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Sample records for alternative medical treatment

  1. Endometriosis: alternative methods of medical treatment

    PubMed Central

    Muñoz-Hernando, Leticia; Muñoz-Gonzalez, Jose L; Marqueta-Marques, Laura; Alvarez-Conejo, Carmen; Tejerizo-García, Álvaro; Lopez-Gonzalez, Gregorio; Villegas-Muñoz, Emilia; Martin-Jimenez, Angel; Jiménez-López, Jesús S

    2015-01-01

    Endometriosis is an inflammatory estrogen-dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. The main purpose of endometriosis management is alleviating pain associated to the disease. This can be achieved surgically or medically, although in most women a combination of both treatments is required. Long-term medical treatment is usually needed in most women. Unfortunately, in most cases, pain symptoms recur between 6 months and 12 months once treatment is stopped. The authors conducted a literature search for English original articles, related to new medical treatments of endometriosis in humans, including articles published in PubMed, Medline, and the Cochrane Library. Keywords included “endometriosis” matched with “medical treatment”, “new treatment”, “GnRH antagonists”, “Aromatase inhibitors”, “selective progesterone receptor modulators”, “anti-TNF α”, and “anti-angiogenic factors”. Hormonal treatments currently available are effective in the relief of pain associated to endometriosis. Among new hormonal drugs, association to aromatase inhibitors could be effective in the treatment of women who do not respond to conventional therapies. GnRH antagonists are expected to be as effective as GnRH agonists, but with easier administration (oral). There is a need to find effective treatments that do not block the ovarian function. For this purpose, antiangiogenic factors could be important components of endometriosis therapy in the future. Upcoming researches and controlled clinical trials should focus on these drugs. PMID:26089705

  2. Review of complementary and alternative medical treatment of arrhythmias.

    PubMed

    Brenyo, Andrew; Aktas, Mehmet K

    2014-03-01

    Complementary and alternative medical (CAM) therapies are commonly used by patients for the treatment of medical conditions spanning the full spectrum of severity and chronicity. The use of alternative remedies, both herbal and others, for conditions lacking effective medical treatment, is on the increase. Included within this categorization, arrhythmic disease-absent effective catheter-based therapy or with medical therapy limited by the toxicities of contemporary antiarrhythmic agents is frequently managed by patients with CAM therapies without their practitioner's knowledge and in the face of potential herb-drug toxicities. This study reviews 9 CAM therapies: 7 individual herbal therapies along with acupuncture and yoga that have been studied and reported as having an antiarrhythmic effect. The primary focuses are the proposed antiarrhythmic mechanism of each CAM agent along with interactions between the CAM therapies and commonly prescribed medical therapy for arrhythmia patients. We stress persistent vigilance on the part of the provider in discussing the use of herbal or other CAM agents within the arrhythmia population.

  3. Alternative Treatments

    MedlinePlus

    ... drug is not required by law for the marketing of dietary supplements or "medical foods." Caprylic acid ... drug is not required by law for the marketing of dietary supplements. The maker of a dietary ...

  4. Implications of the Emergency Medical Treatment and Labor Act (EMTALA) during public health emergencies and on alternate sites of care.

    PubMed

    Roszak, Andrew R; Jensen, Frances R; Wild, Richard E; Yeskey, Kevin; Handrigan, Michael T

    2009-12-01

    Hospitals throughout the country are using innovative strategies to accommodate the surge of patients brought on by the novel H1N1 virus. One strategy has been to help decompress the amount of patients seeking care within emergency departments by using alternate sites of care, such as tents, parking lots, and community centers as triage, staging, and screening areas. As at any other time an individual presents on hospital property, hospitals and providers must be mindful of the requirements of the Emergency Medical Treatment and Labor Act. In this article we review the act and its implications during public health emergencies, with a particular focus on its implications on alternative sites of care.

  5. Alternative disinfectant water treatments

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Alternative disinfestant water treatments are disinfestants not as commonly used by the horticultural industry. Chlorine products that produce hypochlorous acid are the main disinfestants used for treating irrigation water. Chlorine dioxide will be the primary disinfestant discussed as an alternativ...

  6. Complementary and alternative medical therapies for chronic low back pain: What treatments are patients willing to try?

    PubMed Central

    Sherman, Karen J; Cherkin, Daniel C; Connelly, Maureen T; Erro, Janet; Savetsky, Jacqueline B; Davis, Roger B; Eisenberg, David M

    2004-01-01

    Background Although back pain is the most common reason patients use complementary and alternative medical (CAM) therapies, little is known about the willingness of primary care back pain patients to try these therapies. As part of an effort to refine recruitment strategies for clinical trials, we sought to determine if back pain patients are willing to try acupuncture, chiropractic, massage, meditation, and t'ai chi and to learn about their knowledge of, experience with, and perceptions about each of these therapies. Methods We identified English-speaking patients with diagnoses consistent with chronic low back pain using automated visit data from one health care organization in Boston and another in Seattle. We were able to confirm the eligibility status (i.e., current low back pain that had lasted at least 3 months) of 70% of the patients with such diagnoses and all eligible respondents were interviewed. Results Except for chiropractic, knowledge about these therapies was low. Chiropractic and massage had been used by the largest fractions of respondents (54% and 38%, respectively), mostly for back pain (45% and 24%, respectively). Among prior users of specific CAM therapies for back pain, massage was rated most helpful. Users of chiropractic reported treatment-related "significant discomfort, pain or harm" more often (23%) than users of other therapies (5–16%). Respondents expected massage would be most helpful (median of 7 on a 0 to 10 scale) and meditation least helpful (median of 3) in relieving their current pain. Most respondents indicated they would be "very likely" to try acupuncture, massage, or chiropractic for their back pain if they did not have to pay out of pocket and their physician thought it was a reasonable treatment option. Conclusions Most patients with chronic back pain in our sample were interested in trying therapeutic options that lie outside the conventional medical spectrum. This highlights the need for additional studies evaluating

  7. Alternative approaches to epilepsy treatment.

    PubMed

    McElroy-Cox, Caitlin

    2009-07-01

    Complementary and alternative medicine (CAM) is a diverse group of health care practices and products that fall outside the realm of traditional Western medical theory and practice and that are used to complement or replace conventional medical therapies. The use of CAM has increased over the past two decades, and surveys have shown that up to 44% of patients with epilepsy are using some form of CAM treatment. This article reviews the CAM modalities of meditation, yoga, relaxation techniques, biofeedback, nutritional and herbal supplements, dietary measures, chiropractic care, acupuncture, Reiki, and homeopathy and what is known about their potential efficacy in patients with epilepsy.

  8. Medical Treatments for Fibroids

    MedlinePlus

    ... NICHD Research Information Clinical Trials Resources and Publications Medical Treatments for Fibroids Skip sharing on social media ... Page Content Your health care provider may suggest medical treatments to reduce the symptoms of fibroids or ...

  9. Listening Clearly: Alternative Treatments for Adolescent Depression

    ERIC Educational Resources Information Center

    McGlasson, Terry D.

    2012-01-01

    For many years now, Cognitive Behavioral Therapy and anti-depressant medications have been the primary treatments for adolescent depression. However, there are many youth today with mild to moderate depressive symptoms for whom these treatments are not necessary. This article briefly summarizes several alternative therapeutic approaches for…

  10. Demographic Characteristics and Medical Service Use of Failed Back Surgery Syndrome Patients at an Integrated Treatment Hospital Focusing on Complementary and Alternative Medicine: A Retrospective Review of Electronic Medical Records

    PubMed Central

    Chi, Eun Hya; Lee, Jinho; Shin, Joon-Shik; Ha, In-Hyuk

    2014-01-01

    Objective. To report the patient demographics and nonsurgical complementary and alternative medicine treatment used at a Korean medicine hospital for low back pain (LBP) and/or sciatica after surgery. Methods. Medical records of patients who visited a spine-specialized Korean medicine hospital at 2 separate sites for continuous or recurrent LBP or sciatica following back surgery were reviewed. The demographics, MRI and/or CT scans, and treatments were assessed. Results. Of the total 707 patients, 62% were male and the average age was 50.20 years. Ninety percent of patients presented with LBP and 67% with sciatica. Eighty-four percent were diagnosed with herniated nucleus pulposus at time of surgery. Of these patients, 70% had pain recurrence 6 months or later, but 19% experienced no relief or immediate aggravation of pain after surgery. Many patients selected traditional Korean medicine treatment as primary means of postsurgery care (47%). When time to pain recurrence was short or pain persisted after surgery, return of symptoms at the same disc level and side was frequent. Conclusion. An integrative treatment model focusing on Korean medicine and used in conjunction with radiological diagnostics and conventional medicine is currently used as a treatment option for patients with pain after lumbar spine surgery. PMID:25530787

  11. Medical treatment of hirsutism.

    PubMed

    Blume-Peytavi, Ulrike; Hahn, Susanne

    2008-01-01

    Hirsutism is usually the result of an underlying adrenal, ovarian, or central endocrine abnormality mainly due to polycystic ovary syndrome but may also be idiopathic or drug induced. The aim of medical treatment of hirsutism is to rectify any causal hormonal balance, slow down or stop excessive hair growth, and improve the aesthetic appearance of hirsutism, thereby positively affecting the patient's quality of life. Today, for the majority of women, a monotherapy with oral contraceptives that have antiandrogenic activity is recommended as a first-line treatment for hirsutism. Combining an oral contraceptive pill with an antiandrogen is recommended if clinical improvement of hirsutism is insufficient after 6-9 months' monotherapy. In women who present with hirsutism, hyperandrogenism, and insulin resistance, insulin sensitizers are effective for the hirsutism as well as the hyperinsulinemia, hyperandrogenism, and infertility but there is no convincing evidence that they are effective for hirsutism alone. Topical eflornithine is a medical therapy that can be a useful adjuvant for hirsutism when used in conjunction with systemic medications or with laser/photoepilation.

  12. 'Medical ethics'--an alternative approach.

    PubMed

    Haldane, J J

    1986-09-01

    Contemporary medical ethics is generally concerned with the application of ethical theory to medico-moral dilemmas and with the critical analysis of the concepts of medicine. This paper presents an alternative programme: the development of a medical philosophy which, by taking as its starting point the two questions: what is man? and, what constitutes goodness in life? offers an account of health as one of the primary concepts of value. This view of the subject resembles that implied by ancient theories of goodness, and in later sections of the paper it is shown how Aristotle points us towards a coherent theory of human nature as psycho-physical, which overcomes the inadequacies of dualism and physicalist reductionism. What is on offer therefore, is the prospect of an integrated account of human nature and of what constitutes its flourishing: to be healthy is to be an active unity-of-parts in equilibrium.

  13. Necessary alternatives: patients’ views of asthma treatment

    PubMed Central

    Kopnina, Helen; Haafkens, Joke

    2010-01-01

    This article is based on semistructured interviews and focus groups conducted with 27 asthma patients in The Netherlands who chose complementary and alternative medicine (CAM) for treatment of their condition. All subjects were contacted through an online forum for asthma patients hosted by the Dutch Asthma Foundation. Nineteen subjects (12 women and seven men) between the ages of 29 and 65 years participated in the interviews, held between June 2009 and January 2010. All of the participating subjects had experience with conventional medications, including anti-inflammatory corticosteroids and bronchodilators. For the focus group meeting, held in February 2010, the sample included seven subjects (four women and three men) between the ages of 31 and 46 years, none of whom had ever used conventional medication and all of whom were using CAM. All subjects in the sample had been diagnosed with asthma by their physician or lung specialist. The study examined the causes of patient noncompliance with the prescribed medical regime. It is argued that evidence-based rationality on the part of subjects is an overlooked dimension of their experience of asthma. This study demonstrates the role that the patients’ social network, including medical practitioners, friends, and family, and other asthmatics, plays in the process of decision-making and choices about treating asthma. It also demonstrates the role of patients’ information-searching strategies. The author concludes that patient noncompliance with commonly prescribed medication and selection of alternative medical treatment is less a matter of denial of their diagnosis or the severity of their illness, but more a matter of choice informed by evidence-based rationality. PMID:20622919

  14. Alternatives in Medical Education: Non-Animal Methods.

    ERIC Educational Resources Information Center

    Carlson, Peggy, Ed.

    The technology explosion in medical education has led to the use of computer models, videotapes, interactive videos, and state-of-the-art simulators in medical training. This booklet describes alternatives to using animals in medical education. Although it is mainly intended to describe products applicable to medical school courses, high-quality,…

  15. Dosimetric feasibility of stereotactic body radiation therapy as an alternative to brachytherapy for definitive treatment of medically inoperable early stage endometrial cancer

    PubMed Central

    2014-01-01

    Purpose This study was designed to evaluate the dosimetric feasibility of definitive stereotactic body radiation therapy (SBRT) for the treatment of medically inoperable early stage endometrial cancer. Methods CT simulation scans from 10 medically inoperable early stage endometrial cancer patients previously treated with high dose-rate (HDR) intracavitary brachytherapy were used to generate Helical Tomotherapy (HT) plans using the IMRT mode with clinical target volumes (CTVs) that included the uterus plus cervix. A prescription dose of 34 Gy in 4 fractions was used. The SBRT dosimetry was compared to the 10 prior intracavitary brachytherapy plans normalized to a standard dose. Organs at risk (OARs) evaluated were the bladder, rectum, sigmoid, femoral heads, and other bowel, including both large and small bowel. The simulation CT and daily image guidance for 4 patients treated with this technique were evaluated to assess for interfraction variation in the uterine position and effects on dosimetry. Results Compared to intracavitary brachytherapy, HT SBRT produced significantly greater overall target coverage to the uterus, boost CTV, and PTV, with exception of the V150% of the uterus. HT SBRT significantly increased dose to the rectum, bowel, and femoral heads compared to intracavitary brachytherapy, though not outside of dose tolerance limits. Review of daily image guidance for patients treated with this technique demonstrated good reproducibility with a mean overlap index of 0.87 (range, 0.74 – 0.99). Conclusions Definitive SBRT for medically inoperable early stage endometrial cancer appears to be a feasible treatment option. Future studies are warranted to evaluate long-term clinical outcomes with this technique, compared to HDR intracavitary brachytherapy. PMID:25059785

  16. Medical Actinium Therapeutic Treatment

    ScienceCinema

    None

    2016-07-12

    Learn how INL researchers are increasing world supplies of Bismuth 213 to help with cancer treatments. For more information about INL research projects, visit http://www.facebook.com/idahonationallaboratory.

  17. Medical Actinium Therapeutic Treatment

    SciTech Connect

    2011-01-01

    Learn how INL researchers are increasing world supplies of Bismuth 213 to help with cancer treatments. For more information about INL research projects, visit http://www.facebook.com/idahonationallaboratory.

  18. Developing gender: The medical treatment of transgender young people.

    PubMed

    Castañeda, Claudia

    2015-10-01

    Situating the contemporary medical treatment of transgender young people--children and adolescents--in the longer history of engagement between transgender activists and the medical community, this article analyzes the World Professional Association for Transgender Health's (WPATH) Standards of Care (SOC) concerning the medical treatment of transgender young people. It traces how the SOC both achieves medical treatment for children and adolescents and reinforces a normative gender system by cleaving to a developmental approach. Without rejecting the value of developmentally-based medical treatment for now, it offers some preliminary thoughts on queer theory's valuation of developmental failure as a potential future alternative to an emergent medico-technological transgender normativity.

  19. Ear Infection Treatment: Do Alternative Therapies Work?

    MedlinePlus

    ... recommended for use in children — some have dangerous side effects or may interfere with conventional treatments. By Mayo Clinic Staff Alternative ear infection treatments abound on the internet and in books and magazines. They include chiropractic adjustments, homeopathy, herbal ...

  20. Medical expulsive treatment in pediatric urolithiasis.

    PubMed

    Atan, Ali; Balcı, Melih

    2015-03-01

    The frequency of stone disease in childhood ranges between 0.1-5 percent. Stone disease occurs as a result of enviromental, metabolic, anatomical, infectious and nutritional factors. Percutaneous nephrolitotomy, uretherorenoscopy, laparoscopic surgery, open surgery and extracorporeal shock wave lithothripsy are treatment alternatives for stone disease during childhood. However, these methods are not completely innocent. Some complications may occur after these procedures. These procedures are generally not cost- effective. Even invasive procedures have high success rates, so medical expulsive treatment modalities have become an alternative for a group of patients. Nonsteroidal anti- inflammatory drugs, antimuscarinic drugs, phospodiesterase type 5 inhibitors, steroids, calcium channel blockers and alpha blockers are treatment alterneatives used for this modality in the literature. The drug is chosen according to the location, size, and composition of the stone, recent technology, cost, surgeon's experience and surgeon's and the parents' preferences. In this review article the following topics will be discussed such as "Why medical expulsive treatment is needed during childhood? Which drug should be chosen for which stone type? How long should a treatment of urolithiasis last?

  1. [The teaching and application of alternative medicine in medical education programs].

