therapy, 1995; 21, 511) concluded, based on the available evidence, that family therapy represented a "promising, but not definitive" approach for the treatment of drug problems among adolescents and adults. Seven years later, Rowe and Liddle (2003) review described considerable progress in this specialty with encouraging findings on adolescent-focused models based on rigorous methodology, as well as advances with adult-focused family-based treatments. The current review brings the field up to date with highlights from research conducted in the intervening 7 years, cross-cutting issues, recommendations for new research, and practice implications of these findings. Adolescent-focused family-based models that attend to the ecology of the teen and family show the most consistent and strongest findings in recent studies. Adult-focused models based on behavioral and systems theories of change also show strong effects with drug abusers and their families. The overarching conclusion is that family-based models are not only a viable treatment alternative for the treatment of drug abuse, but are now consistently recognized among the most effective approaches for treating both adults and adolescents with drug problems. PMID:22283381

Rowe, Cynthia L

2012-01-01

345

Normobaric hyperoxia therapy for traumatic brain injury and stroke: a review.  

PubMed

Traumatic brain injury (TBI) and acute ischaemic stroke are major causes of mortality and morbidity and there is an urgent demand for new neuroprotective strategies following the translational failure of neuroprotective drug trials. Oxygen therapy--especially normobaric, may offer a simple and effective therapeutic strategy which we review in this paper. Firstly we review mechanisms underlying the therapeutic effects of hyperoxia (both normobaric and hyperbaric) including mitochondrial rescue, stabilisation of intracranial pressure, attenuation of cortical spreading depression and inducing favourable endothelial-leukocyte interactions, all effects of which are postulated to decrease secondary injury. Next we survey studies using hyperbaric oxygen therapy for TBI and stroke, which formed the basis for early studies on normobaric hyperoxia. Thirdly, we present clinical studies of the efficacy of normobaric hyperoxia on TBI and stroke, emphasising their safety, efficacy and practicality. Finally we consider safety concerns and side effects, particularly pulmonary pathology, respiratory failure and theoretical risks in paediatric patients. A neuroprotective role of normobaric hyperoxia is extremely promising and further studies are warranted. PMID:19922270

Kumaria, Ashwin; Tolias, Christos M

2009-12-01

346

Tumor necrosis factor-? inhibitor therapy and fetal risk: A systematic literature review  

PubMed Central

Tumor necrosis factor-? inhibitors (anti-TNFs) are effective in the treatment of inflammatory bowel disease (IBD) recalcitrant to conventional medical therapy. As the peak incidence of IBD overlaps with the prime reproductive years, it is crucial to establish pharmacologic regimens for women of childbearing age that achieve effective disease control without posing significant fetal harm. A systematic literature review was performed to identify all human studies with birth outcomes data after maternal exposure to infliximab, adalimumab, or certolizumab pegol within 3 mo of conception or during any trimester of pregnancy. Live births, spontaneous abortions or stillbirths, preterm or premature births, low birth weight or small for gestational age infants, and congenital abnormalities were recorded. Fifty selected references identified 472 pregnancy exposures. The subsequent review includes general information regarding anti-TNF therapy in pregnancy followed by a summary of our findings. The benefits of biologic modalities in optimizing disease control during pregnancy must be weighed against the potential toxicity of drug exposure on the developing fetus. Although promising overall, there is insufficient evidence to prove absolute safety for use of anti-TNFs during pregnancy given the limitations of available data and lack of controlled trials. PMID:23674866

Marchioni, Renee M; Lichtenstein, Gary R

2013-01-01

347

Prothrombin complex concentrates for oral anticoagulant therapy-related intracranial hemorrhage: a review of the literature.  

PubMed

Warfarin-related intracranial hemorrhage carries a high mortality and poor neurological outcome. Rapid reversal of coagulopathy is a cornerstone of medical therapy to halt bleeding progression; however the optimal approach remains undefined. Prothrombin complex concentrates have promising features that may rapidly reverse coagulopathy, but remain relatively unstudied. We aim to review the literature regarding the use of prothrombin complex concentrates in patients with warfarin-related intracranial hemorrhage. A comprehensive review of the literature was conducted using PUBMED and Google Scholar databases to identify the use of PCC in patients with warfarin-related intracranial hemorrhage. The characteristics abstracted included the type of PCC, dosing, study design, type of intracranial hemorrhage, changes in the INR, and adverse effects. Prothrombin complex concentrates are heterogeneous in regards to factor concentration. PCC consistently reversed the INR in patients with intracranial hemorrhage. There is some evidence that PCC may reverse the INR more rapidly compared to fresh frozen plasma. Serious adverse effects were uncommon and included mainly thromboembolism. PCC has features which make it a promising therapy for patients with warfarin-related intracranial hemorrhage, and deserves more rigorous study in prospective-randomized controlled trials. PMID:19967567

Bershad, Eric M; Suarez, Jose I

2010-06-01

348

A systematic review of proton therapy in the treatment of chondrosarcoma of the skull base.  

PubMed

Chondrosarcoma (CSA) of the skull base (SB) is an uncommon, slowly growing, neoplasm comprising approximately 0.1% of all intracranial tumors and 6% of SB lesions. Even though its growth is slow, CSA is a potentially lethal tumor. The therapeutic approach to CSA of the SB is still controversial and clinical experience is limited because of the relative rarity of this tumor. The use of proton therapy (PT) after maximal surgery is widely accepted, but there are no controlled studies demonstrating the need of PT and its superiority in comparison to radiotherapy with photons. We conducted a systematic review of the scientific literature published during the period between January 1980 and June 2008 on data regarding irradiation of CSA of the SB with PT and a series of inclusion criteria. During August 2008, two independent reviewers (M.A. and D.A.), by applying the key words "skull base", "chondrosarcoma", and "proton therapy" selected those studies from the PubMed database in which a minimum of ten patients received palliative, radical, or postoperative irradiation with protons and which furnished a minimum of 24 months of follow-up. Forty nine reports were retrieved. There were no prospective trials (randomized or nonrandomized) but just nine uncontrolled single-arm studies for PT mainly related to advanced and frequently incompletely resected tumors. According to the inclusion criteria, only four articles, reporting the most recent updated results of the publishing institution, were included in the analysis providing clinical outcomes for 254 patients in total. Therapeutic approach to CSA of the SB has traditionally relied on surgical control. Radiation therapy has demonstrated to be a valuable modality for local control in the postoperative setting or in advanced/inoperable cases treated with definitive intent. The use of PT following maximal surgical resection shows a very high probability of medium- and long-term cure with a relatively low risk of significant complications. PMID:19921291

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

2010-04-01

349

The Prevalence of Root Sensitivity following Periodontal Therapy: A Systematic Review  

PubMed Central

The reported prevalence of dentine/root (hyper)sensitivity (DH/RS) in the published literature varies, and this may be due in part to a) the different study populations and (b) the different methodologies employed in evaluating the pain response. According to von Troil et al. (2002) there are limited data available in terms of the prevalence and intensity of DH/RS following periodontal therapy. Objectives. The aim of the present study was therefore to review the literature in order to identify all relevant studies for inclusion and to determine whether there was any evidence of DH/RS following periodontal procedures in the published literature up to 31st December 2009 using an agreed search protocol. Methods. 840 papers were identified, from searching both electronic databases (PUBMED) and hand searching of relevant written journals. Twelve papers were subsequently accepted for inclusion. Results. The results of the present study would indicate that the reported prevalence for DH/RS (following nonsurgical therapy) was between 62.5% and 90% one day after treatment decreasing to approximately 52.6% to 55% after one week. The prevalence of DH/RS following surgical therapy was between 76.8% and 80.4% one day after treatment subsequently decreasing over time to 36.8% after 1 week, 33.4% after 2 weeks, 29.6% after 4 weeks, and 21.7% after 8 weeks. Conclusions. It is evident from reviewing the included studies that patients may suffer from mild discomfort following periodontal procedures although both the prevalence and intensity of DH/RS may vary depending on the duration and the type of procedure involved. Most of the studies included in this paper would tend to suggest that DH/RS may be relatively mild/moderate in nature and transient in duration. PMID:23193405

Lin, Y. H.; Gillam, D. G.