    PubMed

    Chiang, Han-Sun

    2014-12-01

    The history of alternative medicine is perhaps as long as the history of human medicine. The development of evidence-based medicine has not annihilated alternative medicine. On the contrary, more people turn to alternative medicine because this approach to treatment serves as an effective remedial or supportive treatment when used in conjunction with evidence-based medicine. In contemporary healthcare, alternative medicine is now an essential part of integrated medicine. In Taiwan, most professional medical practitioners have not received proper education about alternative medicine and therefore generally lack comprehensive knowledge on this subject. While alternative medicine may be effective when used with some patients, it may also impart a placebo effect, which helps restore the body and soul of the patients. Medical staff with advanced knowledge of alternative medicine may not only help patients but also improve the doctor-patient relationship. There is great diversity in alternative medicine, with some alternative therapies supported by evidence and covered by insurance. However, there also remain fraudulent medical practices that may be harmful to health. Medical staff must be properly educated so that they can provide patients and their family a proper understanding and attitude toward alternative medicine. Therefore, alternative medicine should be included in the standard medical education curriculum. Offering classes on alternative medicine in university for more than 10 years, the author shares his experiences regarding potential content, lecture subjects, group experience exercises, and in-class activities. This article is intended to provide a reference to professors in university medical education and offer a possible model for alternative medicine education in Taiwan.

  2. The patenting of medical treatment.

    PubMed

    Loughlan, P L

    1995-04-03

    The Full Federal Court of Australia recently held, in a decisive break with long-established legal principle, that methods of medical treatment are patentable inventions. The judgment signals the advent of monopolies and therefore monopoly prices on new therapeutic procedures until now made freely available to the medical profession. It also heralds delays in the dissemination of information about discoveries of such procedures through teaching and publication until a patent application can be prepared for and made.

  3. Intention to Encourage Complementary and Alternative Medicine among General Practitioners and Medical Students

    ERIC Educational Resources Information Center

    Godin, Gaston; Beaulieu, Dominique; Touchette, Jean-Sebastien; Lambert, Leo-Daniel; Dodin, Sylvie

    2007-01-01

    The authors' goal was to identify factors explaining intention to encourage a patient to follow complementary and alternative medicine (CAM) treatment among general practitioners (GPs), fourth-year medical students, and residents in family medicine. They surveyed 500 GPs and 904 medical students via a self-administered mailed questionnaire that…

  4. Medical Countermeasure Product Development - Alternatives Paper

    DTIC Science & Technology

    2014-04-01

    Health Departments of Australia, Canada, the United Kingdom and the United States. The Consortium seeks to develop MedCM including drugs, vaccines...Australia, Canada, the United Kingdom and the United States. The Consortium seeks to develop MedCM including drugs, vaccines and diagnostics to assist...been very little incentive for the biotechnology /medical technology community to focus on MedCM product development. This was because the focus of

  5. Alternative Treatments for Ankylosing Spondylitis

    MedlinePlus

    Login/Register Site Feedback About Spondylitis Overview Types of Spondylitis For The Newly Diagnosed Could I Have Spondylitis? Treatment ... Vehicle Purchase from our Store Shop Cart Login Register About Spondylitis Overview Types of Spondylitis Ankylosing Spondylitis ...

  6. Statutory requirements for disclosure of breast cancer treatment alternatives.

    PubMed

    Nayfield, S G; Bongiovanni, G C; Alciati, M H; Fischer, R A; Bergner, L

    1994-08-17

    Therapeutic options for breast cancer, particularly for early-stage disease, and increased patient participation in medical decision-making have oriented state legislatures toward ensuring that women with breast cancer have adequate information about treatment alternatives. Currently, 18 states have enacted statutes regarding physician disclosure of treatment alternatives to breast cancer patients. This paper reviews these statutes in the context of the requirements imposed on the physician as health care provider and the content of medical information presented to the patient as a consequence of the laws. State statutes were identified through the National Cancer Institute's State Cancer Legislative Database, and the statutory requirements were analyzed. For statutes requiring development of a written summary of treatment alternatives, the most recent summary was obtained through the responsible state agency, and informational content was analyzed for relevance to treatment decisions in early-stage disease. As a group, these laws address informed consent for treatment, physician behavior within the patient-physician relationship, and the medical information upon which treatment decisions are based. Individual statutes vary in the scope of the issues addressed, particularly in the responsibility placed on physicians, and treatment option summaries developed in response to this legislation vary widely in content and scope. Despite broad implications of these statutes in oncology practice, little is known about their effects on breast cancer care. Additional research is needed to define the impact of these statutes on breast cancer care, as such legislation is considered by other states for this and other diseases.

  7. Compulsory Medical Treatment of Adults

    ERIC Educational Resources Information Center

    Riga, Peter J.

    1976-01-01

    The compulsory medical treatment of adults is discussed with regard to the legal authority relevant to the problem. Attention is directed toward the "right to die" issue, the public interest and individual freedom of conscious or religion, and the courts' dealing with the freedom of the individual to control his own body. (LBH)

  8. Alternative treatment of heartworm disease.

    PubMed

    Kato, G; Ross, J N

    1992-06-01

    Conventional adulticidal therapy may cause acute death due to embolism in major pulmonary arteries resulting in severe infarction of the lung. To avoid this problem removing a significant number of worms with flexible alligator forceps prior to adulticidal therapy is recommended. Before surgery, an accurate diagnosis and critical evaluation of the patient is mandated for proper choice and sequence of treatment.

  9. Alternative methods of ophthalmic treatment in Russia.

    PubMed

    Vader, L

    1994-04-01

    Russian ophthalmic nurses and physicians are using alternative methods of treatment to supplement traditional eye care. As acupuncture and iridology become more popular in the United States, ophthalmic nurses need to be more knowledgeable about these treatments and the implications for patients.

  10. Alternatives to Drug Treatment for Hyperactivity.

    ERIC Educational Resources Information Center

    Den Houtter, Kathryn

    1980-01-01

    Results from recent studies on the effectiveness of Ritalin for "hyperactivity" show that this treatment is dubious at best. This article presents an alternative treatment approach, placing emphasis on devising an appropriate learning situation that meets the needs of the so-called hyperactive child. (Author)

  11. Patients' self-treatment with alternative treatment before presenting to the ED.

    PubMed

    Zun, Leslie S; Gossman, William; Lilienstein, David; Downey, LaVonne

    2002-09-01

    This study examined the frequency of patients using alternative medicine to treat their condition before presenting to an emergency department (ED). This was a prospective randomized, consecutive survey conducted at a level I 24-bed inner-city trauma center. Patients were eligible for enrollment if they were at least 18 years old and able to consent. Exclusion criteria included patients delivered by an ambulance and patients unable or unwilling to consent. The questionnaire collected information about sociodemographic variables, alternative treatment used, why was it used, who prescribed the treatment, route, treatment satisfaction, and past history of alternative treatment and medication use. A total of 189 patients were surveyed. Of these, 10.6% of the surveyed patients used alternative treatment. The most common reason for using alternative medicine was "I wanted to try the simplest treatment first" (55%). These treatment options were self-prescribed by 55%, advice from a friend or family member by 40% and other health professional in 5%. The alternative medicines included massage (35%), home remedies (20%), prayer (20%), chiropractor (15%), herbal medicines (5%) and other methods (5%). The treatment was administered orally (20%) or topically (80%). Most said that the alternative therapy was helpful (60%). The use of alternative therapy versus no use of alternative therapy was correlated with gender (P =.05), treatment (P =.025) and how it was administered (P =.021). A small but significant number of inner-city patients use alternative treatments before presenting to an ED. Emergency physicians need to consider the use of alternative treatment and medicine by patients presenting to the ED for treatment.

  12. [Medical treatment of ureteral calculi].

    PubMed

    Vaessen, C; Roumeguere, T; Simon, J; Schulman, C

    1997-10-01

    Antiinflammatory drugs are the first choice in the treatment of the acute nephretic colic. This is due to their fast and direct action on the ureteral wall. The use of antispasmodics are still controversial and opioïds are not indicated. During the acute crisis, an hydric restriction should be associated to the medical treatment. After the crisis an increase of diuresis could help to "wash out" the stone. A spontaneous elimination can be expected, especially if the stone is small and located in the third part of the ureter. The ureteral rupture is rare but serious and must be treated by antibiotics and some time to be drained. The rapidity of a more aggressive treatment is function of numerous factors.

  13. Alternatives for sodium-potassium alloy treatment

    SciTech Connect

    Takacs, T.J.; Johnson, M.E.

    1993-04-08

    Sodium-potassium alloy (NaK) is currently treated at the Y-12 Plant by open burning. Due to uncertainties with future permits for this process alternative treatment methods were investigated, revealing that two treatment processes are feasible. One process reacts the NaK with water in a highly concentrated molten caustic solution (sodium and potassium hydroxide). The final waste is a caustic that may be used elsewhere in the plant. This process has two safety concerns: Hot corrosive materials used throughout the process present handling difficulties and the process must be carefully controlled (temperature and water content) to avoid explosive NaK reactions. To avoid these problems a second process was developed that dissolves NaK in a mixture of propylene glycol and water at room temperature. While this process is safer, it generates more waste than the caustic process. The waste may possibly be used as a carbon food source in biological waste treatment operations at the Y-12 Plant. Experiments were conducted to demonstrate both processes, and they showed that both processes are feasible alternatives for NaK treatment. Process flow sheets with mass balances were generated for both processes and compared. While the caustic process generates less waste, the propylene glycol process is safer in several ways (temperature, material handling, and reaction control). The authors recommend that the propylene glycol alternative be pursued further as an alternative for NaK treatment. To optimize this process for a larger scale several experiments should be conducted. The amount of NaK dissolved in propylene glycol and subsequent waste generated should be optimized. The offgas processes should be optimized. The viability of using this waste as a carbon food source at one of the Y-12 Plant treatment facilities should be investigated. If the state accepts this process as an alternative, design and construction of a pilot-scale treatment system should begin.

  14. Treatment Technology and Alternative Water Resources

    NASA Astrophysics Data System (ADS)

    Chapman, M. J.

    2014-12-01

    At this point in our settlement of the planet Earth, with over seven billion human inhabitants, there are very few unallocated sources of fresh water. We are turning slowly toward "alternatives" such as municipal and industrial wastewater, saline groundwater, the sea, irrigation return flow, and produced water that comes up with oil and gas deposits from deep beneath the surface of the earth. Slowly turning, not because of a lack in technological ability, but because it takes a large capital investment to acquire and treat these sources to a level at which they can be used. The regulatory system is not geared up for alternative sources and treatment processes. Permitting can be circular, contradictory, time consuming, and very expensive. The purpose for the water, or the value of the product obtained using the water, must be such that the capital and ongoing expense seem reasonable. There are so many technological solutions for recovering water quality that choosing the most reliable, economical, and environmentally sound technology involves unraveling the "best" weave of treatment processes from a tangled knot of alternatives. Aside from permitting issues, which are beyond the topic for this presentation, the "best" weave of processes will be composed of four strands specifically fitted to the local situation: energy, pretreatment, driving force for separation processes, and waste management. A range of treatment technologies will be examined in this presentation with a focus on how the quality of the feed water, available power sources, materials, and waste management opportunities aid in choosing the best weave of treatment technologies, and how innovative use of a wide variety of driving forces are increasing the efficiency of treatment processes.

  15. Osteoporosis Treatment: Medications Can Help

    MedlinePlus

    ... prescribed amount of medication Stopping the pills Two infusion medications — those that are injected directly into your ... some people to schedule a quarterly or yearly infusion than to remember to take a weekly or ...

  16. Medical and alternative therapies in urinary tract stone disease.

    PubMed

    Yuvanc, Ercan; Yilmaz, Erdal; Tuglu, Devrim; Batislam, Ertan

    2015-11-06

    Nephrolithiasis is a serious problem for both patients and the health system. Recurrence stands out as a significant problem in urinary system stone disease, the prevalence of which is increasing gradually. If recurrence is not prevented, patients may go through recurrent operations due to nephrolithiasis. While classical therapeutic options are available for all stone types, the number of randomized controlled studies and extensive meta-analyses focusing on their efficiency are inadequate. Various alternative therapeutic options to these medical therapies also stand out in recent years. The etiology of urolithiasis is multifactorial and not always related to nutritional factors. Nutrition therapy seems to be useful, either along with pharmacological therapy or as a monotherapy. General nutrition guidelines are useful in promoting public health and developing nutrition plans that reduce the risk or attenuate the effects of diseases affected by nutrition. Nutrition therapy involves the evaluation of a patient's nutritional state and intake, the diagnosis of nutrition risk factors, and the organization and application of a nutrition program. The main target is the reduction or prevention of calculus formation and growth via decreasing lithogenic risk factors and increasing lithogenic inhibitors in urine. This review focuses briefly on classical medical therapy, along with alternative options, related diets, and medical expulsive therapy.

  17. 28 CFR 549.43 - Involuntary psychiatric treatment and medication.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... treatment for the mental illness and less restrictive alternatives (e.g., seclusion or physical restraint... institution mental health division administrator shall appoint a staff representative. Witnesses should be called if they have information relevant to the inmate's mental condition and/or need for medication,...

  18. Medical vest broadens treatment capability

    NASA Technical Reports Server (NTRS)

    Johnson, G. S.

    1970-01-01

    Universal sized vest, with specially tailored pockets designed to hold medical supplies, provides first aid/first care medical teams with broadened on-site capability. Vest is made of nylon, tough fibrous materials, and polyvinyl chloride. Design facilitates rapid donning, doffing, and adjustment.

  19. Developments in alternative treatments for organophosphate poisoning.

    PubMed

    Iyer, Rupa; Iken, Brian; Leon, Alex

    2015-03-04

    Organophosphosphates (OPs) are highly effective acetylcholinesterase (AChE) inhibitors that are used worldwide as cheap, multi-purpose insecticides. OPs are also used as chemical weapons forming the active core of G-series and V-series chemical agents including tabun, sarin, soman, cyclosarin, VX, and their chemical analogs. Human exposure to any of these compounds leads to neurotoxic accumulation of the neurotransmitter acetylcholine, resulting in abnormal nerve function and multiple secondary health complications. Suicide from deliberate exposure to OPs is particularly prevalent in developing countries across the world and constitutes a major global health crisis. The prevalence and accessible nature of OP compounds within modern agricultural spheres and concern over their potential use in biochemical weapon attacks have incentivized both government agencies and medical researchers to enact stricter regulatory policies over their usage and to begin developing more proactive medical treatments in cases of OP poisoning. This review will discuss the research undertaken in recent years that has investigated new supplementary drug options for OP treatment and support therapy, including progress in the development of enzymatic prophylaxis.

  20. Treatment Alternatives to Negotiate Peri-Implantitis

    PubMed Central

    Machtei, Eli E.

    2014-01-01

    Peri-implant diseases are becoming a major health issue in dentistry. Despite the magnitude of this problem and the potential grave consequences, commonly acceptable treatment protocols are missing. Hence, the present paper reviews the literature treatment of peri-implantitis in order to explore their benefits and limitations. Treatment of peri-implantitis may include surgical and nonsurgical approaches, either individually or combined. Nonsurgical therapy is aimed at removing local irritants from the implants' surface with or without surface decontamination and possibly some additional adjunctive therapies agents or devices. Systemic antibiotics may also be incorporated. Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth. This can be done alone or in conjunction with either osseous respective approach or regenerative approach. Finally, if all fails, explantation might be the best alternative in order to arrest the destruction of the osseous structure around the implant, thus preserving whatever is left in this site for future reconstruction. The available literature is still lacking with large heterogeneity in the clinical response thus suggesting possible underlying predisposing conditions that are not all clear to us. Therefore, at present time treatment of peri-implantitis should be considered possible but not necessarily predictable. PMID:26556414

  1. Medication-free Alternatives for Long-term Maintenance of Bipolar Disorder: A Case Series

    PubMed Central

    Robinson, Cassandra L.

    2015-01-01

    Psychopharmacological treatment has been the mainstay in long-term maintenance of bipolar disorder (BD) patients for the last 60 years. Conventionally accepted treatment options are primarily based on expert opinion rather than on well-executed, independently funded research. Investigation of maintaining patients without medications using treatment alternatives has been neglected. This clinical case series examines the outcomes of 7 BD patients who experienced a poor response or significant side effects with conventional treatment modalities. Patients were gradually and safely withdrawn from all medications. Treatment strategies were based on an individualized holistic approach using herbs, nutritional supplements, vitamins, amino acids, acupuncture, dietary recommendations, and behavioral modifications. Multiple treatment modalities were combined addressing the etiological causes for BD symptoms. Upon withdrawal from psychotropic medications, patients were free of medication-induced side effects and obtained psychiatric stability for at least 10 months. Further research is needed to investigate the long-term outcomes of BD treatment modalities based on well-defined successful outcome criteria, such as reduction in symptoms, improvement in quality of life, overall health outcomes, and cost effectiveness. PMID:25984407

  2. Medication-free Alternatives for Long-term Maintenance of Bipolar Disorder: A Case Series.

    PubMed

    Gurevich, Michael I; Robinson, Cassandra L

    2015-03-01

    Psychopharmacological treatment has been the mainstay in long-term maintenance of bipolar disorder (BD) patients for the last 60 years. Conventionally accepted treatment options are primarily based on expert opinion rather than on well-executed, independently funded research. Investigation of maintaining patients without medications using treatment alternatives has been neglected. This clinical case series examines the outcomes of 7 BD patients who experienced a poor response or significant side effects with conventional treatment modalities. Patients were gradually and safely withdrawn from all medications. Treatment strategies were based on an individualized holistic approach using herbs, nutritional supplements, vitamins, amino acids, acupuncture, dietary recommendations, and behavioral modifications. Multiple treatment modalities were combined addressing the etiological causes for BD symptoms. Upon withdrawal from psychotropic medications, patients were free of medication-induced side effects and obtained psychiatric stability for at least 10 months. Further research is needed to investigate the long-term outcomes of BD treatment modalities based on well-defined successful outcome criteria, such as reduction in symptoms, improvement in quality of life, overall health outcomes, and cost effectiveness.

  3. Complementary and Alternative Medicine Education for Medical Profession: Systematic Review

    PubMed Central

    Quartey, Nana K.; Ma, Polly H. X.; Chung, Vincent C. H.; Griffiths, Sian M.

    2012-01-01

    Purpose. To help integrate traditional, complementary and alternative medicine (TCAM) into health systems, efforts are being made to educate biomedical doctors (BMD) and medical students on TCAM. We systematically evaluated the effect of TCAM education on BMD and medical students' attitude, knowledge, and behavior towards TCAM utilization and integration with biomedical medicine. Methods. Evaluative studies were identified from four databases. Methodological quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Study outcomes were classified using Kirkpatrick's hierarchy. Results. 3122 studies were identified and 12 studies of mediocre quality met inclusion criteria. Qualitative synthesis showed usage of diverse approaches including didactic, experiential learning, varying length, teacher background and intensity of exposure. More positive attitudes and improved knowledge after intervention were noted especially when teachers were BM trained. However, few studies assessed behavior change objectively. Finally, longer-term objective outcomes such as impact on patient care were not assessed. Conclusions. Lack of use of objective and reliable instruments preclude firm conclusion on the effect of TCAM education on study participants. However, positive changes, although mostly subjectively reported, were noted in most studies. Future evaluation should use validated or objective outcome assessments, and the value of using dual trained instructors. PMID:22619692

  4. Alternative headache treatments: nutraceuticals, behavioral and physical treatments.

    PubMed

    Sun-Edelstein, Christina; Mauskop, Alexander

    2011-03-01

    There is a growing body of evidence supporting the efficacy of various complementary and alternative medicine approaches in the management of headache disorders. These treatment modalities include nutraceutical, physical and behavioral therapies. Nutraceutical options comprise vitamins and supplements (magnesium, riboflavin, coenzyme Q(10), and alpha lipoic acid) and herbal preparations (feverfew, and butterbur). Although controversial, there are some reports demonstrating the benefit of recreational drugs such as marijuana, lysergic acid diethylamide and psilocybin in headache treatment. Behavioral treatments generally refer to cognitive behavioral therapy and biobehavioral training (biofeedback, relaxation training). Physical treatments in headache management are not as well defined but usually include acupuncture, oxygen therapy, transcutaneous electrical nerve stimulation, occlusal adjustment, cervical manipulation, physical therapy, massage, chiropractic therapy, and osteopathic manipulation. In this review, the available evidence for all these treatments will be discussed.

  5. The role of exercise and alternative treatments for low back pain.

    PubMed

    Carneiro, Kevin A; Rittenberg, Joshua D

    2010-11-01

    The determination of whether a patient should pursue an active or passive treatment program is often made by medical practitioners. Knowledge about all forms of treatment, including complementary and alternative (CAM) treatments, is essential in the treatment of low back pain. Medical practitioner-directed active treatments that have been shown to be effective for the treatment of low back pain include physical therapy-directed exercise programs such as core stabilization and mechanical diagnosis and therapy (MDT). Based on the current literature, it appears that yoga is the most effective nonphysician-directed active treatment approach to nonspecific low back pain when comparing other CAM treatments. Acupuncture is a medical practitioner-directed passive treatment that has been shown to be a good adjunct treatment. More randomized controlled studies are needed to support both CAM treatments and exercise in the treatment of low back pain.

  6. Exploring alternative treatments for Helicobacter pylori infection.

    PubMed

    Ayala, Guadalupe; Escobedo-Hinojosa, Wendy Itzel; de la Cruz-Herrera, Carlos Felipe; Romero, Irma

    2014-02-14

    Helicobacter pylori (H. pylori) is a successful pathogen that can persist in the stomach of an infected person for their entire life. It provokes chronic gastric inflammation that leads to the development of serious gastric diseases such as peptic ulcers, gastric cancer and Mucosa associated lymphoid tissue lymphoma. It is known that these ailments can be avoided if the infection by the bacteria can be prevented or eradicated. Currently, numerous antibiotic-based therapies are available. However, these therapies have several inherent problems, including the appearance of resistance to the antibiotics used and associated adverse effects, the risk of re-infection and the high cost of antibiotic therapy. The delay in developing a vaccine to prevent or eradicate the infection has furthered research into new therapeutic approaches. This review summarises the most relevant recent studies on vaccine development and new treatments using natural resources such as plants, probiotics and nutraceuticals. In addition, novel alternatives based on microorganisms, peptides, polysaccharides, and intragastric violet light irradiation are presented. Alternative therapies have not been effective in eradicating the bacteria but have been shown to maintain low bacterial levels. Nevertheless, some of them are useful in preventing the adverse effects of antibiotics, modulating the immune response, gastroprotection, and the general promotion of health. Therefore, those agents can be used as adjuvants of allopathic anti-H. pylori eradication therapy.

  7. Exploring alternative treatments for Helicobacter pylori infection

    PubMed Central

    Ayala, Guadalupe; Escobedo-Hinojosa, Wendy Itzel; de la Cruz-Herrera, Carlos Felipe; Romero, Irma

    2014-01-01

    Helicobacter pylori (H. pylori) is a successful pathogen that can persist in the stomach of an infected person for their entire life. It provokes chronic gastric inflammation that leads to the development of serious gastric diseases such as peptic ulcers, gastric cancer and Mucosa associated lymphoid tissue lymphoma. It is known that these ailments can be avoided if the infection by the bacteria can be prevented or eradicated. Currently, numerous antibiotic-based therapies are available. However, these therapies have several inherent problems, including the appearance of resistance to the antibiotics used and associated adverse effects, the risk of re-infection and the high cost of antibiotic therapy. The delay in developing a vaccine to prevent or eradicate the infection has furthered research into new therapeutic approaches. This review summarises the most relevant recent studies on vaccine development and new treatments using natural resources such as plants, probiotics and nutraceuticals. In addition, novel alternatives based on microorganisms, peptides, polysaccharides, and intragastric violet light irradiation are presented. Alternative therapies have not been effective in eradicating the bacteria but have been shown to maintain low bacterial levels. Nevertheless, some of them are useful in preventing the adverse effects of antibiotics, modulating the immune response, gastroprotection, and the general promotion of health. Therefore, those agents can be used as adjuvants of allopathic anti-H. pylori eradication therapy. PMID:24587621

  8. Complementary and alternative treatment of musculoskeletal pain.

    PubMed

    Grazio, Simeon; Balen, Diana

    2011-12-01

    The use of complementary and alternative medicine (CAM) is high and increasing worldwide. Patients usually use CAM in addition to conventional medicine, mainly to treat pain. In a large number of cases, people use CAM for chronic musculoskeletal pain as in osteoarthritis, back pain, neck pain, or fibromyalgia. Herewith, a review is presented of CAM efficacy in treating musculoskeletal pain for which, however, no scientific research has so far provided evidence solid enough. In some rare cases where adequate pain control cannot be achieved, CAM might be considered in rational and individual approach based on the first general rule in medicine "not to harm" and on the utility theory of each intervention, i.e. according to the presumed mechanism of painful stimulus and with close monitoring of the patient's response. Further high quality studies are warranted to elucidate the efficacy and side effects of CAM methods. Therefore, conventional medicine remains the main mode of treatment for patients with musculoskeletal painful conditions.

  9. The UMKC medical education experiment. An alternative pathway to physicianhood.

    PubMed

    Dimond, E G

    1988-08-19

    The UMKC plan for medical education offers an alternative pathway for motivated high achievers with early evidence of health care commitment. Essentially, such a program is an honors program for the academically elite. The UMKC plan makes a large, sustained effort to influence attitude. In our descriptive literature and in our curriculum content, we have emphasized that we seek health care talent at the earliest age possible and that we use these formative years to enhance, to influence, and to inculcate the qualities of compassion, sensitivity, honesty, integrity, dependability, and responsibility. The reason for early admission is to influence attitude. We hold to the national standards in terms of science and technology, and all graduates have been required to pass Parts I and II of the National Board of Medical Examiners examinations. The graduate of this program, using performance in the first postgraduate year as a measure, is comparable with the product of the traditional eight-year concept, with a dividend of two extra years of career time. The UMKC program is not for all students; it is not offered as a replacement for the traditional American system. However, a proper distribution of medical admissions spaces should be made that takes advantage of the high level of ability, commitment, and dedication already present in the best of our high school students. A program such as the UMKC plan offers the prospect of educating American physicians, fully prepared technically but especially concerned with the important attitudinal values sought by the American public. Ward Darley, MD, was a consultant and guide during the founding years of this medical school. In his words, "The UMKC program is aimed at humanizing medicine, lowering the cost per student for education, providing a pool of dedicated physicians educated broadly enough to provide community leadership for future changes in the function and structure of society." Dr Darley's anticipation that this six

  10. Medical treatment in carotid artery intervention.

    PubMed

    Kolkert, J L; Meerwaldt, R; Lefrandt, J D; Geelkerken, R H; Zeebregts, C J

    2011-12-01

    Medical treatment has a pivotal role in the treatment of patients with occlusive carotid artery disease. Large trials have provided the justification for operative treatment besides medical treatment in patients with recent significant carotid artery stenosis two decades ago. Since then, medical therapy has evolved tremendously. Next to aspirin, antiplatelet regimens acting on a different level in the modulation of platelet aggregation have made their entry. Moreover, statin therapy has been introduced. These changes among others in secondary stroke prevention, along with better understanding in life-style adjustments and perioperative medical management, have led to a decrease in stroke recurrence. Secondary prevention is therefore now the most important pillar of medical therapy. It consists of antiplatelet therapy, statins and blood pressure lowering agents in all patients. Small adjustments are recommended for those patients referred for invasive treatment. Moreover, long-term medical treatment is imperative. In this article, we summarize current evidence in literature regarding medical management in patients with previous stroke or TIA.

  11. The status of alternative treatment in cancer patients in Turkey.

    PubMed

    Isikhan, Vedat; Komurcu, Seref; Ozet, Ahmet; Arpaci, Fikret; Ozturk, Bekir; Balbay, Oner; Guner, Perihan

    2005-01-01

    This study was designed to measure the frequency at which Turkish patients with cancer resort to complementary and alternative medicine (CAM). A total of 704 patients referred to the Gülhane Military Medical Academy and Ankara Numune Training Hospital between September 2002 and January 2003 were asked about the CAM therapies they used. Of these, 276 patients (39.2%) had used CAM. Gender, marital status, educational status, age, financial status, severity of pain, history of cancer in the family, and their own ideas concerning CAM therapies were found to be correlated with the frequency of resorting to CAM. Resorting to CAM may lead to delayed diagnosis and treatment, adverse drug interactions, treatment withdrawal, and disease progression. Therefore, it is very important to inform patients about these potential dangers. Further studies are needed to clarify the reasons that lead patients to resort to CAM.

  12. What is the role of alternative treatments in late-life depression?

    PubMed

    Nyer, Maren; Doorley, James; Durham, Kelley; Yeung, Albert S; Freeman, Marlene P; Mischoulon, David

    2013-12-01

    Late-life depression remains challenging to treat. One major limitation to treatment is the concern over medication-related side effects to which the elderly are especially vulnerable. Also, because many elderly people are already taking multiple medications for medical conditions, there is the concern over drug-drug interactions. This article reviews various complementary and alternative medicine interventions for late-life depression, including natural remedies, exercise, yoga, tai chi, massage therapy, music therapy, and religion and spirituality.

  13. Noninvasive Medical Diagnostics & Treatment Using Ultrasonics

    NASA Technical Reports Server (NTRS)

    Bar-Cohen, Y.; Siegel, R.; Grandia, W.

    1998-01-01

    In parallel to the industrial application of NDE to flaw detection and material property determination, the medical community has succesfully adapted such methods to the noninvasaive diagnostics and treatment of many conditions and disorders of the human body.

  14. Knowledge and attitudes towards complementary and alternative medicine among medical students in Turkey

    PubMed Central

    2012-01-01

    Objective This study aims to examine knowledge and attitudes towards Complementary and Alternative Medicine among medical students in Turkey, and find out whether they want to be trained in Complementary and Alternative Medicine (CAM). Methods A cross-sectional study was carried out between October and December 2010 among medical students. Data were collected from a total of seven medical schools. Findings The study included 943 medical students. The most well known methods among the students were herbal treatment (81.2 %), acupuncture (80.8 %), hypnosis (78.8 %), body-based practices including massage (77 %) and meditation (65.2 %), respectively. Acupuncture, aromatherapy, herbal treatment and meditation were better known among female participants compared to males (p < 0.05). Females and first year students, generally had more positive attitudes. A larger proportion of female students compared to male students reported that a doctor should be knowledgeable about CAM (p = 0.001), and this knowledge would be helpful in their future professional lives (p = 0.015). Positive attitudes towards and willingness to receive training declined as the number of years spent in the faculty of medicine increased. Conclusions Majority of the medical students were familiar with the CAM methods widely used in Turkey, while most of them had positive attitudes towards CAM as well as willingness to receive training on the subject, and they were likely to recommend CAM methods to their patients in their future professional lives. With its gradual scientific development and increasing popularity, there appears a need for a coordinated policy in integrating CAM into the medical curriculum, by taking expectations of and feedback from medical students into consideration in setting educational standards. PMID:22862993

  15. Another Alternative: A Ninety-Day Contractual Detoxification Treatment Program

    ERIC Educational Resources Information Center

    Kahn, Robert B.; And Others

    1976-01-01

    In May, 1974, Fresno County's Narcotic Abuse Treatment Program began a twenty-one-day outpatient methadone detoxification treatment modality. The results of the evaluation suggested an alternative treatment modality. The purpose of this paper is to examine this alternative treatment modality, its characteristics, its therapeutic outcomes and the…

  16. Complementary and Alternative Medicine Treatment Options for Otitis Media

    PubMed Central

    Marom, Tal; Marchisio, Paola; Tamir, Sharon Ovnat; Torretta, Sara; Gavriel, Haim; Esposito, Susanna

    2016-01-01

    Abstract Otitis media (OM) has numerous presentations in children. Together with conventional medical therapies aimed to prevent and/or treat OM, a rising number of complementary and alternative medicine (CAM) treatment options can be offered. Since OM is common in children, parents may ask healthcare professionals about possible CAM therapies. Many physicians feel that their knowledge is limited regarding these therapies, and that they desire some information. Therefore, we conducted a literature review of CAM therapies for OM, taking into account that many of these treatments, their validity and efficacy and have not been scientifically demonstrated. We performed a search in MEDLINE (accessed via PubMed) using the following terms: “CAM” in conjunction with “OM” and “children. Retrieved publications regarding treatment of OM in children which included these terms included randomized controlled trials, prospective/retrospective studies, and case studies. The following CAM options for OM treatment in children were considered: acupuncture, homeopathy, herbal medicine/phytotherapy, osteopathy, chiropractic, xylitol, ear candling, vitamin D supplement, and systemic and topical probiotics. We reviewed each treatment and described the level of scientific evidence of the relevant publications. The therapeutic approaches commonly associated with CAM are usually conservative, and do not include drugs or surgery. Currently, CAM is not considered by physicians a potential treatment of OM, as there is limited supporting evidence. Further studies are warranted in order to evaluate the potential value of CAM therapies for OM. PMID:26871802

  17. Medical treatment for biochemical relapse after radiotherapy.

    PubMed

    Quero, L; Hennequin, C

    2014-10-01

    This article's purpose was to review the medical data justifying the use of a medical treatment for biochemical relapse after external beam radiotherapy. The MEDLINE database was searched to identify relevant information with the following medical subject headings: "prostate cancer", "radiotherapy" and "biochemical relapse". Prognostic factors affecting the overall survival of patients with a biochemical relapse after external beam radiotherapy have been identified: short prostate specific antigen (PSA)-doubling time (< 12 months), high PSA value (> 10 ng/mL) and short interval between treatment and biochemical relapse (< 18 months). If a second local treatment is not feasible, timing to initiate a salvage medical treatment is not defined. Particularly, randomized trials did not demonstrate a significant benefit of an early initiation of androgen deprivation treatment. Some retrospective studies suggest that an early androgen deprivation is justified if poor prognostic factors are found. However, if an androgen deprivation treatment is prescribed, intermittent schedule is non-inferior to a continuous administration and seems to offer a better quality of life. Many non-hormonal treatments have also been evaluated in this setting: only 5-alpha-reductase inhibitors could be proposed in some specific situations. In conclusion, the judicious use of a medical treatment for biochemical relapse is still debated. Given the natural history of this clinical situation, a simple surveillance is justified in many cases.

  18. Attitudes towards complementary and alternative medicine among medical and psychology students.

    PubMed

    Ditte, Darja; Schulz, Wolfgang; Ernst, Gundula; Schmid-Ott, Gerhard

    2011-03-01

    The use of complementary and alternative medicine (CAM) is increasing in Europe as well as in the USA, but CAM courses are infrequently integrated into medical curricula. In Europe, but also especially in the USA and in Canada, the attitudes of medical students and health science professionals in various disciplines towards CAM have been the subject of investigation. Most studies report positive attitudes. The main aim of this study was to compare the attitudes towards CAM of medical and psychology students in Germany. An additional set of questions concerned how CAM utilisation and emotional and physical condition affect CAM-related attitudes. Two hundred thirty-three medical students and 55 psychology students were questioned concerning their attitudes towards CAM using the Questionnaire on Attitudes Towards Complementary Medical Treatment (QACAM). Both medical students and psychology students were sceptical about the diagnostic and the therapeutic proficiency of doctors and practitioners of CAM. Students' attitudes towards CAM correlated neither with their experiences as CAM patients nor with their emotional and physical condition. It can be assumed that German medical and psychology students will be reluctant to use or recommend CAM in their professional careers. Further studies should examine more closely the correlation between attitudes towards CAM and the students' worldview as well as their existing knowledge of the effectiveness of CAM.