2012-01-01

350

Combination Therapy of Sorafenib and TACE for Unresectable HCC: A Systematic Review and Meta-Analysis  

PubMed Central

Background and Aim A large number of studies have tried to combine sorafenib with TACE for patients with unresectable hepatocellular carcinoma (HCC) and the results were controversial. We conducted this systematic review and meta-analysis to evaluate the safety and efficacy of combination therapy of sorafenib and TACE in the management of unresectable HCC. Methods MEDLINE, PsycINFO, Scopus, EMBASE, and the Cochrane Library were searched from January 1990 to October 2013 and these databases were searched for appropriate studies combining TACE and sorafenib in treatment of HCC. Two authors independently reviewed the databases and extracted the data and disagreements were resolved by discussion. Effective value and safety were analyzed. Effective value included disease control rate (DCR), time to progression (TTP) and overall survival (OS). Results 17 studies were included in the study. In the 10 noncomparative studies, DCR ranged from 18.4 to 91.2%. Median TTP ranged from 7.1 to 9.0 months, and median OS ranged from 12 to 27 months. In the 7 comparative studies, the hazard ratio (HR) for TTP was found to be 0.76 (95% CI 0.66–0.89; P<0.001) with low heterogeneity among studies (P?=?0.243; I2?=?25.5%). However, the HR for OS was found to be 0.81 (95% CI 0.65–1.01; P?=?0.061) with low heterogeneity among studies (P?=?0.259; I2?=?25.4%). The common toxicities included fatigue, diarrhea, nausea, hand foot skin reaction (HFSR), hematological events, hepatotoxicity, alopecia, hepatotoxicity, hypertension and rash/desquamation. AEs are generally manageable with dose reductions. Conclusions Combination therapy may bring benefits for unresectable HCC patients in terms of TTP but not OS. Further well-designed randomized controlled studies are needed to confirm the efficacy of combination therapy. PMID:24651044

Zhao, Yan; Cai, Guohong; Qi, Xingshun; Han, Guohong

2014-01-01

351

Silver (Ag) Transport Mechanisms in TRISO coated particles: A Critical Review  

SciTech Connect

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.

I J van Rooyen; J H Neethling; J A A Engelbrecht; P M van Rooyen; G Strydom

2012-10-01

352

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations  

PubMed Central

Objective A comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts. Data sources PubMed, CINAHL, AMED, PsychInfo, Web of Science and EMBASE were searched from inception through 2010. In addition, bibliographies of found articles and reviews were searched, and key researchers were contacted. Eligibility criteria for selecting studies Studies of CIM were identified using criteria based on those of the Cochrane complementary and alternative medicine group. All studies of CIM reporting economic outcomes were included. Study appraisal methods All recent (and likely most cost-relevant) full economic evaluations published 2001–2010 were subjected to several measures of quality. Detailed results of higher-quality studies are reported. Results A total of 338 economic evaluations of CIM were identified, of which 204, covering a wide variety of CIM for different populations, were published 2001–2010. A total of 114 of these were full economic evaluations. And 90% of these articles covered studies of single CIM therapies and only one compared usual care to usual care plus access to multiple licensed CIM practitioners. Of the recent full evaluations, 31 (27%) met five study-quality criteria, and 22 of these also met the minimum criterion for study transferability (‘generalisability’). Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460). Conclusions This comprehensive review identified many CIM economic evaluations missed by previous reviews and emerging evidence of cost-effectiveness and possible cost savings in at least a few clinical populations. Recommendations are made for future studies. PMID:22945962

Herman, Patricia M; Poindexter, Beth L; Witt, Claudia M; Eisenberg, David M

2012-01-01

353

Review of occupational therapy intervention research in the practice area of children and youth 2009-2013.  

PubMed

PURPOSE. We conducted a systematic review examining the extent to which pediatric intervention research recently published in the American Journal of Occupational Therapy reflects occupational therapy's holistic occupation-based tenets. METHOD. We surveyed 10 systematic reviews and analyzed 38 single effectiveness studies for intervention approach, type, level of environmental targeting, level of occupational task and participation practice, and measures used. RESULTS. Of the 38 single effectiveness studies, 12 (32%) explicitly incorporated both environmental targets of intervention and practice of complex or in vivo occupational tasks, with steady increases during the 2009-2013 time frame. CONCLUSION. In the area of children and youth, occupational therapy is making steady gains in reflecting and demonstrating the effectiveness of the profession's holistic, occupation-based tenets. Occupational therapy researchers must be mindful to ensure that despite the reductionist nature of intervention research, interventions reflect the profession's holistic understanding of the interplay between the child, environment, and occupations. PMID:24581415

Kreider, Consuelo M; Bendixen, Roxanna M; Huang, Yu Yun; Lim, Yoonjeong

2014-01-01

354

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

PubMed Central

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

Kumar, Senthil P

2011-01-01

355

Particle size dependence of heating power in MgFe2O4 nanoparticles for hyperthermia therapy application  

NASA Astrophysics Data System (ADS)

Magnetic nanoparticles with narrow size distributions have successfully been synthesized by an ultrasonic assisted co-precipitation method. The effects of particle size on magnetic properties, heat generation by AC fields, and the cell cytotoxicity were investigated for MgFe2O4 nanoparticles with mean diameters varying from 7 ± 0.5 nm to 29 ± 1 nm. The critical size for superparamagnetic to ferrimagnetic transition (DS?F) of MgFe2O4 was determined to be about 13 ± 0.5 nm at 300 K. The specific absorption rate (SAR) of MgFe2O4 nanoparticles was strongly size dependent; it showed a maximum value of 19 W/g when the particle size was 10 ± 0.5 nm at which the Néel and Brownian relaxations are the major cause of heating. The SAR value was suppressed dramatically by 46% with increasing particle size from 10 ± 0.5 nm to 13 ± 0.5 nm, where Néel relaxation slows down and SAR results primarily from Brownian relaxation loss. A further reduction in SAR value was evident when the size was increased from 13 ± 0.5 nm to 16 ± 1 nm, where the superparamagnetic to ferromagnetic transition occurs. However, SAR showed a tendency to increase with particle size again above 16 ± 1 nm where hysteresis loss becomes the dominant mechanism of heat generation. The particle size dependence of SAR in the superparamagnetic region was well described by considering the effective relaxation time estimated based on a log-normal size distribution. The clear size dependence of SAR is attributable to the high degree of monodispersity of particles synthesized here. The high SAR value of water-based MgFe2O4 magnetic suspension combined with low cell cytotoxicity suggests a great potential of MgFe2O4 nanoparticles for magnetic hyperthermia therapy applications.

Reza Barati, Mohammad; Selomulya, Cordelia; Suzuki, Kiyonori

2014-05-01

356

Management of Calcium Channel Antagonist Overdose with Hyperinsulinemia-Euglycemia Therapy: Case Series and Review of the Literature  

PubMed Central

Calcium channel antagonists (CCAs) are commonly involved in drug overdoses. Standard approaches to the management of CCA overdoses, including fluid resuscitation, gut decontamination, administration of calcium, glucagon, and atropine, as well as supportive care, are often ineffective. We report on two patients who improved after addition of hyperinsulinemia-euglycemia (HIE) therapy. We conclude with a literature review on hyperinsulinemia-euglycemia therapy with an exploration of the physiology behind its potential use. PMID:24826345

Shah, Shiwan K.; Goswami, Sanjeev Kumar; Babu, Rajesh V.; Sharma, Gulshan; Duarte, Alexander G.

2012-01-01

357

Brain Tissue Oxygen-Based Therapy and Outcome After Severe Traumatic Brain Injury: A Systematic Literature Review  

Microsoft Academic Search

Observational clinical studies demonstrate that brain hypoxia is associated with poor outcome after severe traumatic brain\\u000a injury (TBI). In this study, available medical literature was reviewed to examine whether brain tissue oxygen (PbtO2)-based therapy is associated with improved patient outcome after severe TBI. Clinical studies published between 1993 and\\u000a 2010 that compared PbtO2-based therapy combined with intracranial and cerebral perfusion

Raj Nangunoori; Eileen Maloney-Wilensky; Michael Stiefel; Soojin Park; W. Andrew Kofke; Joshua M. Levine; Wei Yang; Peter D. Le Roux

358

COST AND PERFORMANCE MODELS FOR PRIMARY FINE PARTICLE CONTROL TECHNOLOGIES: A CRITICAL REVIEW (SYSTEMS ANALYSIS BRANCH, SUSTAINABLE TECHNOLOGY DIVISION, NRMRL)  

EPA Science Inventory

Based upon the risks associated with fine particle emissions, primary fine particle control technology was selected to be the subject of a critical review. The objective was to evaluate selected particulate matter cost and performance models, critically analyze their strengths an...

359

Spectroscopy, manipulation and trapping of neutral atoms, molecules, and other particles using optical nanofibers: a review.  