  19. [Medical treatment of prostate cancer].

    PubMed

    Lobel, B; Cipolla, B; Labrador, J

    1994-03-01

    Hormone dependence of prostate cancer is well known. In 80% of cases with metastases, hormone suppression leads to the reduction of tumour volume and related disorders. However the treatment is generally palliative because malignant process recurs after about around 16 months. Mean survival is less than 3 years in these forms. Lack of response come always together with a poor prognosis, and there is 90% mortality at 2 years. Advanced prostatic cancer should not be treated with hormones if the patient has few symptoms and his quality of life is satisfactory. Symptomatic forms require hormone manipulation. Orchidectomy or LH-RH are recommended. Total androgen ablation (combined treatment) leads rapidly to more relief of symptoms, but its drawbacks and especially high cost indicate that its use should be weighed individually. Estramustine is not a first-lune treatment. Presently, there is no criteria to predict response to treatment.

  20. Alternative/Complementary Approaches to Treatment of Children with Autism Spectrum Disorders.

    ERIC Educational Resources Information Center

    Levy, Susan E.; Hyman, Susan L.

    2002-01-01

    This article reviews common complementary or alternative medicine (CAM) treatments used to address symptoms of autistic spectrum disorders, including vitamin supplements, medications, antibiotics, antifungals, diet strategies, chelation/mercury detoxification, and nonbiologic treatments. Strategies that professionals may use in assessing the…

  1. Integrating complementary and alternative medicine into medical intern teaching: preliminary findings from an Australian Hospital.

    PubMed

    Pierantozzi, A M; Steel, A; Seleem, M

    2013-11-01

    Globally, the use of complementary and alternative medicine (CAM) as a component of healthcare is well documented [1]. In Australia, despite escalating use of CAM [2], inclusion within medical curriculum is poorly developed. This study reports findings from a pilot-study of medical interns which examined whether the delivery of a CAM education session had impacted on their attitude, perceived knowledge and subsequent clinical practice. The results indicate that the participants' attitudes towards CAM education were positive, with 92% of participants considering it important for inclusion in junior doctor education. Post-session, participants also reported an acquisition of knowledge in relation to common interactions between CAM and conventional medical treatments and indicated a positive impact on subsequent clinical practice, specifically noting increased awareness of CAM enquiry in clinical practice. Results of this pilot study indicate that CAM and junior doctor education may have a positive impact on improving patient safety and management.

  2. Diversity, the Individual, and Proof of Efficacy: Complementary and Alternative Medicine in Medical Education

    PubMed Central

    Park, Constance M.

    2002-01-01

    Patients will always have access to a variety of possibly effective, but unproved, therapies directed at maintaining health or treating illness. And there will always be complex, potentially therapeutic regimens that cannot be adequately tested for financial, ethical, or methodological reasons. Furthermore, even after adequate study of a given regimen, there will always be the fundamental uncertainty of medical practice: the fact that epidemiological research produces probabilistic results that cannot predict with certainty the best treatment for the single unique patient before us. The exploration of complementary and alternative medicine topics in the medical school curriculum helps to elucidate the complex and uncertain nature of medical practice, sharpens skills for clinical decisionmaking, increases cultural sensitivity, and provides ideas for future research. PMID:12356593

  3. Medical Treatment of Essential Tremor

    PubMed Central

    Rajput, Ali H; Rajput, Alex

    2014-01-01

    Essential tremor (ET) is the most common pathological tremor characterized by upper limb action—postural tremor (PT)/kinetic tremor (KT). There are no specific neuropathological or biochemical abnormalities in ET. The disability is consequent to amplitude of KT, which may remain mild without handicap or may become disabling. The most effective drugs for sustained tremor control are propranolol and primidone. Symptomatic drug treatment must be individualized depending on the circumstances that provoke the tremor-related disability. Broad guidelines for treatment are discussed in this review. Patients may be treated intermittently only on stressful occasions with propranolol, clonazepam, or primidone monotherapy, or an alcoholic drink. Those with persistently disabling tremor need continued treatment. PMID:24812533

  4. A Survey of Medical Students' Knowledge and Attitudes Toward Complementary and Alternative Medicine in Urmia, Iran.

    PubMed

    Sadeghi, Mahshid; Rabiepoor, Soheila; Forough, Aida Sefidani; Jabbari, Shiva; Shahabi, Shahram

    2016-10-01

    Personal beliefs of medical students may interfere with their tendency for learning Complementary and Alternative Medicine concepts. This study aimed to investigate the knowledge and attitudes of medical students toward complementary and alternative medicine in Urmia, Iran. A structured questionnaire was used as data collection instrument. One hundred questionnaires were returned. Thirty-one percent of students reported use of alternative medicine for at least once. Iranian Traditional Medicine was the main type of alternative medicine used by medical students (93.5%). Neuromuscular disorders were the main indication of alternative medicine use among students (34.4%). Ninety percent of participants demonstrated competent knowledge about acupuncture while the lowest scores belonged to homeopathy (12%). Study results showed that 49% of medical students had positive attitudes and demonstrated a willingness to receive training on the subject. Thus, there appears a necessity to integrate complementary and alternative medicine into the medical curriculum, by taking expectations and feedbacks of medical students into consideration.

  5. Controversial Medical Treatments of Learning Disabilities

    ERIC Educational Resources Information Center

    Sieben, Robert L.

    1977-01-01

    The author presents a critical review of popular medical treatments for children with learning disabilities, including dietary treatment (food additives theories, brain allergies, hypoglycemia, megavitamin therapy, and trace mineral tests) and neurophysiologic retraining (patterning, sensory integrative therapy, and optometric training). (IM)

  6. [Promoting "well-treatment" in medical imaging].

    PubMed

    Renouf, Nicole; Llop, Marc

    2012-12-01

    A project to promote "well-treatment" has been initiated in the medical imaging department of a Parisian hospital. With the aim of promoting the well-being of the patient and developing shared values of empathy and respect, the members of this medico-technical team have undertaken to build a culture of "well-treatment" which respects the patient's dignity and rights.

  7. 40 CFR 142.46 - Alternative treatment techniques.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Alternative treatment techniques. 142... Administrator Under Section 1415(a) of the Act § 142.46 Alternative treatment techniques. The Administrator may grant a variance from any treatment technique requirement of a national primary drinking...

  8. Medical Treatment of Ankylosing Spondylitis

    PubMed Central

    Kim, Young-Tae

    2014-01-01

    The diagnosis of ankylosing spondylitis is often delayed due to ambiguous clinical manifestations and strict diagnostic criteria. However, imaging techniques such as magnetic resonance imaging have been found effective for the early diagnosis of non-radiographic sacroiliitis. New tumor necrosis factor alpha (TNF-α) inhibitors have good efficacy for patients with persistently high disease activity despite conventional nonsteroidal anti-inflammatory drug treatment. Thus, early diagnosis and aggressive treatments are essential for ankylosing spondylitis patients. Because many patients complain of musculoskeletal pains, especially around the sacroiliac joint area, hip specialists should be informed of up-to-date knowledge. In this review, we discuss new diagnostic criteria for ankylosing spondylitis, administration methods of TNF-α inhibitors, and the long-term follow-up results for patients treated with TNF-α inhibitors. PMID:27536570

  9. Herbs, Supplements and Alternative Medicines

    MedlinePlus

    ... Living With Diabetes > Treatment and Care > Medication > Other Treatments > Herbs, Supplements, and Alternative Medicines Share: Print Page Text ... magazine: meds-other, In this section Medication Other Treatments Herbs, Supplements, and Alternative Medicines Types of Dietary Supplements ...

  10. Integrating Primary Medical Care With Addiction Treatment

    PubMed Central

    Weisner, Constance; Mertens, Jennifer; Parthasarathy, Sujaya; Moore, Charles; Lu, Yun

    2010-01-01

    Context The prevalence of medical disorders is high among substance abuse patients, yet medical services are seldom provided in coordination with substance abuse treatment. Objective To examine differences in treatment outcomes and costs between integrated and independent models of medical and substance abuse care as well as the effect of integrated care in a subgroup of patients with substance abuse–related medical conditions (SAMCs). Design Randomized controlled trial conducted between April 1997 and December 1998. Setting and Patients Adult men and women (n=592) who were admitted to a large health maintenance organization chemical dependency program in Sacramento, Calif. Interventions Patients were randomly assigned to receive treatment through an integrated model, in which primary health care was included within the addiction treatment program (n=285), or an independent treatment-as-usual model, in which primary care and substance abuse treatment were provided separately (n=307). Both programs were group based and lasted 8 weeks, with 10 months of aftercare available. Main Outcome Measures Abstinence outcomes, treatment utilization, and costs 6 months after randomization. Results Both groups showed improvement on all drug and alcohol measures. Overall, there were no differences in total abstinence rates between the integrated care and independent care groups (68% vs 63%, P=.18). For patients without SAMCs, there were also no differences in abstinence rates (integrated care, 66% vs independent care, 73%; P=.23) and there was a slight but nonsignificant trend of higher costs for the integrated care group ($367.96 vs $324.09, P=.19). However, patients with SAMCs (n=341) were more likely to be abstinent in the integrated care group than the independent care group (69% vs 55%, P=.006; odds ratio [OR], 1.90; 95% confidence interval [CI], 1.22-2.97). This was true for both those with medical (OR, 3.38; 95% CI, 1.68-6.80) and psychiatric (OR, 2.10; 95% CI, 1

  11. [Treatment of refractory medication overuse headache].

    PubMed

    Hamada, Junichi

    2011-11-01

    Medication overuse headache (MOH) is refractory headache with continuous and large amount use of drugs (analgesics, non-steroidal anti-inflammatory drugs, and triptans etc.) For treatment of MOH, overused drugs must be stopped as soon as possible. And preventive medication should be started at the same time. Also, the history of the patient's headache and social condition must be clarified. In some cases, replacement therapy with another medication must be considered. But, even in recent years, scientific research in high-evidence level cannot be achieved. We should make more clear animal models of MOH and the investigations with more basic study must be scheduled.

  12. Medical Treatment of Tattoo Complications.

    PubMed

    Serup, Jørgen

    2017-01-01

    Tattooing is a skin trauma and involves a special vulnus punctatum (with inserted tattoo ink, a vulnus venenatum), which should heal with no infection and no local complication. Local treatment in the healing phase ideally builds on the 'moist wound' principle using plastic film, hydrocolloids, silver dressing, and compression. Bacterial infections during healing are treated with oral antibiotics, and a list of first-line antibiotics is proposed. Notice is given to severe infections with affected general condition, and it is emphasized that intravenous antibiotic treatment must be instituted as early as possible to prevent septic shock and death. Hydrophilic antibiotics shall be given in high load and maintenance dose due to increased renal clearance of such antibiotics. Chronic allergic reactions of red tattoos respond little to local corticoids and are best treated with dermatome shaving. Laser removal is contraindicated due to the risk of photochemical activation of the allergy with anaphylaxis or worsening. Chronic reactions in black tattoos can be treated with local corticoids, dermatome shaving, and lasers as well. Systemic corticoid is used in allergic reactions in red tattoos and in cross-allergic reactions of other red tattoos as well as in black tattoo reactions associated with sarcoidosis and with cutaneous 'rush phenomenon' affecting any black tattoo. Systemic corticoid is also indicated in generalized eczema due to nickel allergy or another allergy challenged through tattooing or introduced by tattooing as a primary sensitization. The use of intralesional corticoid, antihistamines, and immunosuppressive medicines is discussed. A warning against the use of lactic acid and other caustic chemicals for tattoo removal is given, since such chemicals and commercial products cannot be dosed properly and very often result in disfiguring scarring.

  13. Medical treatment for pyometra in dogs.

    PubMed

    Fieni, F; Topie, E; Gogny, A

    2014-06-01

    Pyometra is a reproductive disorder very common in bitches over 8 years of age in which physiological effects of progesterone on the uterus play a major role. The traditional therapy for pyometra is ovariohysterectomy. The main advantage of ovariohysterectomy over medical management is that it is both curative and preventive for recurrence of pyometra. However, surgery is associated with the risk of anaesthesia and renders the bitch sterile. During the last 10 years, numerous medical treatments have been proposed to treat both open and closed cervix pyometra. The most effective medical treatment with minor side effects seems to be the repeated administration of aglepristone with or without the additional treatment with low doses of prostaglandins.

  14. Current medical treatment in pediatric urolithiasis

    PubMed Central

    Akın, Yiğit; Uçar, Murat; Yücel, Selçuk

    2013-01-01

    Although the prevalence of urolithiasis is nearly 2–3% in childhood, the risk of recurrence may range from 6.5–54%. There has been an increase in urinary stone disease among pediatric age groups, and stone disease has a multifactorial etiology. After the diagnosis, detailed metabolic evaluation is required. High recurrence rates, therapeutic irregularities and deficiency in diagnosis may lead to comorbidities such as loss of kidney function. Following diagnosis, the requirement for surgery, such as stone extraction and correction of anatomical anomalies, is determined. Medical and supportive treatments are also needed to prevent recurrence and urinary tract infections and to preserve renal function. Supportive care includes increased fluid intake and dietary modifications. Medical treatment is dependent on the cause of the urinary stone disease. The morbidities associated with pediatric urolithiasis can be prevented by early diagnosis, detailed metabolic analysis, regular follow-up and medical treatment protocols. PMID:26328120

  15. Complementary and alternative medical therapies for attention-deficit/hyperactivity disorder and autism.

    PubMed

    Weber, Wendy; Newmark, Sanford

    2007-12-01

    Complementary and alternative medical (CAM) therapies are commonly used by parents for their children who have attention deficit hyperactivity disorder (ADHD) or autism spectrum disorders. The use of these therapies is well documented, yet the evidence of the safety and efficacy of these treatments in children is limited. This article describes the current evidence-based CAM therapies for ADHD and autism, focusing on nutritional interventions; natural health products, including essential fatty acids, vitamins, minerals, and other health supplements; biofeedback; and reducing environmental toxins. The CAM evidence in ADHD is addressed, as is the CAM literature in autism.

  16. Complementary and Alternative Medicine (CAM) Treatments and Pediatric Psychopharmacology

    ERIC Educational Resources Information Center

    Rey, Joseph M.; Walter, Garry; Soh, Nerissa

    2008-01-01

    Children and adolescents often use complementary and alternative medicine (CAM) treatments outside their indications, particularly to lose weight. Some of the herbal remedies and dietary supplements that may of relevance for psychopharmacological practice are discussed with respect to CAM treatments.

  17. Alternative Treatment Technologies – Working With the Pathogen Equivalency Committee

    EPA Science Inventory

    Under current Federal regulations (40 CFR 503), municipal sludge must be treated prior to land application. The regulations identify two classes of treatment with respect to pathogen reduction: Class B (three alternatives) which provides a minimum acceptable level of treatment;...

  18. Complementary and alternative medicine for the treatment of multiple sclerosis

    PubMed Central

    Yadav, Vijayshree; Shinto, Lynne; Bourdette, Dennis

    2010-01-01

    Multiple sclerosis (MS) is a chronic disabling disease of the CNS that affects people during early adulthood. Despite several US FDA-approved medications, the treatment options in MS are limited. Many people with MS explore complementary and alternative medicine (CAM) treatments to help control their MS and treat their symptoms. Surveys suggest that up to 70% of people with MS have tried one or more CAM treatment for their MS. People with MS using CAM generally report deriving some benefit from the therapies. The CAM therapies most frequently used include diet, omega-3 fatty acids and antioxidants. There is very limited research evaluating the safety and effectiveness of CAM in MS. The most promising among CAM therapies that warrant further investigation are a low-fat diet, omega-3 fatty acids, lipoic acid and vitamin D supplementation as potential anti-inflammatory and neuroprotective agents in both relapsing and progressive forms of MS. There is very limited research evaluating the safety and effectiveness of CAM in MS. However, in recent years, the NIH and the National MS Society have been actively supporting the research in this very important area. PMID:20441425

  19. Complementary and Alternative Medicine Use in Musculoskeletal Disorders: Does Medical Skepticism Matter?

    PubMed Central

    Wiley-Exley, Elizabeth K; Mielenz, Thelma J; Norton, Edward C; Callahan, Leigh F

    2007-01-01

    Medical skepticism is the reservation about the ability of conventional medical care to significantly improve health. Individuals with musculoskeletal disorders seeing specialists usually experience higher levels of disability; therefore it is expected they might be more skeptical of current treatment and thus more likely to try Complementary and Alternative Medicine (CAM). The goal of this study was to define these relationships. These data were drawn from a cross-sectional survey from two cohorts: those seeing specialists (n=1,344) and non-specialists (n=724). Site-level fixed effects logistic regression models were used to test associations between medical skepticism and 10 CAM use categories. Some form of CAM was used by 88% of the sample. Increased skepticism was associated with one CAM category for the non-specialist group and six categories for the specialist group. Increased medical skepticism is associated with CAM use, but medical skepticism is more often associated with CAM use for those seeing specialists. PMID:19088894

  20. Expert consensus document: A consensus on the medical treatment of acromegaly.

    PubMed

    Giustina, Andrea; Chanson, Philippe; Kleinberg, David; Bronstein, Marcello D; Clemmons, David R; Klibanski, Anne; van der Lely, Aart J; Strasburger, Christian J; Lamberts, Steven W; Ho, Ken K Y; Casanueva, Felipe F; Melmed, Shlomo

    2014-04-01

    In March 2013, the Acromegaly Consensus Group met to revise and update guidelines for the medical treatment of acromegaly. The meeting comprised experts skilled in the medical management of acromegaly. The group considered treatment goals covering biochemical, clinical and tumour volume outcomes, and the place in guidelines of somatostatin receptor ligands, growth hormone receptor antagonists and dopamine agonists, and alternative modalities for treatment including combination therapy and novel treatments. This document represents the conclusions of the workshop consensus.