PubMed

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

Morrissey, Michael J; Deasy, Kieran; Frawley, Mary; Kumar, Ravi; Prel, Eugen; Russell, Laura; Truong, Viet Giang; Chormaic, Síle Nic

2013-01-01

360

Hepatitis C, mental health and equity of access to antiviral therapy: a systematic narrative review  

PubMed Central

Introduction Access to hepatitis C (hereafter HCV) antiviral therapy has commonly excluded populations with mental health and substance use disorders because they were considered as having contraindications to treatment, particularly due to the neuropsychiatric effects of interferon that can occur in some patients. In this review we examined access to HCV interferon antiviral therapy by populations with mental health and substance use problems to identify the evidence and reasons for exclusion. Methods We searched the following major electronic databases for relevant articles: PsycINFO, Medline, CINAHL, Scopus, Google Scholar. The inclusion criteria comprised studies of adults aged 18 years and older, peer-reviewed articles, date range of (2002–2012) to include articles since the introduction of pegylated interferon with ribarvirin, and English language. The exclusion criteria included articles about HCV populations with medical co-morbidities, such as hepatitis B (hereafter HBV) and human immunodeficiency virus (hereafter HIV), because the clinical treatment, pathways and psychosocial morbidity differ from populations with only HCV. We identified 182 articles, and of these 13 met the eligibility criteria. Using an approach of systematic narrative review we identified major themes in the literature. Results Three main themes were identified including: (1) pre-treatment and preparation for antiviral therapy, (2) adherence and treatment completion, and (3) clinical outcomes. Each of these themes was critically discussed in terms of access by patients with mental health and substance use co-morbidities demonstrating that current research evidence clearly demonstrates that people with HCV, mental health and substance use co-morbidities have similar clinical outcomes to those without these co-morbidities. Conclusions While research evidence is largely supportive of increased access to interferon by people with HCV, mental health and substance use co-morbidities, there is substantial further work required to translate evidence into clinical practice. Further to this, we conclude that a reconsideration of the appropriateness of the tertiary health service model of care for interferon management is required and exploration of the potential for increased HCV care in primary health care settings. PMID:24245959

2013-01-01

361

Does Quality of Radiation Therapy Predict Outcomes of Multicenter Cooperative Group Trials? A Literature Review  

SciTech Connect

Central review of radiation therapy (RT) delivery within multicenter clinical trials was initiated in the early 1970s in the United States. Early quality assurance publications often focused on metrics related to process, logistics, and timing. Our objective was to review the available evidence supporting correlation of RT quality with clinical outcomes within cooperative group trials. A MEDLINE search was performed to identify multicenter studies that described central subjective assessment of RT protocol compliance (quality). Data abstracted included method of central review, definition of deviations, and clinical outcomes. Seventeen multicenter studies (1980-2012) were identified, plus one Patterns of Care Study. Disease sites were hematologic, head and neck, lung, breast, and pancreas. Between 0 and 97% of treatment plans received an overall grade of acceptable. In 7 trials, failure rates were significantly higher after inadequate versus adequate RT. Five of 9 and 2 of 5 trials reported significantly worse overall and progression-free survival after poor-quality RT, respectively. One reported a significant correlation, and 2 reported nonsignificant trends toward increased toxicity with noncompliant RT. Although more data are required, protocol-compliant RT may decrease failure rates and increase overall survival and likely contributes to the ability of collected data to answer the central trial question.

Fairchild, Alysa, E-mail: alysa.fairchild@albertahealthservices.ca [Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); Straube, William [Advanced Technology Consortium, Imaged-Guided Therapy QA Center, St. Louis, Missouri (United States); Laurie, Fran [Quality Assurance Review Center, Lincoln, Rhode Island (United States); Followill, David [Radiological Physics Center, University of Texas MD Anderson Cancer Centre, Houston, Texas (United States)

2013-10-01

362

A review of measurements and numerical studies for the effect of wall roughness on the gas-particle flow behavior  

NASA Astrophysics Data System (ADS)

In earlier studies of gas-particle flows the effect of wall roughness was not taken into account. The present author and his colleagues did detailed PDPA measurements and numerical studies for the effect of wall roughness on the gas-particle flow behavior. This paper gives a review of our studies, showing the following results. The PDPA measurements of backward-facing step gas-particle flows shows that as the wall roughness increases, the longitudinal and transverse particle fluctuation velocities increase. The numerical simulation of swirling gas-particle flows shows that the simulation results accounting for the wall roughness agree well with the measurement results. The numerical simulation of gas-particle channel flows indicates the increase of particle fluctuation velocity with increasing wall roughness.

Zhou, Lixing

2014-04-01

363

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

Microsoft Academic Search

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

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

2006-01-01

364

Disparity implications of the Medicare medication therapy management eligibility criteria: a literature review.  

PubMed

The emphasis on eliminating racial and ethnic disparities in healthcare has received national attention, with various policy initiatives addressing this problem and proposing solutions. However, in the current economic era requiring tight monetary constraints, emphasis is increasingly being placed on economic efficiency, which often conflicts with the equality doctrine upon which many policies have been framed. The authors' review aims to highlight the disparity implications of one such policy provision - the predominantly utilization-based eligibility criteria for medication therapy management services under Medicare Part D - by identifying studies that have documented racial and ethnic disparities in health status and the use of and spending on prescription medications. Future design and evaluation of various regulations and legislations employing utilization-based eligibility criteria must use caution in order to strike an equity-efficiency balance. PMID:23570431

Munshi, Kiraat D; Shih, Ya-Chen T; Brown, Lawrence M; Dagogo-Jack, Samuel; Wan, Jim Y; Wang, Junling

2013-04-01

365

Converging paths to progress for skull base chordoma: Review of current therapy and future molecular targets  

PubMed Central

Background: Chordomas of the skull base are rare locally aggressive neoplasms with a predilection for encapsulating critical neurovascular structures, bony destruction and irregular growth patterns, and from which patients succumb to recurrence and treatment failures. Methods: A review of the medical literature is performed, using standard search engines and identifying articles related to skull base chordomas, surgery, radiation therapy, chemotherapy, molecular genetics, and prospective trials. Results: A synthesis of the literature is presented, including sections on pathology, treatment, molecular genetics, challenges, and future directions. Conclusion: Beyond an understanding of the current treatment paradigms for skull base chordomas, the reader gains insight into the collaborative approach applied to orphan diseases, of which chordomas is a prime exemplar. PMID:23776758

Maio, Salvatore Di; Kong, Esther; Yip, Stephen; Rostomily, Robert

2013-01-01

366

Review of treatment assessment using DCE-MRI in breast cancer radiation therapy  

PubMed Central

As a noninvasive functional imaging technique, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is being used in oncology to measure properties of tumor microvascular structure and permeability. Studies have shown that parameters derived from certain pharmacokinetic models can be used as imaging biomarkers for tumor treatment response. The use of DCE-MRI for quantitative and objective assessment of radiation therapy has been explored in a variety of methods and tumor types. However, due to the complexity in imaging technology and divergent outcomes from different pharmacokinetic approaches, the method of using DCE-MRI in treatment assessment has yet to be standardized, especially for breast cancer. This article reviews the basic principles of breast DCE-MRI and recent studies using DCE-MRI in treatment assessment. Technical and clinical considerations are emphasized with specific attention to assessment of radiation treatment response. PMID:25332905

Wang, Chun-Hao; Yin, Fang-Fang; Horton, Janet; Chang, Zheng

2014-01-01

367

The effects of TNF ? antagonist therapy on bone metabolism in rheumatoid arthritis: a systematic review.  

PubMed

Osteoporosis is a common complication observed in rheumatoid arthritis (RA). Accelerated bone loss is always a matter of concern. The pathogenesis of RA may be important for better understanding of the bone loss. The mechanism involved in the bone loss in RA is not well understood although cytokines such as interleukin 1 and tumour necrosis factor ? (TNF ?) have been strongly implicated. TNF ? antagonists have revolutionised the treatment of RA in the recent years. Beyond the control of disease activity in RA, accumulating evidence suggests that this form of therapy may provide beneficial effects to the bone metabolism and remodeling. An extensive search of the literature was performed in the Medline, Scopus and EBSCO databases to evaluate the documented research on the effects of TNF ? antagonists in RA on bone mineral density and bone turnover markers. The available data based on our systematic review, depict a significant association between TNF ? antagonists treatment and suppression of bone resorption. PMID:23848441

Sakthiswary, Rajalingham; Das, Srijit

2013-12-01

368

Nanoparticles and cancer therapy: A concise review with emphasis on dendrimers  

PubMed Central

The emergence of nanotechnology has had a profound effect on many areas of healthcare and scientific research. Having grown exponentially, the focus of nanotechnology has been on engineering diversified novel applications that even go beyond therapeutic activity; nanotechnology also offers the ability to detect diseases, such as cancer, much earlier than ever imaginable. Often, patients diagnosed with breast, lung, colon, prostate, and ovarian cancer have hidden or overt metastatic colonies. With the advent of diagnostic nanotechnology, these numbers are expected to greatly diminish. This review provides a brief description of nanoparticle (liposome, quantum dot, and dendrimer)-mediated cancer therapy in the last decade with an emphasis on the development and use of dendrimers in cancer therapeutics. PMID:19421366

Bharali, Dhruba J; Khalil, Marianne; Gurbuz, Mujgan; Simone, Tessa M; Mousa, Shaker A

2009-01-01

369

Thyroid tumor-initiating cells: Increasing evidence and opportunities for anticancer therapy (Review)  

PubMed Central

Accumulating evidence supports the notion that thyroid cancer is initiated by tumor-initiating cells (TICs) (commonly known as cancer stem cells), which are thought to play a crucial role in malignant progression, therapeutic resistance and recurrence. Thyroid TICs have been isolated and identified using specific biomarkers (such as CD133), the side population, sphere formation and aldehyde dehydrogenase activity assays. Although their characteristics remain largely unknown, TICs provide an attractive cellular mechanism to explain therapeutic refractoriness. Efforts are currently being directed toward the identification of therapeutic strategies that could target these cells. The present review discusses the cellular origins of TICs and the main approaches used to isolate and identify thyroid TICs, with a focus on the remaining challenges and opportunities for anticancer therapy. PMID:24424445

GAO, YONG-JU; LI, BO; WU, XIN-YU; CUI, JING; HAN, JIAN-KUI

2014-01-01

370

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

PubMed

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

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

2014-01-01

371

The efficacy of Acceptance and Commitment Therapy: an updated systematic review and meta-analysis.  

PubMed

Acceptance and Commitment therapy (ACT) has attracted a lot of interest during the last 10-15 years with a strong increase of the number of randomized controlled trials (RCTs). The present review and meta-analysis includes 60 RCTs (4234 participants) on psychiatric disorders, somatic disorders, and stress at work. The mean effect size across all comparisons was small (0.42). Compared to the Öst (2008) meta-analysis there was no significant improvement in methodological quality and deterioration in effect size (from 0.68). When ACT was compared to various forms of cognitive or behavioral treatments a small and non-significant effect size of 0.16 was obtained. An evidence-base evaluation showed that ACT is not yet well-established for any disorder. It is probably efficacious for chronic pain and tinnitus, possibly efficacious for depression, psychotic symptoms, OCD, mixed anxiety, drug abuse, and stress at work, and experimental for the remaining disorders. PMID:25193001

Ost, Lars-Göran

2014-10-01

372

Molecular-targeted therapy for chemotherapy-refractory gastric cancer: a case report and literature review.  

PubMed

The prognosis of advanced gastric cancer (AGC) remains poor despite therapeutic advances in recent decades. Several recent positive phase III trials established the efficacy of second-line chemotherapy for metastatic gastric cancer in prolonging overall survival. However, malnutrition and poor performance of AGC in late stages usually preclude such patients from intensive treatment. Many targeted-therapies failed to show a significant survival benefit in AGC, but have regained attention after the positive result of ramucirumab was announced last year. Among all targeted agents, only trastuzumab, a monoclonal antibody against Human epidermal growth factor receptor-2 (HER2) protein, has been proven as having survival benefit by addition to first-line chemotherapy. Herein we reported a patient who benefited from adding trastuzumab to the same second-line combination chemotherapy (paclitaxel, 5-fluorouracil, and leucovorin) upon progression of bulky liver metastases. At least five months of progression-free survival were achieved without any additional toxicity. We also reviewed literature of molecularly-targeted therapy for chemotherapy-refractory gastric cancer, including several large phase III trials (REGARD, GRANITE-1, EXPAND, and REAL-3) published in 2013-2014. PMID:24982389

Kuo, Hung-Yang; Yeh, Kun-Huei

2014-07-01

373

HERBAL THERAPY USE BY CANCER PATIENTS: A LITERATURE REVIEW ON CASE REPORTS  

PubMed Central

Complementary and alternative medicine use is common among cancer patients. In many surveys, herbal medicines are among the most commonly used group of treatments. Herbal remedies are believed by the general public to be safe, cause less side effects and less likely to cause dependency. The authors performed a literature review to assess which herbal approaches have had associated cancer case reports and determine which of these have been studied in prospective research. Eighteen case reports of patients having apparent antitumour effects from herbal therapy and 21 case reports of toxic effects of herbs used by cancer patients were identified. Clinicaltrials.gov and MEDLINE (via PubMed) were searched for each of the herbal products identified in these reports. Clinical trials in cancer populations were identified for green tea extracts or compounds (n = 34), phytoestrogens (n=27), mistletoe (n =8), Ganoderma lucidum (n=1), Noni (n = 1) and Silymarin (n = 1). Daikenchuto, PC-SPES, Nyoshinsan/TJ and Saw palmetto have also been studied prospectively. In conclusion, some of the herbs with promising case report findings have undergone prospective clinical investigations but many others have either not yet been explored or the results have not been reported in English. Unconventional therapies, such as herbs and minerals, used in ancient medical traditions have led to the identification of active anticancer agents. Mechanisms to support prospective research with such approaches are discussed. PMID:21185719

Olaku, Oluwadamilola; White, Jeffrey D.

2011-01-01

374

Effect of Preventive Hormonal Therapy on Breast Density: A Systematic Qualitative Review  

PubMed Central

Breast density (BD) is recognized as one of the strongest independent risk factors of breast cancer (BC). Unlike most other risk factors, BD can be modified, suggesting that it may be a biomarker for preventive interventions. We conducted a qualitative systematic review to address the effect of preventive hormonal therapy on BD. Among the 26 relevant studies, 10 assessed the effect of tamoxifen on BD (TAM: n = 2?877), 9 that of raloxifene (RLX: n = 1?544), and 7 that of aromatase inhibitors (AI: n = 416). The studies were characterized by a large heterogeneity in designs and in methods of BD measurement. BD could be reduced by TAM (10 studies/10). However, the effect of RLX and AI on BD remains unclear due to conflicting results between studies. Consequently, it is crucial to develop practical, accurate, and reproducible methods of measurement in order to be able to compare the effect of preventive hormonal agents on BD and to determine whether change in BD can be used as a predictor of response to therapy. PMID:24895676

Lienart, Virginie; Carly, Birgit; Liebens, Fabienne

2014-01-01

375

Stereotactic body radiation therapy (SBRT) for lung cancer patients previously treated with conventional radiotherapy: a review.  

PubMed

Lung cancer continues to be one of the most prevalent malignancies worldwide and is the leading cause of death in both men and women. Presently, local control rates are quite poor. Improvements in imaging and radiation treatment delivery systems however have provided radiation oncologists with new tools to better target these tumors. Stereotactic body radiation therapy (SBRT) is one such technique that has shown efficacy as upfront treatment for lung cancer. In addition, more recent studies have demonstrated some effectiveness in recurrent tumors in prior irradiated fields as well. This review summarizes seven recent studies of re-irradiation with SBRT in patients with thoracic recurrences treated previously with conventionally fractionated radiation therapy. Combined, 140 patients were included. The median initial thoracic radiation doses ranged from 50-87.5 Gy and median re-irradiation dose ranged from 40-80 Gy. Local control rates varied from 65-92%. Re-irradiation was well tolerated with few grade 4 and 5 complications (observed in one study). Currently, based on these published reports, re-irradiation with SBRT appears feasible for in-field thoracic recurrences, though caution must be taken in all cases of retreatment. PMID:25239200

Amini, Arya; Yeh, Norman; Gaspar, Laurie E; Kavanagh, Brian; Karam, Sana D

2014-01-01

376

Review on the demographic and social impact of methadone-medication therapy on Malaysian patients.  

PubMed

This study is an observational cross-sectional study aimed to examine the possible demographic and social characteristics of patients enrolled at the Methadone Maintenance Therapy Adherence Clinic (MMTAC) in Malaysia. Medical records from year 2009 - 2011 were Reviewed. Demographic, social characteristics and laboratory examinations such as age, gender, race, clinic attendances and urine analysis were recorded. Subjects were selected by means of convenient sampling but based on the specified inclusion and exclusion criteria. Data were analyzed by either Chi-square test, Fisher's exact test Mann-Whitney U-test, with the limit of significance was set at p < 0.05. Demographically, this study found that the ratio of Malays, Chinese and Indian enrolled to the MMTAC program is similar to the distribution of races in Malaysia. Their starting age for drug use was between 14-35 years and the age to enrolment between 30-58 years. Socially, many are unemployed, lowly educated and married. Most are drug users with a high percentage of HCV accompanied with impaired liver function. Retention rate was 87% but illicit drug use was at 57.50%. However, percentage of employment increased significantly after therapy. The study managed to identify several demographical and social distributions of patients attending the MMTAC. Although attendance rate was high, many were on illicit drug use. Nevertheless, employment rate improved significantly. PMID:23811468

Manan, Mohamed Mansor; Ali, Salmiah Mohd; Khan, Muhammad Anwar Nawab; Jafarian, Sara; Hameed, Mohammed Abdul

2013-07-01

377

Calculation of radiation therapy dose using all particle Monte Carlo transport  

DOEpatents

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.