  1. Acceptability of alternative treatments for school refusal: evaluations by students, caregivers, and professionals.

    PubMed

    Gullone, E; King, N J

    1991-11-01

    School refusal is a debilitating condition that may be treated in various ways. This study examined the acceptability and perceived effectiveness of alternative treatments for school refusal. A total of 376 people comprising students, parents, and professionals, were required to evaluate several treatment options in relation to a vignette. Despite its potential aversiveness, behavioural management was the most acceptable treatment approach followed, in order, by home tuition with psychotherapy, hospitalisation, and medication. A strong positive relationship was found between acceptability and perceived effectiveness.

  2. Portable medical status and treatment system

    NASA Technical Reports Server (NTRS)

    1981-01-01

    A portable medical status and treatment system is discussed. The vital signs monitor includes electrocardiogram, respiration, temperature, blood pressure, alarm, and power subsystems, which are described. A DC defibrillator module, a radio module, and their packaging are also described. These subsystems were evaluated and the results and recommendations are presented.

  3. [Present situation of the genetic medical treatment].

    PubMed

    Kondoh, Tatsuro

    2002-12-01

    Medical treatment has been changing due to the recent and great progress in the molecule genetics. Gene tests are contained in the ordinary medical treatments. However, this progress in Japan has apparently thrown the general population into confusion, at least in part because of the lack of consent between inhabitants and clinicians/researchers. Some of the genetic diseases are difficult to be cured completely, although they can be diagnosed. Furthermore, genetic diseases spread the influences to other relations including their offspring. The preparation of the various genetic guidelines and the fulfillment of the genetic counseling are going to proceed to keep the human rights of the patients of the genetic diseases. A discussion of the bio-ethical problems has been developing at the same time. The necessity against the genetic service is increasing gradually. Genetic medical treatment may be a part of the genetic service. I report here the current status of "the genetic counseling and the genetic medical treatment" have been advanced in Nagasaki university hospital as an example. It is very important and expected that a proper genetic service is provided to the clients under the network of the specialists of the various fields.

  4. Assessing observational studies of medical treatments

    PubMed Central

    Hartz, Arthur; Bentler, Suzanne; Charlton, Mary; Lanska, Douglas; Butani, Yogita; Soomro, G Mustafa; Benson, Kjell

    2005-01-01

    Background Previous studies have assessed the validity of the observational study design by comparing results of studies using this design to results from randomized controlled trials. The present study examined design features of observational studies that could have influenced these comparisons. Methods To find at least 4 observational studies that evaluated the same treatment, we reviewed meta-analyses comparing observational studies and randomized controlled trials for the assessment of medical treatments. Details critical for interpretation of these studies were abstracted and analyzed qualitatively. Results Individual articles reviewed included 61 observational studies that assessed 10 treatment comparisons evaluated in two studies comparing randomized controlled trials and observational studies. The majority of studies did not report the following information: details of primary and ancillary treatments, outcome definitions, length of follow-up, inclusion/exclusion criteria, patient characteristics relevant to prognosis or treatment response, or assessment of possible confounding. When information was reported, variations in treatment specifics, outcome definition or confounding were identified as possible causes of differences between observational studies and randomized controlled trials, and of heterogeneity in observational studies. Conclusion Reporting of observational studies of medical treatments was often inadequate to compare study designs or allow other meaningful interpretation of results. All observational studies should report details of treatment, outcome assessment, patient characteristics, and confounding assessment. PMID:16137327

  5. Current Pharmaceutical Treatments and Alternative Therapies of Parkinson's Disease

    PubMed Central

    Dong, Jie; Cui, Yanhua; Li, Song; Le, Weidong

    2016-01-01

    Over the decades, pharmaceutical treatments, particularly dopaminergic (DAergic) drugs have been considered as the main therapy against motor symptoms of Parkinson's disease (PD). It is proposed that DAergic drugs in combination with other medications, such as monoamine oxidase type B inhibitors, catechol-O-methyl transferase inhibitors, anticholinergics and other newly developed non-DAergic drugs can make a better control of motor symptoms or alleviate levodopa-induced motor complications. Moreover, non-motor symptoms of PD, such as cognitive, neuropsychiatric, sleep, autonomic and sensory disturbances caused by intrinsic PD pathology or drug-induced side effects, are gaining increasing attention and urgently need to be taken care of due to their impact on quality of life. Currently, neuroprotective therapies have been investigated extensively in pre-clinical studies, and some of them have been subjected to clinical trials. Furthermore, non-pharmaceutical treatments, including deep brain stimulation (DBS), gene therapy, cell replacement therapy and some complementary managements, such as Tai chi, Yoga, traditional herbs and molecular targeted therapies have also been considered as effective alternative therapies to classical pharmaceutics. This review will provide us updated information regarding the current drugs and non-drugs therapies for PD. PMID:26585523

  6. Current Pharmaceutical Treatments and Alternative Therapies of Parkinson's Disease.

    PubMed

    Dong, Jie; Cui, Yanhua; Li, Song; Le, Weidong

    2016-01-01

    Over the decades, pharmaceutical treatments, particularly dopaminergic (DAergic) drugs have been considered as the main therapy against motor symptoms of Parkinson's disease (PD). It is proposed that DAergic drugs in combination with other medications, such as monoamine oxidase type B inhibitors, catechol-O-methyl transferase inhibitors, anticholinergics and other newly developed non-DAergic drugs can make a better control of motor symptoms or alleviate levodopa-induced motor complications. Moreover, non-motor symptoms of PD, such as cognitive, neuropsychiatric, sleep, autonomic and sensory disturbances caused by intrinsic PD pathology or drug-induced side effects, are gaining increasing attention and urgently need to be taken care of due to their impact on quality of life. Currently, neuroprotective therapies have been investigated extensively in pre-clinical studies, and some of them have been subjected to clinical trials. Furthermore, non-pharmaceutical treatments, including deep brain stimulation (DBS), gene therapy, cell replacement therapy and some complementary managements, such as Tai chi, Yoga, traditional herbs and molecular targeted therapies have also been considered as effective alternative therapies to classical pharmaceutics. This review will provide us updated information regarding the current drugs and non-drugs therapies for PD.

  7. Medical education and cognitive continuum theory: an alternative perspective on medical problem solving and clinical reasoning.

    PubMed

    Custers, Eugène J F M

    2013-08-01

    Recently, human reasoning, problem solving, and decision making have been viewed as products of two separate systems: "System 1," the unconscious, intuitive, or nonanalytic system, and "System 2," the conscious, analytic, or reflective system. This view has penetrated the medical education literature, yet the idea of two independent dichotomous cognitive systems is not entirely without problems.This article outlines the difficulties of this "two-system view" and presents an alternative, developed by K.R. Hammond and colleagues, called cognitive continuum theory (CCT). CCT is featured by three key assumptions. First, human reasoning, problem solving, and decision making can be arranged on a cognitive continuum, with pure intuition at one end, pure analysis at the other, and a large middle ground called "quasirationality." Second, the nature and requirements of the cognitive task, as perceived by the person performing the task, determine to a large extent whether a task will be approached more intuitively or more analytically. Third, for optimal task performance, this approach needs to match the cognitive properties and requirements of the task. Finally, the author makes a case that CCT is better able than a two-system view to describe medical problem solving and clinical reasoning and that it provides clear clues for how to organize training in clinical reasoning.

  8. ALTERNATIVE DISINFECTION FOR DRINKING WATER TREATMENT

    EPA Science Inventory

    During a one-yr study at Jefferson Parish, La., the chemical, microbiological, and mutagenic effects os using the major drinkgin water disinfectants (chlorine, chlorine dioxide, chloramine, ozone) were evaluated. Tests were performed on samples collected from various treatment s...

  9. Extracts from fruits of saw palmetto (Sabal serrulata) and roots of stinging nettle (Urtica dioica): viable alternatives in the medical treatment of benign prostatic hyperplasia and associated lower urinary tracts symptoms.

    PubMed

    Koch, E

    2001-08-01

    Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) are very common disorders in aging men. Despite the great clinical importance, many aspects of their aetiology remain uncertain although it is generally accepted that advanced age and testicular androgens are important requirements for the development of these complaints. The currently available therapeutic options include watchful waiting, changes of life style, medical treatments and invasive therapies. In many European countries the use of phytopharmaceuticals for the management of BPH and related LUTS is common and these products represent up to 80 % of all drugs prescribed for this disorder. In particularly, extracts from the fruits of saw palmetto (Sabal serrulata, syn. Serenoa repens) and the roots of stinging nettle (Urtica dioica) are popular. During the last years numerous papers have been published which elaborated on the pharmacological activities and the clinical assessment of these herbal remedies. These investigations have not only broadened the scientific basis for the rational use of phytotherapeutics but have also provided evidence for their therapeutic efficacy and favourable safety profile.

  10. Complementary and alternative medical therapies for interstitial cystitis: an update from the United States

    PubMed Central

    Atchley, Megan Danielle; Shah, Nima M.

    2015-01-01

    The diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) has shifted from organ-specific to a multifactorial, multidisciplinary and individualized approach. Patients with refractory and debilitating symptoms may respond to complementary and alternative medical treatments (CAM). Through CAM therapies, practitioners assist the patient to be at the center of their care, empowering them to be emotionally and physically involved. Multi-disciplinary care, including urology, gynecology, gastroenterology, neurology, psychology, physiotherapy and pain medicine, is also identified to be the crux of adequate management of patients with chronic pelvic pain because of its variable etiology. The purpose of this review is to emphasize these changes and discuss management strategies. PMID:26816868

  11. [Contributions of medical hypnosis to orthodontic treatment].

    PubMed

    Simonnet Garcia, Marie-Hélène

    2014-09-01

    Hypnosis is making a comeback in all of the medical disciplines. But in a world where everyone wants to control everything and manage everything, it's helpful to know that hypnosis is a dynamic process that cannot be forced on anyone, a psychic reality, clearly demonstrated today by brain imaging. Hypnosis does not take any power over the individual. It is just one more tool to help ease patient's discomfort. It is also useful to avoid professional burnout to provide care without depleting our energy and without wasting our valuable time. Medical hypnosis is a real asset for providing comfortable orthodontic treatment and creating a serene atmosphere. It can be done simply and rapidly to take high quality impressions, to place braces comfortably on a patient who is sitting quietly. Orthodontic treatment requires cooperation and motivation, so let's give our patients a new sense of confidence and a willingness to cooperate.

  12. Another Alternative: A 90-Day Contractual Detoxification Treatment Program

    ERIC Educational Resources Information Center

    Kahn, Robert B.; And Others

    1978-01-01

    In May 1974, Fresno County's Narcotic Abuse Treatment Program began a 21-day outpatient methadone detoxification treatment modality. The purpose of this paper is to examine this alternative treatment modality, its characteristics, its therapeutic outcomes and the rationale for its use. (Author)

  13. Treatment, promotion, commotion: Antibiotic alternatives in food-producing animals

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Alternatives to antibiotics in animal agriculture are urgently needed but present a complex problem because of their various uses: disease treatment, disease prevention, and feed efficiency improvement. Numerous antibiotic alternatives, such as feed amended with pre- and probiotics, have been propos...

  14. Use of medical foods and nutritional approaches in the treatment of Alzheimer’s disease

    PubMed Central

    Thaipisuttikul, Papan; Galvin, James E

    2012-01-01

    SUMMARY Alzheimer’s disease, the most common cause of dementia, has a high global economic impact. To date, there is no curative treatment; therefore, many efforts are directed not only at novel potential disease-modifying treatments and interventions, but also to develop alternative symptomatic and supportive treatments. Examples of these efforts include the medical foods. There are three medical foods that claim to offer symptomatic benefits: Axona®, Souvenaid® and CerefolinNAC®. Axona supplies ketone bodies as alternative energy source to neurons. Souvenaid provides precursors thought to enhance synaptic function. CerefolinNAC addresses the role of oxidative stress related to memory loss. The current scientific evidence on these medical foods is reviewed in this article. Furthermore, we also review the concept and evidence supporting use of the Mediterranean diet, a possible alternative to medical foods that, if implemented correctly, may have lower costs, fewer side effects and stronger epidemiological health outcomes. PMID:23362453

  15. Proven Alternatives for Aboveground Treatment of Arsenic in Groundwater

    EPA Pesticide Factsheets

    This issue paper, developed for EPA's Engineering Forum, identifies and summarizes experiences with proven aboveground treatment alternatives for arsenic in groundwater, and provides information on their relative effectiveness and cost.

  16. Alternatives for the treatment of salivary duct obstruction.

    PubMed

    McGurk, Mark; Brown, Jackie

    2009-12-01

    Minimally invasive alternatives for treatment of salivary duct obstruction are discussed. Radiologically- and endoscopically-guided interventions using wire baskets and dilating balloons, including cutting balloons, are covered as are combined endoscopic and open approaches.

  17. 28 CFR 549.43 - Involuntary psychiatric treatment and medication.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... medication. 549.43 Section 549.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Administrative Safeguards for Psychiatric Treatment and Medication § 549.43 Involuntary psychiatric treatment and medication. Title 18 U.S.C. 4241-4247 and federal...

  18. [Medical treatment in patients with chronic thromboembolic pulmonary hypertension].

    PubMed

    Subias, Pilar Escribano; Cano, María José Ruiz; Flox, Angela

    2009-06-01

    Pulmonary thromboendarterectomy is the treatment of choice in patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, specific medical treatment of pulmonary hypertension (PH) can be an alternative or play a complementary role to surgery. Thus, in patients unsuitable for surgery due to distal thrombotic obstruction, residual or persistent PH after surgery or very severe PH and a high-risk hemodynamic profile, medical treatment may improve their clinical course and the outcome of thromboendarterectomy. Patients with distal obstruction in the pulmonary tree and those with residual PH after surgery show clinical and hemodynamic deterioration due to progression of the pulmonary vascular disease in the smallcaliber arterioles. Conventional treatment with diuretics, anticoagulants and oxygen therapy has been demonstrated to have little effectiveness. In the last decade, numerous drugs have been developed for the treatment of PH: prostacyclin analogs, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors acting principally in vascular remodelling of small-caliber arterioles. Although evidence of the effectiveness of these drugs in PH and the histological similarity of small-vessel vasculopathy in CTEPH to that of other forms of PH provide the main rationale for the use of these drugs in patients with CTEPH, the evidence from clinical trials is still limited.

  19. Alternative Technical Summary Report: Electrometallurgical Treatment Variant

    SciTech Connect

    Gray, L.W.

    1995-11-30

    Immobilization is the fixation of the surplus fissile materials in an acceptable matrix such as glass or ceramics to create an environmentally benign form for disposal in a repository. In addition to the traditional characteristics required of an immobilization form to achieve isolation of the fissile material from the biosphere over geologic times, the immobilization form for the Fissile Materials Disposition Program (FMDP) must also possess the property that it is inherently as unattractive and inaccessible as the fissile material from commercial spent fuel. This latter requirement is similar to the wording of the ''spent fuel standard'' invoked in the National Academy of Sciences (NAS) study on plutonium disposition. High-level wastes (HLW) or separated cesium ({sup 137}Cs), can be added with the fissile material into the waste form to create a radiation field that increases the proliferation resistance and decreases reuse by the host nation in the following ways: (1) Plutonium will be diluted with elements that must be removed by extensive chemical processing to return it to weapons-usable purity; (2) The immobilized plutonium canisters will contain approximately 2 tonnes (2000 kg; 2.2 tons) of mass, thereby forcing the use of heavy equipment to move the canisters; (3) A gamma radiation barrier will be added to the immobilized plutonium canisters; the present concept is to add a radiation barrier that is greater than 1 Gy (100 rad) per hour at 1 m (3 ft) 30 years after fabrication; (4) These canisters will then be sealed in casks and emplaced into drifts in a federal repository where they will be monitored for 100 years before the repository is sealed. This immobilization process is shown conceptually in Figure 1. In the electrometallurgical treatment (ET) variant, plutonium-rich residues are shipped to existing Argonne National Laboratory-West (ANL-W) facilities where the plutonium is converted to plutonium chloride, dissolved in a molten salt solution, sorbed

  20. Successful medical treatment of spinal epidural abscess.

    PubMed

    Xiao, Bo-Ren; Wang, Chih-Wei; Lin, Jung-Chung; Chang, Feng-Yee

    2008-04-01

    Spinal epidural abscess is a rare but potentially fatal disease. A 67-year-old female suffered fever and painful swelling of the right knee and lower leg for one week. Both synovial fluid and blood cultures yielded methicillin-sensitive Staphylococcus aureus. Low back pain developed and fever was sustained despite the administration of intravenous oxacillin. Magnetic resonance imaging (MRI) of the thoracolumbar spine revealed spinal epidural abscess from T12 to S1. Because of severe hypoalbuminemia and general anasarca and followed by exploratory laparotomy for massive duodenal bleeding, she did not receive surgical intervention for the spinal epidural abscess. After intravenous administration of oxacillin 2 g 4-hourly for 12 weeks, she recovered and follow-up MRI confirmed the efficacy of the medical treatment. She remained well at 1-year follow-up. In a patient with minimal neurological deficit or surgical contraindication, spinal epidural abscess can be successfully treated with a medical regimen.