Chandler, William P. (Tracy, CA); Hartmann-Siantar, Christine L. (San Ramon, CA); Rathkopf, James A. (Livermore, CA)

1999-01-01

378

Sleep Disturbances in Individuals with Alcohol-Related Disorders: A Review of Cognitive-Behavioral Therapy for Insomnia (CBT-I) and Associated Non-Pharmacological Therapies  

PubMed Central

Sleep disturbances are common among alcohol-dependent individuals and are often associated with relapse. The utility of behavioral therapies for sleep disturbances, including cognitive-behavioral therapy for insomnia (CBT-I), among those with alcohol-related disorders is not well understood. This review systematically evaluates the evidence of CBT-I and related behavioral therapies applied to those with alcohol-related disorders and accompanying sleep disturbances. A search of four research databases (PubMed, PsycINFO, Embase, and CINAHL Plus) yielded six studies that met selection criteria. Articles were reviewed using Cochrane’s Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) scoring system. A majority of the studies demonstrated significant improvements in sleep efficiency among behavioral therapy treatment group(s), including but not limited to CBT-I. While behavioral sleep interventions have been successful in varied populations, they may not be utilized to their full potential among those with alcohol-related disorders as evidenced by the low number of studies found. These findings suggest a need for mixed-methods research on individuals’ sleep experience to inform interventions that are acceptable to the target population. PMID:25288884

Brooks, Alyssa T; Wallen, Gwenyth R

2014-01-01

379

Schema therapy for borderline personality disorder: a comprehensive review of its empirical foundations, effectiveness and implementation possibilities.  

PubMed

Borderline personality disorder is a serious psychiatric disorder for which the effectiveness of the current pharmacotherapeutical and psychotherapeutic approaches has shown to be limited. In the last decades, schema therapy has increased in popularity as a treatment of borderline personality disorder; however, systematic evaluation of both effectiveness and empirical evidence for the theoretical background of the therapy is limited. This literature review comprehensively evaluates the current empirical status of schema therapy for borderline personality disorder. We first described the theoretical framework and reviewed its empirical foundations. Next, we examined the evidence regarding effectiveness and implementability. We found evidence for a considerable number of elements of Young's schema model; however, the strength of the results varies and there are also mixed results and some empirical blanks in the theory. The number of studies on effectiveness is small, but reviewed findings suggest that schema therapy is a promising treatment. In Western-European societies, the therapy could be readily implemented as a cost-effective strategy with positive economic consequences. PMID:23422036

Sempértegui, Gabriela A; Karreman, Annemiek; Arntz, Arnoud; Bekker, Marrie H J

2013-04-01

380

Progenitor Cell Therapy for the Treatment of Central Nervous System Injury: A Review of the State of Current Clinical Trials  

PubMed Central

Recent preclinical work investigating the role of progenitor cell therapies for central nervous system (CNS) injuries has shown potential neuroprotection in the setting of traumatic brain injury (TBI), spinal cord injury (SCI), and ischemic stroke. Mechanisms currently under investigation include engraftment and transdifferentiation, modulation of the locoregional inflammatory milieu, and modulation of the systemic immunologic/inflammatory response. While the exact mechanism of action remains controversial, the growing amount of preclinical data demonstrating the potential benefit associated with progenitor cell therapy for neurological injury warrants the development of well-controlled clinical trials to investigate therapeutic safety and efficacy. In this paper, we review the currently active or recently completed clinical trials investigating the safety and potential efficacy of bone marrow-derived progenitor cell therapies for the treatment of TBI, SCI, and ischemic stroke. Our review of the literature shows that while the preliminary clinical trials reviewed in this paper offer novel data supporting the potential efficacy of stem/progenitor cell therapies for CNS injury, a great deal of additional work is needed to ensure the safety, efficacy, and mechanisms of progenitor cell therapy prior to widespread clinical trials. PMID:21048846

Walker, Peter A.; Harting, Matthew T.; Shah, Shinil K.; Day, Mary-Clare; El Khoury, Ramy; Savitz, Sean I.; Baumgartner, James; Cox, Charles S.

2010-01-01

381

Development of Particle Interface Bonding in Thermal Spray Coatings: A Review  

NASA Astrophysics Data System (ADS)

Thermal spray ceramic coatings deposited following the conventional routine exhibit a typical lamellar structure with a limited interface bonding ratio. The bonding between particles in the coating dominates coating properties and performance. In this review paper, the bonding formation at the interface between thin lamellae in the coating is examined. The effect of spray parameters on the bonding ratio is presented to reveal the main droplet parameters controlling bonding formation, which reveals that the temperature of the spray particle rather than its velocity dominates the bonding formation. The limitation to increase significantly the ceramic particle temperature inherent to the thermal spray process leads to the observation of a maximum bonding ratio of about 32%, while through controlling the surface temperature of the coating prior to molten droplet impact, the bonding at the lamellar interface can be significantly increased. Consequently, it is shown that with the proper selection of deposition conditions and control of the deposition temperature, the bonding ratio of ceramic deposits can be altered from a maximum of 32% for a conventional deposit to a maximum of 100%. Such wide adjustability of the lamellar bonding opens new possibilities for using thermal spray coatings in various applications requiring different microstructures and properties. The examination of recent studies shows that the bonding control makes it possible to fabricate porous deposits through surface-molten particles. Such an approach could be applied for the fabrication of porous materials, the deposition of high temperature abradable ceramic coatings, and for forming functional structured surfaces, such as a surface with super-hydrophobicity or a solid oxide fuel cell cathode interface with high specific surface area and high catalytic performance. Furthermore, complete interface bonding leads to crystalline structure control of individual splats through epitaxial grain growth.

Li, Chang-Jiu; Yang, Guan-Jun; Li, Cheng-Xin

2013-03-01

382

The Efficacy of Short- and Long-Term Therapy in the Treatment of Childhood Sexual Abuse: A Review of the Literature.  

ERIC Educational Resources Information Center

This paper presents a review of the short- and long-term treatments for children who have been sexually abused. Short-term group therapy, long-term group therapy, short-term individual, and long-term individual therapy were each evaluated in terms of efficacy in alleviating symptoms associated with sexual abuse. The paper also evaluates the…

Aoto-Sullivan, Stacey Y.

383

Revisão sistemática sobre a efetividade da fisioterapia aquática no tratamento da fibromialgia Effectiveness of aquatic physical therapy in treating patients with fibromyalgia: systematic review  

Microsoft Academic Search

The Physical therapy interventions promote functionality and fostering quality of life in the rheumatic diseases. Comparison between aquatic physical therapy and a non specific exercise program execution or physical therapy executed on land, for patients with fibromyalgia. The study type was the systematic review of randomized clinical trials. Patients with fibromyalgia whose diagnostic was based on the criteria of the

Regiane Mazzarioli; Pereira Nogueira; Jefferson Rosa Cardoso

384

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

PubMed

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

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

2014-06-01

385

Cognitive-behavioral therapy for comorbid bipolar and substance use disorders: a systematic review of controlled trials  

Microsoft Academic Search

There are a number of negative intrapersonal, physical, and economic effects of comorbid bipolar and substance use disorders. The purpose of the present review is to systematically identify, describe, and summarize controlled trials evaluating the overall outcomes of cognitive-behavioral therapy (CBT) for persons with comorbid bipolar and substance use disorder (SUD); so trends regarding efficacy, effectiveness, and gaps in research

Virgil L. Gregory Jr

2011-01-01

386

A Critical Review of Literature Regarding the Effectiveness of Physical Therapy Management of Hip Fracture in Elderly Persons  

Microsoft Academic Search

The purpose of this review is to analyze the research literature that has examined the effectiveness of physical therapy in the management of hip fractures in elderly persons. Using literature databases and keywords, we located relevant studies. Fifteen studies met the criteria and were then categorized according to Sackett's levels of evidence. Six studies were graded at level I, six

Emily Marie Toussant; Mohamed Kohia

387

The effectiveness of extra corporeal shock wave therapy for plantar heel pain: a systematic review and meta-analysis  

PubMed Central

Background There is considerable controversy regarding the effectiveness of extracorporeal shock wave therapy in the management of plantar heel pain. Our aim was to conduct a systematic review of randomised controlled trials to investigate the effectiveness of extracorporeal shock wave therapy and to produce a precise estimate of the likely benefits of this therapy. Methods We conducted a systematic review of all randomised controlled trials (RCTs) identified from the Cochrane Controlled trials register, MEDLINE, EMBASE and CINAHL from 1966 until September 2004. We included randomised trials which evaluated extracorporeal shock wave therapy used to treat plantar heel pain. Trials comparing extra corporeal shock wave therapy with placebo or different doses of extra corporeal shock wave therapy were considered for inclusion in the review. We independently applied the inclusion and exclusion criteria to each identified randomised controlled trial, extracted data and assessed the methodological quality of each trial. Results Six RCTs (n = 897) permitted a pooled estimate of effectiveness based on pain scores collected using 10 cm visual analogue scales for morning pain. The estimated weighted mean difference was 0.42 (95% confidence interval 0.02 to 0.83) representing less than 0.5 cm on a visual analogue scale. There was no evidence of heterogeneity and a fixed effects model was used. Conclusion A meta-analysis of data from six randomised-controlled trials that included a total of 897 patients was statistically significant in favour of extracorporeal shock wave therapy for the treatment of plantar heel pain but the effect size was very small. A sensitivity analysis including only high quality trials did not detect a statistically significant effect. PMID:15847689

Thomson, Colin E; Crawford, Fay; Murray, Gordon D

2005-01-01

388

Selective retina therapy (SRT): a review on methods, techniques, preclinical and first clinical results.  

PubMed

Selective retina therapy (SRT) is a new laser procedure for retinal diseases that are thought to be associated with a degradation of the retinal pigment epithelium (RPE). The aim of the irradiation is to selectively damage the RPE without affecting the neural retina, the photoreceptors and the choroid. Goal of the treatment is to stimulate RPE cell migration and proliferation into the irradiated areas in order to improve the metabolism at the diseased retinal sites. In a pilot study more than 150 patients with soft drusen, retinopathia centralis serosa (RCS) and macular edema were treated. The first 3-center international trial targets diabetic macular edema and branch vein occlusion. In this review, selective RPE effects are motivated and two modalities to achieve selective RPE effects will be introduced: a pulsed and a continuous wave scanning mode. The mechanism behind selective RPE-effects will be discussed reviewing in vitro results and temperature calculations. So far clinical SRT is performed by applying trains of 30 laser pulses from a Nd:YLF-Laser (527 nm, 1.7 micros, 100 Hz) to the diseased fundus areas. In the range of 450-800 mJ/cm(2) per pulse, RPE-defects in patients were proved angiographically by fluorescein or ICG-leakage. The selectivity with respect to surrounding highly sensitive tissue and the safety range of the treatment will be reviewed. With the laser parameters used neither bleeding nor scotoma, proved by microperimetry, were observed thus demonstrating no adverse effects to the choroid and the photoreceptors, respectively. During and after irradiation, it shows that the irradiated locations are ophthalmoscopically invisible, since the effects are very limited and confined to the RPE, thus a dosimetry control is demanded. We report on a non-invasive opto-acoustic on-line technique to monitor successful RPE-irradiation and compare the data to those achieved with standard angiography one-hour post treatment. PMID:17265790

Brinkmann, R; Roider, J; Birngruber, R

2006-01-01

389

A retrospective review of sirolimus (Rapamune) therapy in orthotopic liver transplant recipients diagnosed with chronic rejection.  

PubMed

Treatment options are limited for orthotopic liver transplant (OLT) recipients suffering from chronic rejection (CR). We performed a retrospective review of OLT recipients diagnosed with CR and treated with sirolimus. The medical records of all OLT recipients treated with sirolimus between October, 1998 and October, 2000 were retrospectively reviewed. The diagnosis of CR was made by both clinical and histologic criteria: bile duct to hepatic artery ratio less than 0.7, histologic activity index, hepatic arterial wall thickening, and chronic elevation of liver chemistries. Two groups were defined in regard to sirolimus response: sirolimus responders (SR) and sirolimus nonresponders (SNR). Response to treatment was granted only when patients were found to have resolution of abnormal liver transaminases and an improvement in hepatic artery to bile duct ratio. Serum collections for liver chemistries were collected on days 1, 30, 60, and 90. Liver biopsies were reviewed in blinded fashion from day 1 and at least 180 days on therapy by double-blinded pathologists. Sirolimus-related complications were recorded and include drug toxicity, anemia with and without treatment, hospitalizations, infections, immunosuppression complications, lipid profile disorders, edema, muscle aches, and gastrointestinal complaints. Twenty-one patients were diagnosed with CR. The SR group included 13 of 21, and 8 of 21 were in the SNR group. Anemia was diagnosed in 12 of 21 patients: SR, 7 of 13; SNR, 5 of 8; with 5 patients requiring red blood cell transfusions (2 SR, 3 SNR). Recombinant erythropoietin was started in 5 of 21 patients. Sirolimus serum levels were found to be greater than 20 ng/dL in 12 patients. Sirolimus was discontinued in 9 patients, PMID:12740790

Neff, Guy W; Montalbano, Marzia; Slapak-Green, Gabriel; Berney, Thierry; Bejarano, Pablo A; Joshi, Anand; Icardi, Mike; Nery, Jose; Seigo, Nishida; Levi, David; Weppler, Debbie; Pappas, Peter; Ruiz, Jose; Schiff, Eugene R; Tzakis, Andreas G

2003-05-01

390

Effectiveness of Cognitive Behavioral and Supportive-Expressive Group Therapy for Women Diagnosed with Breast Cancer: A Review of the Literature  

ERIC Educational Resources Information Center

A review of the literature revealed 20 studies that examined the extent to which cognitive behavioral therapy (CBT), supportive-expressive group therapy (SEGT), and a combination of these two treatments impact women with breast cancer. Based on this review, it is determined that CBT and SEGT have repeated experimental support for positively…

Boutin, Daniel L.

2007-01-01

391

Radium-223 dichloride bone-targeted alpha particle therapy for hormone-refractory breast cancer metastatic to bone  

PubMed Central

Background Hormone-refractory breast cancer metastatic to bone is a clinically challenging disease associated with high morbidity, poor prognosis, and impaired quality of life owing to pain and skeletal-related events. In a preclinical study using a mouse model of breast cancer and bone metastases, Ra-223 dichloride was incorporated into bone matrix and inhibited proliferation of breast cancer cells and differentiation of osteoblasts and osteoclasts (all P values?particle therapy for the treatment of symptomatic bone metastases in patients with castration-resistant prostate cancer. On the basis of a strong preclinical rationale, we used Ra-223 dichloride to treat bone metastases in a patient with breast cancer. Results A 44-year-old white woman with metastatic breast cancer who was estrogen receptor–positive, BRCA1-negative, BRCA2-negative, PIK3CA mutation (p.His1047Arg) positive presented with diffuse bony metastases and bone pain. She had hormone refractory and chemotherapy refractory breast cancer. After Ra-223 therapy initiation her bone pain improved, with corresponding decrease in tumor markers and mixed response in 18F-FDG PET/CT and 18F-NaF bone PET/CT. The patient derived clinical benefit from therapy. Conclusion We have shown that Ra-223 dichloride can be safely administered in a patient with hormone-refractory bone metastasis from breast cancer at the US FDA–approved dose for prostate cancer. Furthermore, because the treatment did not cause any drop in hematologic parameters, it has the potential to be combined with other radiosensitizing therapies, which may include chemotherapy or targeted therapies. Given that Ra-223 dichloride is already commercially available, this case report may help future patients and provide a rationale for initiating clinical research in the use of Ra-223 dichloride to treat bone metastasis from breast cancer. A randomized clinical trial is needed to provide evidence of efficacy, safety, and good outcomes. PMID:25243101

2014-01-01

392

The effect of spinal manipulative therapy on spinal range of motion: a systematic literature review  

PubMed Central

Background Spinal manipulative therapy (SMT) has been shown to have an effect on spine-related pain, both clinically and in experimentally induced pain. However, it is unclear if it has an immediate noticeable biomechanical effect on spinal motion that can be measured in terms of an increased range of motion (ROM). Objective To assess the quality of the literature and to determine whether or not SMT is associated with an immediate increase in ROM. Design A systematic critical literature review. Method Systematic searches were performed in Pubmed, the Cochrane Library and EMBASE using terms relating to manipulation, movement and the spine. Selection of articles was made according to specific criteria by two independent reviewers. Two checklists were created based on the needs of the present review. Articles were independently reviewed by two reviewers. Articles were given quality scores and the data synthesized for each region treated in the literature. Findings were summarized in tables and reported in a narrative fashion. Results Fifteen articles were retained reporting on experiments on the neck, lumbar spine, hip and jaw. The mean quality score was 71/100 (ranges 33/100 - 92/100). A positive effect of SMT was reported in both studies where mouth opening was assessed after cervical manipulation. In five of the nine studies on cervical ROM a positive effect was reported, whereas the remaining four studies did not show improvement. None of the three studies of the lumbar spine showed an effect of SMT on lumbar ROMs and one study of sacroiliac manipulation reported no effect on the ROM of the hip joint. In relation to the quality score, the seven highest ranked studies, showed significant positive effects of SMT on ROM. Continuing down the list, the other studies reported no significant differences in the outcomes between groups. Conclusion SMT seems sometimes to have a small effect on ROM, at least in the cervical spine. Further research should concentrate on areas of the spine that have the potential of actually improving to such a degree that a change can be easily uncovered. PMID:22866816

2012-01-01

393

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

PubMed

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

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

2013-03-01

394

Arts therapies for anxiety, depression, and quality of life in breast cancer patients: a systematic review and meta-analysis.  