  1. Allergic Contact Dermatitis to Ophthalmic Medications: Relevant Allergens and Alternative Testing Methods.

    PubMed

    Grey, Katherine R; Warshaw, Erin M

    Allergic contact dermatitis is an important cause of periorbital dermatitis. Topical ophthalmic agents are relevant sensitizers. Contact dermatitis to ophthalmic medications can be challenging to diagnose and manage given the numerous possible offending agents, including both active and inactive ingredients. Furthermore, a substantial body of literature reports false-negative patch test results to ophthalmic agents. Subsequently, numerous alternative testing methods have been described. This review outlines the periorbital manifestations, causative agents, and alternative testing methods of allergic contact dermatitis to ophthalmic medications.

  2. What should medical practitioners know about the role of alternative medicines in cardiovascular disease management?

    PubMed

    Whayne, Thomas F

    2010-04-01

    Alternative medications as a term call up many different meanings, significance, and perceptions to various medical practitioners. Some are good; others are bad. A wide range of alternative medications with relevance or connection to cardiovascular (CV) disease have been considered. While many are worthless, others have definite benefit, and at least one, chelation therapy, is associated with definite harm, significant risk, no benefit, and enrichment of the practitioners who prescribe it. The issues concerning alternative therapies will likely never be studied with randomized clinical trials due to the lack of a profit motive on the part of pharmaceutical companies--only rarely do other institutions, such as the National Institutes of Health, support medicinal studies. Basic knowledge of alternative therapies is essential for the CV specialist and other practicing physicians and other practitioners, since at least a few of their patients will take these medications regardless of medical advice. The result is that a number of these alternative medications will then interact with conventional CV medications, many times unfavorably.

  3. 20 CFR 61.204 - Furnishing of medical treatment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Furnishing of medical treatment. 61.204..., Disability or Death § 61.204 Furnishing of medical treatment. All medical services, appliances, drugs and supplies which in the opinion of the Office are necessary for the treatment of an injury coming within...

  4. Treatment of alternating hemiplegia of childhood with aripiprazole.

    PubMed

    Haffejee, Shereen; Santosh, Paramala J

    2009-01-01

    We report the pharmacological treatment of a case of alternating hemiplegia of childhood (AHC) in a 14-year-old female with an established diagnosis. Although the patient's symptoms are consistent with those of the condition, she did not respond to treatment with haloperidol, flunarizine, or propranolol. Treatment with aripiprazole resulted in a reduction in the frequency, duration, and severity of episodes of alternating hemiplegia, along with other therapeutic benefits. After treatment with aripiprazole was started, the patient was inadvertently given an inactive drug, resulting in a worsening of her hemiplegic episodes, which improved again on rechallenge. A comparison of the pharmacological actions of successful and unsuccessful treatments for AHC is made. Modulation of both dopamine and histamine systems together appears to be important in the treatment of AHC and further investigation of such pharmacotherapies is suggested.

  5. Mobile medical clinics offer alternative to renovation and construction.

    PubMed

    Ayres, D

    1997-01-01

    Mobile Health Care Programs have many attributes. Every organization genuinely concerned with client access to their services should consider having one. When the need to service outlying areas arises, a mobile clinic offers more flexibility and is the most economically feasible alternative. Granted, there is no shortage of vacant structures for rent or purchase in rural America. That, of course, is just the start; you also have the expense of renovating the interior to accommodate the patients and staff. And do not forget the four P's: Planners, Permits, Politics and Payola (taxes and fees).

  6. Screening and evaluating alternative and innovative psychiatric treatments: a contextual framework.

    PubMed

    Arnold, L E

    1994-01-01

    Alternative treatments are unconventional, unestablished, nontraditional, and often innovative. Innovative treatments may be mainstream or alternative. All psychiatric treatments, whether mainstream or alternative, whether psychosocial or "biological," can be classified in a framework based on the means used to beneficially impact the patient's brain. An imaginative and comprehensive perspective on therapeutic possibilities might derive from considering the broad array of sensory/perceptual transducer channels as well as media. Most treatments utilize a medium (energy, substance, person, or machine). A full classification should therefore include the general category or means, any media involved, any sensory transducers used, and any special techniques. A positive approach to nurturing innovation, especially in psychosocial treatments, might consider: (1) the study of neglected transducer channels, (2) mechanization/computerization of transducer input and other innovations of media, (3) a comparison of packaging options for information/feedback, and (4) a comparison of the effect of inputing a single sensory channel to the effect of inputting simultaneous multiple channels. Screens for promising new psychiatric treatments are proposed in response to one of the recommendations at the National Institutes of Health (NIH) Workshop on Unconventional Medical Treatments held in September 1992. Two unscientific pitfalls must be skirted: embracing new or alternative treatments uncritically and rejecting them without fair examination; and they must be skirted without dissipating scarce research resources.

  7. Mechanical chest compression: an alternative in helicopter emergency medical services?

    PubMed

    Gässler, Holger; Kümmerle, Simone; Ventzke, Marc-Michael; Lampl, Lorenz; Helm, Matthias

    2015-09-01

    Mechanical chest compression devices are mentioned in the current guidelines of the European Resuscitation Council (ERC) as an alternative in long-lasting cardiopulmonary resuscitations (CPR) or during transport with ongoing CPR. We compared manual chest compression with mechanical devices in a rescue-helicopter-based scenario using a resuscitation manikin. Manual chest compression was compared with the mechanical devices LUCAS™ 2, AutoPulse™ and animax mono (10 series each) using the resuscitation manikin AmbuMan MegaCode Wireless, which was intubated endotracheally and controlled ventilated during the entire scenario. The scenario comprised the installation of each device, transport and loading phases, as well as a 10-min phase inside the helicopter (type BK 117). We investigated practicability as well as measured compression quality. All mechanical devices could be used readily in a BK 117 helicopter. The LUCAS 2 group was the only one that fulfilled all recommendations of the ERC (frequency 102 ± 0.1 min(-1), compression depth 54 ± 3 mm, hands-off time 2.5 ± 1.6 %). Performing adequate manual chest compression was barely possible (fraction of correct compressions 21 ± 15 %). In all four groups, the total hands-off time was <10 %. Performing manual chest compressions during rescue-helicopter transport is barely possible, and only of poor quality. If rescuers are experienced, mechanical chest compression devices could be good alternatives in this situation. We found that the LUCAS 2 system complied with all recommendations of ERC guidelines, and all three tested devices worked consistently during the entire scenario.

  8. Medical treatment of renal cancer: new horizons

    PubMed Central

    Greef, Basma; Eisen, Tim

    2016-01-01

    Renal cell carcinoma (RCC) makes up 2–3% of adult cancers. The introduction of tyrosine kinase inhibitors (TKIs) and mammalian target of rapamycin inhibitors in the mid-2000s radically changed the management of RCC. These targeted treatments superseded immunotherapy with interleukin-2 and interferon. The pendulum now appears to be shifting back towards immunotherapy, with the evidence of prolonged overall survival of patients with metastatic RCC on treatment with the anti-programmed cell death 1 ligand monoclonal antibody, nivolumab. Clinical prognostic criteria aid prediction of relapse risk for resected localised disease. Unfortunately, for patients at high risk of relapse, no adjuvant treatment has yet shown benefit, although further trials are yet to report. Clinical prognostic models also have a role in the management of advanced disease; now there is a pressing need for predictive biomarkers to direct therapy. Treatment selection for metastatic disease is currently based on histology, prognostic group and patient preference based on side effect profile. In this article, we review the current medical and surgical management of localised, oligometastatic and advanced RCC, including side effect management and the evidence base for management of poor-risk and non-clear cell disease. We discuss recent results from clinical trials and how these are likely to shape future practice and a renaissance of immunotherapy for renal cell cancer. PMID:27490806

  9. Medical treatment of hirsutism in women.

    PubMed

    Lumachi, F; Basso, S M M

    2010-01-01

    Hirsutism is the presence of excess hair growth in women in the typical male hair growth areas, thereby reflecting a deviation from the normal female hair pattern. It affects from 5% to 10% of women, depending on age, menopausal status and ethnic background. The presence of hirsutism is very distressing for women, and subsequently may have a negative impact on their psychosocial life. In the treatment of hirsutism several options are now available, including pharmacologic regimens and cosmetic measures. Both the hormonal profile of the patient and her expectations and preferences should guide the therapeutic approach. The aims of the medical therapy are suppression of excessive androgen production, inhibition of peripheral action of androgens, and treatment of patients at risk for metabolic disorders or reproductive cancers. For other diseases related to endocrine abnormalities, such as thyroid disorders or Cushing's syndrome, specific treatment is mandatory. After an ineffective local approach by direct hair removal, a pharmacological treatment should be suggested, using estrogen and progestin combinations, antiandrogens (i.e. cyproterone acetate, spironolactone) or both as a first line. Finasteride, gonadotropin-releasing hormone agonists, and glucocorticoids should be used in selected cases. Adequate contraception is also recommended if antiandrogens are used. Unfortunately, since systemic therapy reduces hair growth in less than 50% of cases, hirsute women frequently require cosmetic measures. The use of a logical combination of different options has been shown to achieve a satisfactory result in most cases. This review provides information and suggestions about the current options of treating hirsutism.

  10. “Complementary and Alternative Medicine Treatments for Children with Autism Spectrum Disorders”

    PubMed Central

    Levy, Susan E.

    2008-01-01

    SYNOPSIS Complementary and alternative medical treatments are commonly used for children with autism spectrum disorders. This review discusses the evidence supporting the most frequently used treatments, including categories of mind-body medicine, energy medicine, biologically based, manipulative and body-based practices, with the latter two the most commonly selected by families. It is important for clinical providers to understand the evidence for efficacy (or lack thereof) and potential side effects. Some CAM practices have evidence to reject their use, such as secretin, others have emerging evidence to support their use, like melatonin. Most treatments, however, have not been adequately studied and do not have evidence to support their use. PMID:18775371

  11. [Limits of pain treatment: medical and judicial aspects].

    PubMed

    Zenz, M; Rissing-van Saan, R

    2011-08-01

    Medical principles of pain treatment are generally in line with the judicial principles. To relieve pain is one of the fundamentals of medicine and this has also been acknowledged by the Federal Court in Germany. It is criminal bodily harm, when a physician denies a possible pain treatment. Whereas courts clearly see an obligation to basic and continuing education in pain diagnosis and therapy, pain is still not represented in the German licensing regulations for physicians. Only palliative medicine has been added to the obligatory curriculum. Very similar pain is not mandatory in many clinical disciplines leaving physicians without the needed knowledge to treat pain. The need for interdisciplinary treatment is not yet acknowledged sufficiently, although meanwhile chronic pain is regarded as a bio-psycho-social illness.Since 2009 the advance directive is regulated by law. However, still many physicians are unaware that not only the position of the patient but also of the relatives have been strengthened. In 2010 the Federal Court has pronounced a judgment allowing "passive euthanasia" in certain conditions but prohibiting any active handling even in line with the patient's will. This is also in line with the European Human Rights Convention. The judicial unpunished assisted suicide has provoked an ethical discussion within the medical profession. However, what is not illegal is not automatically accepted as ethical handling for physicians. Palliative medicine is at least one alternative in this discussion.

  12. 28 CFR 301.317 - Medical treatment following release.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Medical treatment following release. 301... INMATE ACCIDENT COMPENSATION Compensation for Work-Related Physical Impairment or Death § 301.317 Medical treatment following release. Federal Prison lndustries, Inc., may not pay the cost of medical,...

  13. 28 CFR 301.317 - Medical treatment following release.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Medical treatment following release. 301... INMATE ACCIDENT COMPENSATION Compensation for Work-Related Physical Impairment or Death § 301.317 Medical treatment following release. Federal Prison lndustries, Inc., may not pay the cost of medical,...

  14. 20 CFR 61.204 - Furnishing of medical treatment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Furnishing of medical treatment. 61.204..., Disability or Death § 61.204 Furnishing of medical treatment. All medical services, appliances, drugs and... the same manner and under the same regulations, as are prescribed for the furnishing of...

  15. Advances in developing alternative treatments for postharvest pest control

    Technology Transfer Automated Retrieval System (TEKTRAN)

    USDA-ARS made two significant advances in the last 10 years in the development of alternative treatments for postharvest pest control: oxygenated phosphine fumigation and nitric oxide fumigation. Oxygenated phosphine is phosphine fumigation in an oxygen enriched atmosphere. It is significantly more...

  16. 20 CFR 61.204 - Furnishing of medical treatment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... STATES CLAIMS FOR COMPENSATION UNDER THE WAR HAZARDS COMPENSATION ACT, AS AMENDED Compensation for Injury, Disability or Death § 61.204 Furnishing of medical treatment. All medical services, appliances, drugs...

  17. 20 CFR 61.204 - Furnishing of medical treatment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... STATES CLAIMS FOR COMPENSATION UNDER THE WAR HAZARDS COMPENSATION ACT, AS AMENDED Compensation for Injury, Disability or Death § 61.204 Furnishing of medical treatment. All medical services, appliances, drugs...

  18. 20 CFR 61.204 - Furnishing of medical treatment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... STATES CLAIMS FOR COMPENSATION UNDER THE WAR HAZARDS COMPENSATION ACT, AS AMENDED Compensation for Injury, Disability or Death § 61.204 Furnishing of medical treatment. All medical services, appliances, drugs...

  19. Use of conventional, complementary, and alternative treatments for pain among individuals seeking primary care treatment with buprenorphine-naloxone

    PubMed Central

    Barry, Declan T.; Savant, Jonathan D.; Beitel, Mark; Cutter, Christopher J.; Moore, Brent A.; Schottenfeld, Richard S.; Fiellin, David A.

    2012-01-01

    Previous studies have not examined patterns of pain treatment use among patients seeking office-based buprenorphine-naloxone treatment (BNT) for opioid dependence. Objectives To examine, among individuals with pain seeking BNT for opioid dependence, the use of pain treatment modalities, perceived efficacy of prior pain treatment, and interest in pursuing pain treatment while in BNT. Methods 244 patients seeking office-based BNT for opioid dependence completed measures of demographics, pain status (i.e. “chronic pain (CP)” [pain lasting at least 3 months] vs. “some pain (SP)” [pain in the past week not meeting the duration criteria for chronic pain]), pain treatment use, perceived efficacy of prior pain treatment, and interest in receiving pain treatment while in BNT. Results In comparison to the SP group (N = 87), the CP group (N = 88) was more likely to report past-week medical use of opioid medication (AOR 3.2, 95% CI 1.2–8.4), lifetime medical use of non-opioid prescribed medication (AOR 2.2, 95% CI 1.1–4.7), and lifetime use of prayer (AOR 2.8, 95% CI 1.2–6.5), and was less likely to report lifetime use of yoga (AOR 0.2, 95% CI 0.1–0.7) to treat pain. While the two pain groups did not differ on levels of perceived efficacy of prior lifetime pain treatments, in comparison to the SP group, the CP group was more likely to report interest in receiving pain treatment while in BNT (P < 0.001). Conclusions Individuals with pain seeking BNT for opioid dependence report a wide range of conventional, complementary, and alternative pain-related treatments and are interested (especially those with CP) in receiving pain management services along with BNT. PMID:23041680

  20. Microwave Medical Treatment Apparatus and Method

    NASA Technical Reports Server (NTRS)

    Arndt, G. Dickey (Inventor); Ngo, Phong H. (Inventor); Carl, James R. (Inventor); George, W. Rflfoul (Inventor)

    2005-01-01

    Methods, simulations, and apparatus are provided that may be utilized for medical treatments which are especially suitable for treatment of benign prostatic hyperplasia (BPH). In a preferred embodiment, a plurality of separate microwave antennas are utilized to heat prostatic tissue to promote necrosing of the prostatic tissue that relieves the pressure of the prostatic tissue against the urethra as the body reabsorbs the necrosed or dead tissue. By utilizing constructive and destructive interference of the microwave transmission, the energy can be deposited on the tissues to be necrosed while protecting other tissues such as the urethra. Saline injections to alter the conductivity of the tissues may also be used to further focus the energy deposits. A computer simulation is Provided that can be used to Predict the resulting temperature profile produced in the prostatic tissue. By changing the various control features of one or more catheters and the methods of applying microwave energy, a temperature profile can be predicted and produced that is similar to the temperature profile desired for the particular patient.

  1. Sodium-Bearing Waste Treatment Alternatives Implementation Study

    SciTech Connect

    Charles M. Barnes; James B. Bosley; Clifford W. Olsen

    2004-07-01

    The purpose of this document is to discuss issues related to the implementation of each of the five down-selected INEEL/INTEC radioactive liquid waste (sodium-bearing waste - SBW) treatment alternatives and summarize information in three main areas of concern: process/technical, environmental permitting, and schedule. Major implementation options for each treatment alternative are also identified and briefly discussed. This report may touch upon, but purposely does not address in detail, issues that are programmatic in nature. Examples of these include how the SBW will be classified with respect to the Nuclear Waste Policy Act (NWPA), status of Waste Isolation Pilot Plant (WIPP) permits and waste storage availability, available funding for implementation, stakeholder issues, and State of Idaho Settlement Agreement milestones. It is assumed in this report that the SBW would be classified as a transuranic (TRU) waste suitable for disposal at WIPP, located in New Mexico, after appropriate treatment to meet transportation requirements and waste acceptance criteria (WAC).