PubMed

Background. Breast cancer is one of the most common types of cancer. However, only a few trials assess the effects of arts therapies. Material and Methods. We searched the Cochrane Central Register of Controlled Trials, PubMed, and Google Scholar from their start date to January 2012. We handsearched reference lists and contacted experts. All randomized controlled trials, quasi-randomized trials, and controlled clinical trials of art interventions in breast cancer patients were included. Data were extracted and risk of bias was assessed. Meta-analyses were performed using standardized mean differences. Results. Thirteen trials with a total of 606 patients were included. Arts therapies comprised music therapy interventions, various types of art therapy, and dance/movement therapies. The methodological quality ranged from poor to high quality with the majority scoring 3 of 4 points on the Jadad scale. Results suggest that arts therapies seem to positively affect patients' anxiety (standardized mean difference: -1.10; 95%, confidence interval: -1.40 to -0.80) but not depression or quality of life. No conclusion could be drawn regarding the effects of arts therapy on pain, functional assessment, coping, and mood states. Discussion. Our review indicates that arts interventions may have beneficial effects on anxiety in patients with breast cancer. PMID:24817896

Boehm, Katja; Cramer, Holger; Staroszynski, Thomas; Ostermann, Thomas

2014-01-01

395

Arts Therapies for Anxiety, Depression, and Quality of Life in Breast Cancer Patients: A Systematic Review and Meta-Analysis  

PubMed Central

Background. Breast cancer is one of the most common types of cancer. However, only a few trials assess the effects of arts therapies. Material and Methods. We searched the Cochrane Central Register of Controlled Trials, PubMed, and Google Scholar from their start date to January 2012. We handsearched reference lists and contacted experts. All randomized controlled trials, quasi-randomized trials, and controlled clinical trials of art interventions in breast cancer patients were included. Data were extracted and risk of bias was assessed. Meta-analyses were performed using standardized mean differences. Results. Thirteen trials with a total of 606 patients were included. Arts therapies comprised music therapy interventions, various types of art therapy, and dance/movement therapies. The methodological quality ranged from poor to high quality with the majority scoring 3 of 4 points on the Jadad scale. Results suggest that arts therapies seem to positively affect patients' anxiety (standardized mean difference: ?1.10; 95%, confidence interval: ?1.40 to ?0.80) but not depression or quality of life. No conclusion could be drawn regarding the effects of arts therapy on pain, functional assessment, coping, and mood states. Discussion. Our review indicates that arts interventions may have beneficial effects on anxiety in patients with breast cancer. PMID:24817896

2014-01-01

396

Monitoring of patients treated with particle therapy using positron-emission-tomography (PET): the MIRANDA study  

PubMed Central

Background The purpose of this clinical study is to investigate the clinical feasibility and effectiveness of offline Positron-Emission-Tomography (PET) quality assurance for promoting the accuracy of proton and carbon ion beam therapy. Methods/Design A total of 240 patients will be recruited, evenly sampled among different analysis groups including tumors of the brain, skull base, head and neck region, upper gastrointestinal tract including the liver, lower gastrointestinal tract, prostate and pelvic region. From the comparison of the measured activity with the planned dose and its corresponding simulated activity distribution, conclusions on the delivered treatment will be inferred and, in case of significant deviations, correction strategies will be elaborated. Discussion The investigated patients are expected to benefit from this study, since in case of detected deviations between planned and actual treatment delivery a proper intervention (e.g., correction) could be performed in a subsequent irradiation fraction. In this way, an overall better treatment could be achieved than without any in-vivo verification. Moreover, site-specific patient-population information on the precision of the ion range at HIT might enable improvement of the CT-range calibration curve as well as safe reduction of the treatment margins to promote enhanced treatment plan conformality and dose escalation for full clinical exploitation of the promises of ion beam therapy. Trial Registration NCT01528670 PMID:22471947

2012-01-01

397

An up-to-date review of theories of shock therapies: are convulsive shock therapies "moral treatments"?  

PubMed

About four decades ago, empirically developed shock therapies were introduced as treatments for mental disorders. However, there still remains today a wide disagreement as to why these procedures are effective. It has long been known that the behavior in lower animals can be altered by the use of planned psychologcal methods. Likewise psychological procedures (employing such factors as suggestion and fear) had been used by preliterate man all through the ages in the treatment of mental illness. During the past century various types of pre-modern shock therapies using suggestion, fear or excitation were used in different forms. Electricity was the most common form used and favorable effects from its use were reported. These treatments were often referred to as "moral treatment" (as having psychological rather than physical effects). Employing the hypothesis that pharmacologic shock therapies could be categorized mainly as forms of central stimulation or excitation and sedation, the writer used Faradic electric stimulation (similar to currents frequently used in the past century) plus a rapidly acting intravenous drug for sedation. This procedure was used by the writer before he had learned that Cerletti and Bini had advocated the use of electric stimulation to produce immediate convulsions as a substitute for metrazol. The fact that definite improvement was observed with the Faradic stimulation and sedation led the writer to believe that the use of fear and suggestion were likewise the paramount therapeutic factors of modern shock therapy. One should discriminate the fear and anxiety which are frequent symptoms in mental disorders from the fear and anxiety a patient usually shows as he anticipates the treatment as an imminent danger or as a punishment. The purpose of this paper is not to attempt to prove which form ofhock treatment i is best,t rabuher to demonstrate the similarity of the modus peranodi in all forms of shock therapies. PMID:17896462

Berkwitz, N J

1974-11-01

398

Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy  

PubMed Central

Introduction: Ankylosing spondylitis (AS) is an idiopathic chronic inflammatory disease that has prominent effects on the spine and peripheral joints. In addition, extraarticular manifestations such as enthesitis and acute anterior uveitis may be clinically important. In recent years, the therapy of AS has changed, largely due to the introduction of inhibitors of the proinflammatory cytokine tumor necrosis factor (TNF). Adalimumab, a human monoclonal antibody specifically for TNF, is the most recent of the TNF blocking agents that have been approved for the treatment of active, nonsteroidal antiinflammatory drug (NSAID)-refractory patients with AS. Aims: To evaluate the evidence for the therapeutic value of adalimumab in ankylosing spondylitis. Evidence review: There is clear evidence that adalimumab, administered 40 mg subcutaneously every 2 weeks, substantially improves the signs and symptoms of NSAID-refractory, active AS when compared with placebo treatment. There is ample evidence that adalimumab causes significant improvements in physical health status and overall AS-specific, health-related quality of life and physical functioning, which consequently leads to better work productivity. There is substantial evidence that adalimumab improves spinal and sacroiliac joint inflammation in AS patients. Initial results from clinical trials suggest that there is no increased risk of serious infections or malignancies in adalimumab-treated patients with AS. The most common adverse events were injection-site reactions. Limited economic evidence suggests that adalimumab 40 mg may be cost effective when used according to current valid treatment guidelines. Place in therapy: Adalimumab is an effective treatment for patients with active AS. PMID:21221193

Hennigan, Stephanie; Ackermann, Christoph; Kavanaugh, Arthur

2007-01-01

399

The efficacy of calcitriol therapy in the management of bone loss and fractures: a qualitative review  

PubMed Central

Summary Osteoporosis, a skeletal disorder characterized by a reduction in bone strength, increases fracture risk. Primary osteoporosis is usually a result of reduced bone mineral density as a consequence of natural aging. Secondary osteoporosis is usually a result of a disease, such as cystic fibrosis, or medical treatment, such as corticosteroids or cancer treatment. Introduction Currently, ten million Americans are osteoporotic and an additional 34 million have the precursor condition, osteopenia. Osteoporosis leads to 1.5 million fractures and 500,000 hospitalizations annually. Osteoporosis-related fractures increase mortality and reduce quality of life. Calcitriol, the active form of vitamin D, regulates intestinal calcium absorption, among other actions. During the past four decades, many clinical trials investigating the effect of calcitriol on bone loss have been performed. Methods We conducted a systematic qualitative review of clinical trials that assessed calcitriol for the treatment of osteoporosis and bone loss. In these clinical trials, calcitriol was used as a monotherapy and in combination with other therapeutic bone agents. Results and conclusion Studies using calcitriol monotherapy, although not conclusive, found that calcitriol slowed the rate of bone loss in a variety of populations. Calcitriol in combination with other therapeutic bone agents was shown to have additional bone-preserving effects when compared to the use of therapeutic bone agents alone. A common side-effect of calcitriol therapy was hypercalcemia and hypercalciuria, but the degree of hypercalcemia was mild. Recent research found that intermittent dosing can reduce hypercalcemia rates. Calcitriol, alone or in combination with other agents, should be considered for the therapy of osteoporosis. PMID:19960185

Hebl, S.; Purnell, J. Q.; Reid, M. E.; Rosier, R. N.; Mustian, K. M.; Palesh, O. G.; Huston, A. J.; Ling, M. N.; Morrow, G. R.