  2. Porcelain veneers as an alternative for esthetic treatment: clinical report.

    PubMed

    Rotoli, B T; Lima, D A N L; Pini, N P; Aguiar, F H B; Pereira, G D S; Paulillo, L A M S

    2013-01-01

    This case report describes the restoration of the anterior dentition with porcelain laminate veneers. The advances in bonding of porcelain to tooth structure make this treatment a feasible alternative to restore teeth with alteration in shape and position in cases in which the esthetic demand is high. The rationale for various choices in this treatment protocol is detailed with reference to the pertinent literature. Thus, the clinical success of the technique depends on the correct identification of a case for which this treatment is appropriate and the successful execution of the clinical steps involved.

  3. Complementary and Alternative Medicine Familiarization: What's happening in Medical Schools in Wales?

    PubMed Central

    Taylor, Natalie

    2010-01-01

    Despite recommendations that complementary and alternative medicine (CAM) familiarization should be offered to UK medical students, in Wales little such teaching was offered. We decided to assess medical students’ knowledge of CAMs, perceived training needs in CAMs, their view of its role in the National Health Service (NHS) and current teaching given. Analysis of data from a questionnaire given to medical students and direct questioning of senior academic medical school staff in Cardiff and Swansea Medical Schools was carried out. The participants comprised 78 first year medical students in the undergraduate entry program in Cardiff and 58 first year medical students from the graduate entry program in Swansea. Senior academic medical school staff at Cardiff and Swansea Medical Schools were asked about current CAM teaching. Results revealed that 32% of undergraduate entry students (UGES) had previous knowledge of CAMs compared with 51% of graduate entry students (GES). Of the UGES, 62% believed they should be taught about CAM's compared with 94% of GES. Of UGES 31% felt that CAMs have a role in the NHS compared with 50% of GES. None of the students had received teaching about CAMs and little formal CAM teaching is currently included in the curricula at each site. The majority of medical students in Wales would like to receive CAM teaching and significant numbers support a role for CAMs in the NHS. Little formal teaching is currently provided. PMID:18955309

  4. Interstitial laser coagulation of benign prostatic hyperplasia: a minimally invasive treatment alternative

    NASA Astrophysics Data System (ADS)

    Ordonez, Robert F.; Mittemeyer, Bernhard T.; Aronoff, David R.; de Riese, Werner T. W.

    2003-06-01

    The use of minimally invasive treatments for benign prostatic hyperplasia (BPH) have been introduced into the medical community. Over the last decade several minimally invasive treatment techniques have been approved for use. In particular, interstitial laser coagulation (ILC) has shown pomise as an alternative to the current gold standard, transurethral resection of prostate (TURP). Studies show ILC to have equal efficacy as TURP while causing less side effects. Future technical advances as well as increased physician experience with ILC could lead to the replacement of TURP as the gold standard in trestment of BPH.

  5. Current medical treatment of pancreatic neuroendocrine tumors.

    PubMed

    Yalcin, Suayib; Oyan, Basak; Bayraktar, Yusuf

    2007-01-01

    Pancreatic neuroendocrine tumors (NETs) consist of a wide group of neoplasms, with different biological behaviors in terms of aggressiveness and hormone production. In the last two decades, significant progress has been observed in our understanding of their biology, diagnosis and treatment. Surgery remains to be the only curative approach, but unfortunately the diagnosis is often delayed due to the slow growth of these tumors and the difficulty in identifying the symptoms related to the tumor-released hormones. In addition to surgery, other approaches to control the disease are biological therapy consisting of somatostatin analogs and interferon (IFN), systemic chemotherapy, radioligand therapy and local therapy with chemoembolization. Several newer cytotoxic agents, including irinotecan, gemcitabine, taxanes, oxaliplatin, capecitabine and PS-341 have been studied in metastatic patients. Considering the high vascularity of these tumors, antiangiogenic agents like endostatin and thalidomide have also been evaluated in advanced NETs. Although these agents seem to have potential activity in NETs and may increase progression free survival, none of these currently available medical therapeutic options are curative. While more efficient novel strategies are to be developed, the rationale use of the current therapeutic options may improve quality of life, control the symptoms related to the hypersecretion of hormones and/or peptides, control tumor proliferation and prolong survival in patients suffering from NETs.

  6. How Should Alternative Medicine Be Taught to Medical Students and Physicians?

    ERIC Educational Resources Information Center

    Marcus, Donald M.

    2001-01-01

    Analyzes alleged deficiencies in medical education and concludes they are based on misrepresentations (for example, that physicians ignore mind-body interactions). Examines fundamental differences between traditional and alternative medicine and asserts that physicians need additional education in order to provide guidance to patients, but that…

  7. Patterns of Complementary and Alternative Medical Therapy Use in Children Diagnosed with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Wong, Helen H. L.; Smith, Ronald G.

    2006-01-01

    Previous studies suggest that complementary and alternative medical (CAM) therapy use in children with chronic illnesses is higher than in children in the general population. In this study, we investigated patterns of CAM therapy use in children diagnosed with autism spectrum disorders (ASD, n = 50) as compared to a control population of children…

  8. Medical Marijuana Use among Adolescents in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Salomonsen-Sautel, Stacy; Sakai, Joseph T.; Thurstone, Christian; Corley, Robin; Hopfer, Christian

    2012-01-01

    Objective: To assess the prevalence and frequency of medical marijuana diversion and use among adolescents in substance abuse treatment and to identify factors related to their medical marijuana use. Method: This study calculated the prevalence and frequency of diverted medical marijuana use among adolescents (n = 164), ages 14-18 years (mean age…

  9. Two implant overdenture–the first alternative treatment for patients with complete edentulous mandible

    PubMed Central

    Marin, M; Preoteasa, E; Tancu, AM; Preoteasa, CT

    2011-01-01

    Given the increasing life expectancy in the coming years, dental practitioners, as other specialists from different medical fields, will encounter an increasing number of complete edentulous patients. These patients, with a longer active life and higher standards of life quality, will have different expectations for their complete dentures, higher than the standard treatment that uses conventional complete dentures. Two–implant overdenture is considered the first alternative treatment in complete edentulous mandible, according to current medical standards established by a team of specialists in prosthodontics and implantology, and globally known as the McGill Consensus from McGill University, Montreal, Canada. The Consensus was established during a–dayߝand–a–half session of presentations done by experts who presented data, scientific information on the subject, and, not less significant, personal experiences of participants and patients. Overdenture on implants, as an alternative treatment for complete edentulous mandible, has multiple benefits in achieving better conditions of prosthesis: balance and effectiveness, with positive effects on oral structures, aesthetics, and quality of life. Mandibular two–implant overdenture, established as a standard treatment by the highest international forum, should gradually become the first choice of treatment in complete edentulous mandible. PMID:21776308

  10. A Critique of "Controversial Medical Treatments of Learning Disabilities"

    ERIC Educational Resources Information Center

    Feingold, Benjamin F.

    1977-01-01

    The author replies to the article titled "Controversial Medical Treatments of Learning Disabilities" (R. Sieben), and discusses research on the relationship between food additives and hyperactivity, and dietary treatments for learning disabled children. (IM)

  11. Risk of interactions between complementary and alternative medicine and medication for comorbidities in patients with melanoma.

    PubMed

    Loquai, Carmen; Dechent, Dagmar; Garzarolli, Marlene; Kaatz, Martin; Kaehler, Katharina C; Kurschat, Peter; Meiss, Frank; Stein, Annette; Nashan, Dorothee; Micke, Oliver; Muecke, Ralph; Muenstedt, Karsten; Stoll, Christoph; Schmidtmann, Irene; Huebner, Jutta

    2016-05-01

    Complementary and alternative medicine (CAM) is used widely among cancer patients. Beside the risk of interaction with cancer therapies, interactions with treatment for comorbidities are an underestimated problem. The aim of this study was to assess prevalence of interactions between CAM and drugs for comorbidities from a large CAM usage survey on melanoma patients and to classify herb-drug interactions with regard to their potential to harm. Consecutive melanoma outpatients of seven skin cancer centers were asked to complete a standardized CAM questionnaire including questions to their CAM use and their taken medication for comorbidities and cancer. Each combination of conventional drugs and complementary substances was evaluated for their potential of interaction. 1089 questionnaires were eligible for evaluation. From these, 61.6% of patients reported taking drugs regularly from which 34.4% used biological-based CAM methods. Risk evaluation for interaction was possible for 180 CAM users who listed the names or substances they took for comorbidities. From those patients, we found 37.2% at risk of interaction of their co-consumption of conventional and complementary drugs. Almost all patients using Chinese herbs were at risk (88.6%). With a high rate of CAM usage at risk of interactions between CAM drugs and drugs taken for comorbidities, implementation of a regular assessment of CAM usage and drugs for comorbidities is mandatory in cancer care.

  12. The current status of animal use and alternatives in Korean veterinary medical schools.

    PubMed

    Lee, Gwi Hyang; Choe, Byung In; Kim, Jin Suk; Hart, Lynette A; Han, Jin Soo

    2010-06-01

    Two new Korean laws regulating animal welfare and the humane use of animals in science came into effect in 2008 and 2009. Both these laws impose ethical committee review prior to the performance of animal experiments in research, testing and education. This study briefly summarises the new Korean laws, and investigates the current status regarding the numbers of animals used, the alternatives to animals which are used, the curricula relating to the humane use of animals, and ethical review practices in Korean veterinary education. Approximately 4,845 animals, representing 20 different species, were used in veterinary medical education in Korea in 2007. Korea has begun to introduce formal courses on animal welfare for the humane treatment of animals used in experiments, and an ethical protocol review system prior to animal use in education. Korea is moving toward better animal welfare, by incorporating practices consistent with international standards. The information presented represents the first such data gathered in Korea, which should prove useful for monitoring the implementation of replacement, reduction, and refinement measures in animal use for education purposes.

  13. Treatment of Lung Cancer in Medically Compromised Patients.

    PubMed

    Crawford, Jeffrey; Wheatley-Price, Paul; Feliciano, Josephine Louella

    2016-01-01

    Outcomes for patients with lung cancer have been improved substantially through the integration of surgery, radiation, and systemic therapy for patients with early-stage disease. Meanwhile, advances in our understanding of molecular mechanisms have substantially advanced our treatment of patients with advanced lung cancer through the introduction of targeted therapies, immune approaches, improvements in chemotherapy, and better supportive care. However, the majority of these advances have occurred among patients with good functional status, normal organ function, and with the social and economic support systems to be able to benefit most from these treatments. The aim of this article is to bring greater attention to management of lung cancer in patients who are medically compromised, which remains a major barrier to care delivery. Impaired performance status is associated with poor outcomes and correlates with the high prevalence of cachexia among patients with advanced lung cancer. CT imaging is emerging as a research tool to quantify muscle loss in patients with cancer, and new therapeutics are on the horizon that may provide important adjunctive therapy in the future. The benefits of cancer therapy for patients with organ failure are poorly understood because of their exclusion from clinical trials. The availability of targeted therapy and immunotherapy may provide alternatives that may be easier to deliver in this population, but clinical trials of these new agents in this population are vital. Patients with lower socioeconomic status are disproportionately affected by lung cancer because of higher rates of tobacco addiction and the impact of socioeconomic status on delay in diagnosis, treatment, and outcomes. For all patients who are medically compromised with lung cancer, multidisciplinary approaches are particularly needed to evaluate these patients and to incorporate rapidly changing therapeutics to improve outcomes.

  14. Emergency Medical Treatment for the "Wilderness" Context.

    ERIC Educational Resources Information Center

    National Association for Search and Rescue, Fairfax, VA.

    This paper offers a brief outline of the training curriculum developed by the National Association for Search and Rescue (NASAR) for its Wilderness Medicine Programs. The training modules are designed for wilderness search and rescue units, rural emergency medical services (EMS) squads, military medics, backcountry rangers, epedition leaders,…

  15. Advances in medical treatment of hypertrophic cardiomyopathy.

    PubMed

    Hamada, Mareomi; Ikeda, Shuntaro; Shigematsu, Yuji

    2014-07-01

    We reviewed the natural history of patients with hypertrophic cardiomyopathy (HCM). The effect of medical treatments on natural history, left ventricular (LV) functions and LV remodeling was also evaluated. Sudden cardiac death and end-stage heart failure are the most serious complications of HCM. Age <30 years and a family history of sudden premature death are risk factors for sudden cardiac death in HCM patients. End-stage heart failure is not a specific additional phenomenon observed in patients with HCM, but is the natural course of the disease in most of those patients. After the occurrence of heart failure, the progression to cardiac death is very rapid. Young age at diagnosis, a family history of HCM, and greater wall thickness are associated with a greater likelihood of developing end-stage heart failure. Neither beta-blockers nor calcium antagonists can prevent this transition. The class Ia antiarrhythmic drugs, disopyramide and cibenzoline are useful for the reduction of LV pressure gradient. Unlike disopyramide, cibenzoline has little anticholinergic activity; therefore, this drug can be easily adapted to long-term use. In addition to the reduction in LV pressure gradient, cibenzoline can improve LV diastolic dysfunction, and induce regression of LV hypertrophy in patients with HCM. A decrease in intracellular Ca(2+) concentration through the activation of the Na(+)/Ca(2+) exchanger associated with cibenzoline therapy is likely to be closely related with the improvement in HCM-related disorders. It is possible that cibenzoline can prevent the progression from typical HCM to end-stage heart failure.

  16. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  17. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  18. 28 CFR 301.317 - Medical treatment following release.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the Claims Examiner. The amount of a payment for medical treatment is limited to reasonable expenses... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Medical treatment following release. 301... INMATE ACCIDENT COMPENSATION Compensation for Work-Related Physical Impairment or Death § 301.317...

  19. An Alternative Surgical Method for Treatment of Osteoid Osteoma.

    PubMed

    Gökalp, Mehmet Ata; Gözen, Abdurrahim; Ünsal, Seyyid Şerif; Önder, Haci; Güner, Savaş

    2016-02-22

    BACKGROUND An osteoid osteoma is a benign bone tumor that tends to be <1 cm in size. The tumor is characterized by night-time pain that may be relieved by aspirin or other non-steroidal anti-inflammatory drugs. Osteoid osteoma can be treated with various conservative and surgical methods, but these have some risks and difficulties. The purpose of the present study was to present an alternative treatment method for osteoid osteoma and the results we obtained. MATERIAL AND METHODS In the period from 2010 to 2014, 10 patients with osteoid osteoma underwent nidus excision by using a safe alternative method in an operating room (OR) with no computed tomography (CT). The localization of the tumor was determined by use of a CT-guided Kirschner wire in the radiology unit, then, in the OR the surgical intervention was performed without removing the Kirschner wire. RESULTS Following the alternative intervention, all the patients were completely relieved of pain. In the follow-up, no recurrence or complication occurred. CONCLUSIONS The presented alternative method for treating osteoid osteoma is an efficient and practical procedure for surgeons working in clinics that lack specialized equipment.

  20. An Alternative Surgical Method for Treatment of Osteoid Osteoma

    PubMed Central

    Gökalp, Mehmet Ata; Gözen, Abdurrahim; Ünsal, Seyyid Şerif; Önder, Haci; Güner, Savaş

    2016-01-01

    Background An osteoid osteoma is a benign bone tumor that tends to be <1 cm in size. The tumor is characterized by night-time pain that may be relieved by aspirin or other non-steroidal anti-inflammatory drugs. Osteoid osteoma can be treated with various conservative and surgical methods, but these have some risks and difficulties. The purpose of the present study was to present an alternative treatment method for osteoid osteoma and the results we obtained. Material/Methods In the period from 2010 to 2014, 10 patients with osteoid osteoma underwent nidus excision by using a safe alternative method in an operating room (OR) with no computed tomography (CT). The localization of the tumor was determined by use of a CT-guided Kirschner wire in the radiology unit, then, in the OR the surgical intervention was performed without removing the Kirschner wire. Results Following the alternative intervention, all the patients were completely relieved of pain. In the follow-up, no recurrence or complication occurred. Conclusions The presented alternative method for treating osteoid osteoma is an efficient and practical procedure for surgeons working in clinics that lack specialized equipment. PMID:26898923

  1. Complementary and Alternative Therapies as Treatment Approaches for Interstitial Cystitis

    PubMed Central

    Whitmore, Kristene E

    2002-01-01

    The management of interstitial cystitis (IC) is predominantly the reduction of the symptoms of frequency, urgency, and pain. Multimodal treatment approaches for IC are helpful in customizing therapy for individual patients. Complementary and alternative therapies are a quintessential addition to the therapeutic armamentarium and frequently include dietary modification, nutraceuticals, bladder training, neuromodulation, stress reduction, and sex therapy. Dietary modification involves elimination of bladder irritants, fluid regulation, and a bowel regimen. Nutraceuticals studied for the treatment of IC include calcium glycerophosphate, L-arginine, mucopolysaccharides, bioflavinoids, and Chinese herbs. Bladder training is effective after pain reduction. The neuromodulation of high-tone pelvic-floor muscle dysfunction is achieved with physical therapy and acupuncture. Stress reduction and sex therapy are best administered by a qualified stress manager and sex therapist. Multimodal, nonconventional management may add efficacy to the treatment of IC. PMID:16986031

  2. Frameless Stereotactic Radiosurgery, a Feasible Alternative to the Frame-Based Technique for the Treatment of Refractory Trigeminal Neuralgia

    PubMed Central

    Thomas, Andrew S; Reed, Aaron D; Skinner, William K

    2016-01-01

    Classic trigeminal neuralgia (TN) causes severe facial pain. Several treatment options exist for classic TN refractory to medical therapy, including stereotactic radiosurgery (SRS). Most studies in the medical literature used a frame-based SRS technique. Improvements in linear accelerator-based treatment systems and image guidance have led to the use of frameless SRS as a safe and feasible alternative to the frame-based technique for the treatment of refractory TN. We present a case of refractory TN successfully treated with frameless SRS. PMID:27186453

  3. An alternative for rapid administration of medication and fluids in the emergency setting using a novel device.

    PubMed

    Lyons, Neal; Nejak, Daniel; Lomotan, Nadine; Mokszycki, Robert; Jamieson, Stephen; McDowell, Marc; Kulstad, Erik

    2015-08-01

    Routes of administration for medications and fluids in the acute care setting have primarily focused on oral, intravenous, or intraosseous routes, but, in many patients, none of these routes is optimal. A novel device (Macy Catheter; Hospi Corp) that offers an easy route for administration of medications or fluids via rectal mucosal absorption (proctoclysis) has recently become available in the palliative care market; we describe here the first known uses of this device in the emergency setting. Three patients presenting to the hospital with conditions limiting more typical routes of medication or fluid administration were treated with this new device; patients were administered water for hydration, lorazepam for treatment of alcohol withdrawal, ondansetron for nausea, acetaminophen for fever, aspirin for antiplatelet effect, and methimazole for hyperthyroidism. Placement of the device was straightforward, absorption of administered medications (judged by immediacy of effects, where observable) was rapid, and use of the device was well tolerated by patients, suggesting that this device may be an appealing alternative route to medication and fluid administration for a variety of indications in acute and critical care settings.