2010-01-01

400

A review on the clinical implementation of respiratory-gated radiation therapy.  

PubMed

Respiratory-gated treatment techniques have been introduced into the radiation oncology practice to manage target or organ motions. This paper will review the implementation of this type of gated treatment technique where the respiratory cycle is determined using an external marker. The external marker device is placed on the abdominal region between the xyphoid process and the umbilicus of the patient. An infrared camera tracks the motion of the marker to generate a surrogate for the respiratory cycle. The relationship, if any, between the respiratory cycle and the movement of the target can be complex. The four-dimensional computed tomography (4DCT) scanner is used to identify this motion for those patients that meet three requirements for the successful implementation of respiratory-gated treatment technique for radiation therapy. These requirements are (a) the respiratory cycle must be periodic and maintained during treatment, (b) the movement of the target must be related to the respiratory cycle, and (c) the gating window can be set sufficiently large to minimise the overall treatment time or increase the duty cycle and yet small enough to be within the gate. If the respiratory-gated treatment technique is employed, the end-expiration image set is typically used for treatment planning purposes because this image set represents the phase of the respiratory cycle where the anatomical movement is often the least for the longest time. Contouring should account for tumour residual motion, setup uncertainty, and also allow for deviation from the expected respiratory cycle during treatment. Respiratory-gated intensity-modulated radiation therapy (IMRT) treatment plans must also be validated prior to treatment. Quality assurance should be performed to check for positional changes and the output in association with the motion-gated technique. To avoid potential treatment errors, radiation therapist (radiographer) should be regularly in-serviced and made aware of the need to invoke the gating feature when prescribed for selected patients. PMID:21614265

Saw, C B; Brandner, E; Selvaraj, R; Chen, H; Saiful Huq, M; Heron, D E

2007-01-01

401

Comparative Effectiveness of Therapies for Graves' Hyperthyroidism: A Systematic Review and Network Meta-Analysis  

PubMed Central

Context: Several treatment options are available for Graves' disease (GD), including antithyroid drugs (ATDs), radioactive iodine (RAI), and thyroidectomy. Objective: The primary outcome was to determine the relapse rates of various treatment options. The secondary outcome was to present data regarding adverse effects of ATDs. Data Sources: We searched multiple databases through March 2012. Study Selection: Eligible studies were randomized clinical trials and comparative cohort studies in adults that included 2 or more treatment options for GD. Data Extraction: Two reviewers independently selected studies, appraised study quality, extracted outcome data, and determined adverse effect profiles. Data Synthesis: We found 8 studies with 1402 patients from 5 continents. Mean follow-up duration in months was: ATDs, 57; RAI, 64; and surgery, 59. Studies were at moderate to high risk of bias. Network meta-analysis suggested higher relapse rates with ATDs (52.7%; 352 of 667) than RAI (15%, 46 of 304) (odds ratio = 6.25; 95% confidence interval, 2.40–16.67) and with ATDs than surgery (10%; 39 of 387) (odds ratio = 9.09; 95% confidence interval, 4.65–19.23). There was no significant difference in relapse between RAI and surgery. Examination of 31 cohort studies identified adverse effects of ATDs in 692 of 5136 (13%) patients. These were more common with methimazole, mainly owing to dermatological complications, whereas hepatic effects were more common with propylthiouracil use. Conclusion: We confirm the relatively high relapse rate of ATD therapy in comparison with RAI or surgery, along with a significant side effect profile for these drugs. These data can inform discussion between physicians and patients regarding the choice of therapy for GD. The limited quality of the evidence in the literature underlines the need for future randomized clinical trials in this area. PMID:23824415

Sundaresh, Vishnu; Brito, Juan P.; Wang, Zhen; Prokop, Larry J.; Stan, Marius N.; Murad, Mohammad H.

2013-01-01

402

Extracorporeal shock wave therapy as an adjunct wound treatment: a systematic review of the literature.  

PubMed

Standard care procedures for complex wounds are sometimes supported and reinforced by physical treatment modalities such as extracorporeal shock wave therapy (ESWT). To evaluate available evidence of ESWT effectiveness in humans, a systematic review of the literature was conducted using MEDLINE, PubMed, Scopus, EBSCOhost, and PEDro databases. Of the 393 articles found, 13 met the publication date (year 2000-2013), study type (clinical study), language (English only), and abstract availability (yes) criteria. The 13 studies (n = 919 patients with wounds of varying etiologies) included seven randomized controlled trials that were evaluated using Cochrane Collaboration Group standards. Only studies with randomization, well prepared inclusion/exclusion criteria protocol, written in English, and full version available were analyzed. An additional six publications reporting results of other clinical studies including a total of 523patients were identified and summarized. ESWT was most commonly applied once or twice a week using used low or medium energy, focused or defocused generator heads (energy range 0.03 to 0.25 mJ/mm2; usually 0.1 mJ/mm2), and electrohydraulic or electromagnetic sources. Few safety concerns were reported, and in the controlled clinical studies statistically significant differences in rates of wound closure were reported compared to a variety of standard topical treatment modalities, sham ESWT treatment, and hyperbaric oxygen therapy. Based on this analysis, ESWT can be characterized as noninvasive, mostly painless, and safe. Controlled, randomized, multicenter, blind clinical trials still are required to evaluate the efficacy and cost-effectiveness of ESWT compared to sham control, other adjunctive treatments, and commonly used moisture-retentive dressings. In the future, ESWT may play an important role in wound care once evidence-based practice guidelines are developed. PMID:25019247

Dymarek, Robert; Halski, Tomasz; Ptaszkowski, Kuba; Slupska, Lucyna; Rosinczuk, Joanna; Taradaj, Jakub

2014-07-01

403

REVIEWS OF TOPICAL PROBLEMS: Ultrahigh-energy neutrinos from astrophysical sources and superheavy particle decays  

NASA Astrophysics Data System (ADS)

Problems in the fields of neutrino astronomy and ultrahigh-energy astrophysics are reviewed. Neutrino fluxes produced in various astrophysical sources (bottom-up acceleration scenarios) and resulting from the decay of superheavy particles (top-down scenarios) are considered. Neutrino oscillation processes and the absorption and regeneration of neutrinos inside the earth are analyzed and some other factors affecting the intensity and flavor composition of astrophysical neutrino fluxes are discussed. Details of ultrahigh-energy neutrino interactions are discussed within the Standard Model, as well as using nonstandard scenarios predicting an anomalous increase in the inelastic neutrino-nucleon cross section. Ultrahigh-energy neutrino detection techniques currently in use in new-generation neutrino telescopes and cosmic ray detectors are also discussed.

Ryabov, Vladimir A.

2006-09-01

404

A review of exenatide as adjunctive therapy in patients with type 2 diabetes  

PubMed Central

Background Incretin glucagon-like peptide-1 (GLP-1) is a hormone released from cells in the gastrointestinal tract (GI), leading to glucose-dependent insulin release from the pancreas. It also suppresses postprandial hyperglycemia, glucagon secretion and slows gastric emptying. Exenatide (EXE), a functional analog of human GLP-1, was approved by the US FDA in April 2005. Objective This article reviews current primary literature on the clinical efficacy and safety of EXE in the treatment of type 2 diabetes mellitus (DM) and describes the pharmacokinetics, pharmacodynamics, dosing and administration of EXE. Methods English-language articles were identified through a search of MEDLINE (1966 to March 2009), International Pharmaceutical Abstracts (1970 to present), and Cochrane Database of Systemic Reviews (1995 to March 2009). Search terms included EXE, diabetes mellitus, postprandial hyperglycemia, gastric emptying, glucagon, pharmacokinetics and pharmacodynamics. Articles were selected for review if their designs were randomized, blinded and of controlled design that focused on clinical outcomes of patients with type 2 DM. Results EXE is administered subcutaneously in the thigh, abdomen or upper arm within the 60-minute period before the morning and evening meals. Its Cmax is reached within 2.1 hours, and its T1/2 in 2.4 hours. EXE’s metabolism is primarily through the kidneys. For the patients who received EXE 10 ?