  4. Current medical diagnosis and treatment 1986

    SciTech Connect

    Krupp, M.A.; Chatton, M.J.; Tierney, L.M.

    1986-01-01

    This book contains 33 chapters. Some of the titles are: Nervous system; Psychiatric disorders; Medical genetics; Endocrine disorders; Introduction to infectious diseases; Disorders due to physical agents; and Anti-infective chemotherapeutic and antibiotic agents.

  5. [Hormonal treatments for hemorrhaging secondary to fibroids. An alternative or complement to surgery?].

    PubMed

    Cancelo Hidalgo, María Jesús

    2013-07-01

    The main objective of treatment in women with uterine fibroids is the control of associated symptoms such as abnormal uterine bleeding, pain and pressure. Although the cost and potential adverse effects of the long-term use of medical treatment may limit its use for a long time, this alternative should be considered before indicating surgical treatment. At present, we have a considerable variety of drugs that, although not specific treatments for fibroids, may be used for the short to medium-term management of bleeding; however, we have still not found an alternative that eliminates the need for invasive treatments. Further research in this field is therefore warranted. Given the heterogeneity of fibroids and the lack of effective treatments in controlling their growth, the identification of signals that stimulate the onset and growth of these fibroids opens doors to the development of new therapies. In the future we may be able to differentiate classes of fibroids by molecular techniques and thereby implement specific treatments that control their development and their associated symptoms.

  6. Is exercise an alternative treatment for chronic insomnia?

    PubMed Central

    Passos, Giselle Soares; Poyares, Dalva Lucia Rollemberg; Santana, Marcos Gonçalves; Tufik, Sergio; de Mello, Marco Túlio

    2012-01-01

    The purposes of this systematic/critical review are: 1) to identify studies on the effects of exercise on chronic insomnia and sleep complaints in middle-aged and older adults and to compare the results of exercise with those obtained with hypnotic medications and 2) to discuss potential mechanisms by which exercise could promote sleep in insomniac patients. We identified studies from 1983 through 2011 using MEDLINE, SCOPUS and Web of Science. For systematic analyses, only studies assessing the chronic effects of exercise on sleep in people with sleep complaints or chronic insomnia were considered. We used the following keywords when searching for articles: insomnia, sleep, sleep complaints, exercise and physical activity. For a critical review, studies were selected on the effects of exercise and possible mechanisms that may explain the effects of exercise on insomnia. We identified five studies that met our inclusion criteria for systematic review. Exercise training is effective at decreasing sleep complaints and insomnia. Aerobic exercise has been more extensively studied, and its effects are similar to those observed after hypnotic medication use. Mechanisms are proposed to explain the effects of exercise on insomnia. There is additional documented evidence on the antidepressant and anti-anxiety effects of exercise. Exercise is effective to decrease sleep complaints and to treat chronic insomnia. Exercise presented similar results when compared with hypnotics; however, prospective studies comparing the effects of exercise with medical and non-medical treatments are warranted before including exercise as a first-line treatment for chronic insomnia are necessary. PMID:22760906

  7. Medical treatments for incomplete miscarriage (less than 24 weeks)

    PubMed Central

    Neilson, James P; Gyte, Gillian ML; Hickey, Martha; Vazquez, Juan C; Dou, Lixia

    2014-01-01

    . Overall, there were fewer surgical evacuations with misoprostol (average RR 0.07, 95% CI 0.03 to 0.18; eight studies, 1538 women) but more unplanned procedures (average RR 6.32, 95% CI 2.90 to 13.77; six studies, 1158 women). There were few data on ‘deaths or serious complications’. Limited evidence suggests that women generally seem satisfied with their care. Long-term follow up from one included study identified no difference in subsequent fertility between the three approaches. Authors’ conclusions The available evidence suggests that medical treatment, with misoprostol, and expectant care are both acceptable alternatives to routine surgical evacuation given the availability of health service resources to support all three approaches. Women experiencing miscarriage at less than 13 weeks should be offered an informed choice. [Note: the 34 citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.] PMID:20091626

  8. Candidiasis: predisposing factors, prevention, diagnosis and alternative treatment.

    PubMed

    Martins, Natália; Ferreira, Isabel C F R; Barros, Lillian; Silva, Sónia; Henriques, Mariana

    2014-06-01

    Candidiasis is the most common opportunistic yeast infection. Candida species and other microorganisms are involved in this complicated fungal infection, but Candida albicans continues to be the most prevalent. In the past two decades, it has been observed an abnormal overgrowth in the gastrointestinal, urinary and respiratory tracts, not only in immunocompromised patients, but also related to nosocomial infections and even in healthy individuals. There is a widely variety of causal factors that contribute to yeast infection which means that candidiasis is a good example of a multifactorial syndrome. Due to rapid increase in the incidence in these infections, this is the subject of numerous studies. Recently, the focus of attention is the treatment and, above all, the prevention of those complications. The diagnosis of candidiasis could become quite complicated. Prevention is the most effective "treatment," much more than eradication of the yeast with antifungal agents. There are several aspects to consider in the daily routine that can provide a strength protection. However, a therapeutic approach is necessary when the infection is established, and therefore, other alternatives should be explored. This review provides an overview on predisposition factors, prevention and diagnosis of candidiasis, highlighting alternative approaches for candidiasis treatment.

  9. Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

    PubMed Central

    Hogue, Aaron; Bobek, Molly; Tau, Gregory Z.; Levin, Frances R.

    2014-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions. PMID:25505817

  10. Alternate Care Sites for the Management of Medical Surge in Disasters

    DTIC Science & Technology

    2013-12-01

    Accountability Office 2010 ). The 2008 report specifically identified alternate care sites as a method to increase hospital capacity and deliver medical...Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project...Florida MS , Florida State University BS, University of Central Florida Submitted in partial fulfillment of the requirements for the degree of MASTER

  11. Conventional and alternative treatment approaches for Clostridium difficile infection

    PubMed Central

    Aljarallah, Khalid M.

    2017-01-01

    Clostridium difficile-associated disease continues to be one of the leading health concerns worldwide. C. difficile is considered as a causative agent of nosocomial diarrhea that causes serious infection, which may result in death. The incidences of C. difficile infection (CDI) in developed countries have become increasingly high which may be attributed to the emergence of newer epidemic strains, extensive use of antibiotics, and limited alternative therapies. The available treatment options against CDI are expensive and promote resistance. Therefore, there is urgent need for new approaches to meet these challenges. This review discusses the current understanding of CDI, the existing clinical treatment strategies and future potential options as antidifficile agents based on the available published works. PMID:28293151

  12. Alternative Therapeutic Approach in the Treatment of Oral Pyogenic Granuloma

    PubMed Central

    Bugshan, Amr; Patel, Harsh; Garber, Karen; Meiller, Timothy F.

    2015-01-01

    Pyogenic granulomas (PGs) in the oral cavity present as an inflammatory hyperplasia usually caused by trauma, hormonal imbalance, chronic irritation, or as the response to a wide variety of drugs. PGs with atypical presentation and behavior may clinically mimic malignant tumors. Thus, histological examination is required to rule out cancer development. Lesions in the oral cavity have been described to be either an isolated entity or present in multiple forms and with multiple recurrences. Conservative surgical excision is the standard choice of treatment in almost every scenario. However, the severity of the lesions and the affected sites often challenge surgical treatment. In this report, we describe the clinical scenario of a recurrent PG, where surgical excision of the lesion was questioned. As an alternative, we describe a noninvasive approach with lesional steroid injections. PMID:26668570

  13. On-site or off-site treatment of medical waste: a challenge.

    PubMed

    Taghipour, Hassan; Mohammadyarei, Taher; Asghari Jafarabadi, Mohamad; Asl Hashemi, Ahmad

    2014-01-01

    Treating hazardous-infectious medical waste can be carried out on-site or off-site of health-care establishments. Nevertheless, the selection between on-site and off-site locations for treating medical waste sometimes is a controversial subject. Currently in Iran, due to policies of Health Ministry, the hospitals have selected on-site-treating method as the preferred treatment. The objectives of this study were to assess the current condition of on-site medical waste treatment facilities, compare on-site medical waste treatment facilities with off-site systems and find the best location of medical waste treatment. To assess the current on-site facilities, four provinces (and 40 active hospitals) were selected to participate in the survey. For comparison of on-site and off-site facilities (due to non availability of an installed off-site facility) Analytical Hierarchy Process (AHP) was employed. The result indicated that most on-site medical waste treating systems have problems in financing, planning, determining capacity of installations, operation and maintenance. AHP synthesis (with inconsistency ratio of 0.01 < 0.1) revealed that, in total, the off-site treatment of medical waste was in much higher priority than the on-site treatment (64.1% versus 35.9%). According to the results of study it was concluded that the off-site central treatment can be considered as an alternative. An amendment could be made to Iran's current medical waste regulations to have infectious-hazardous waste sent to a central off-site installation for treatment. To begin and test this plan and also receive the official approval, a central off-site can be put into practice, at least as a pilot in one province. Next, if it was practically successful, it could be expanded to other provinces and cities.

  14. Medication Treatment for Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Ryan, Joseph B.; Katsiyannis, Antonis; Hughes, Elizabeth M.

    2011-01-01

    Attention deficit hyperactivity disorder (ADHD) has become the most commonly diagnosed psychiatric disorder among school-age children. For more than half a century, physicians have prescribed medications to help manage behaviors such as hyperactivity, impulsivity, and inattention. Today, there is a growing consensus that ADHD is a biologically…

  15. Psychotherapeutic Medication in the Treatment of Refugees.

    ERIC Educational Resources Information Center

    Jaranson, James M.

    This paper is an overview of issues and findings in the use of medication to treat mentally ill refugees. The introductory background section briefly discusses the development of interest in ethnic differences in response to psychotropic drugs. The second section highlights the results of research literature on the use of the following kinds of…

  16. [New alternatives in the treatment of bacterial vaginosis].

    PubMed

    Luis Arredondo, J; Higuera, F; Narcio, M L; Casanova, G; Beltrán, M

    1994-08-01

    Efficiency and security clindamycin vaginal cream (2%) were compared to oral metronidazole's for the treatment of 184 women with symptomatic bacterial vaginosis in a multicentric, randomized, double-blind, controlled study. The treatment was of 7 days duration, using placebo capsules for the clindamycin group and placebo cream for the metronidazole group. Patients were observed during a follow up (4-13 and 20-43 days after completion of therapy). Global results of this treatment indicated that clindamycin vaginal cream offers a similar efficiency than oral metronidazole. Improvement or total healing was 87% for clindamycin and 79% for metronidazole, with no significant differences (p > 0.22). No relapses were observed in the clindamycin group, and 7% in the metronidazole group. The clindamycin group had a failure rate of 3% compared to 15% in the oral metronidazole group. Both drugs were well tolerated. Side effects more frequently reported were vulvovaginal irritation and cervicitis/vaginitis. The only side effect that could have been classified as serious was a generalized rash in a patient receiving metronidazole. It was concluded that clindamycin vaginal cream (2%) is an efficient and secure alternative to oral metronidazole for the treatment of bacterial vaginosis being the elective therapy for pregnant women in their first gestational trimester.

  17. Five Medical Treatment Stages of Infertility: Implications for Counselors.

    ERIC Educational Resources Information Center

    Gerrity, Deborah A.

    2001-01-01

    Explores the marital happiness, state/trait anxiety, coping techniques, and types of support received for a national sample of men and women experiencing the infertility medical process. Suggests that counselors should be aware that medical treatment affects the distress level of the individual and couple and the types of coping used. Further…

  18. Medical Student Views of Substance Abuse Treatment, Policy and Training

    ERIC Educational Resources Information Center

    Agrawal, Shantanu; Everett, Worth W.; Sharma, Sonali

    2010-01-01

    Purpose: This study examined the impact of medical education on students' views of substance abuse treatment, public policy options and training. Method: A longitudinal survey was conducted on a single-class cohort of 101 students in a major American, urban medical school. The survey was administered in the Spring semesters of the first to third…

  19. Medications Used in the Treatment of Ischemic Heart Disease.

    ERIC Educational Resources Information Center

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on medications used in the treatment of ischemic heart disease is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first.…

  20. Medical treatment update on pulmonary arterial hypertension.

    PubMed

    Enderby, Cher Y; Burger, Charles

    2015-09-01

    Pulmonary arterial hypertension is a chronic, progressive disease of the pulmonary vasculature resulting in poor outcomes if left untreated. The management of group 1 pulmonary arterial hypertension has included the use of prostanoids, phosphodiesterase-5 inhibitors, and endothelin receptor antagonists targeting the prostacyclin, endothelin-1, and nitric oxide pathways. Three new medications have been approved by the US Food and Drug Administration over the past couple of years. Macitentan is the newest endothelin receptor antagonist, riociguat is a soluble guanylate cyclase stimulator, and treprostinil diolamine is the first oral prostanoid. This review will focus on the key trials leading to their approval, special considerations for each medication, and their potential place in therapy. The use of combination therapy as initial therapy in pulmonary arterial hypertension will also be discussed.

  1. [EXPERIENCE OF DIAGNOSTICS AND MEDICAL TREATMENT OF THE DIEULAFOYS DISEASE].

    PubMed

    P'iatykop, H I; Kravets', O V; Moskalenko, R A; Bratushka, V O

    2014-01-01

    The article is dedicated to the features of diagnostics and medical treatment of the Dieulafoys disease. Clinical description of six cases of foregoing pathology is resulted. The morphological features ulcers Dieulafoy are described. One fatal outcome of disease is analysed.

  2. Medical Treatment of Osteoporotic Vertebral Fractures

    PubMed Central

    Langdahl, Bente Lomholt; Harsløf, Torben

    2011-01-01

    A vertebral fracture is a serious symptom of osteoporosis. Vertebral fractures cause moderate-to-severe back pain for a shorter or longer duration, increase the risk of a subsequent vertebral fracture approximately four-fold, reduce quality of life significantly and are associated with increased mortality. In order to choose the optimal treatment for the patient, the severity and type of osteoporosis should be investigated. Prevention of new osteoporotic fractures can be accomplished through treatment with both antiresorptive and anabolic treatments. The antiresorptive treatment modalities comprise calcium, vitamin D, bisphosphonates, hormone therapy, selective oestrogen receptor modulators (SERMs), strontium ranelate, receptor activator of NF-kB ligand (RANKL) antibody and calcitonin. The anabolic treatments comprise teriparatide and parathyroid hormone [(PTH)-(1–84)]. Adherence with treatment of osteoporosis is generally poor and therefore once the choice of treatment has been made and the patient has been instructed properly, long-term adherence to the treatment should be secured through information and regular control visits. PMID:22870463

  3. Medical tourism: A snapshot of evidence on treatment abroad.

    PubMed

    Lunt, Neil; Horsfall, Daniel; Hanefeld, Johanna

    2016-06-01

    The scoping review focuses on medical tourism, whereby consumers elect to travel across borders or to overseas destinations to receive their treatment. Such treatments include: cosmetic and dental surgery; cardio, orthopaedic and bariatric surgery; IVF; and organ and tissue transplantation. The review assesses the emerging focus of research evidence post-2010. The narrative review traverses discussion on medical tourism definitions and flows, consumer choice, clinical quality and outcomes, and health systems implications. Attention is drawn to gaps in the research evidence.

  4. Risky Treatments: A Jewish Medical Ethics Perspective

    PubMed Central

    Steinberg, Avraham

    2015-01-01

    The Jewish principle concerning a decision with regard to a dangerous treatment is as following: A patient who is estimated to die within 12 months because of a fatal illness is permitted to undergo a treatment that on the one hand may extend his life beyond 12 months, but on the other hand may hasten his death. There are, however, several limitations to this ruling related to the chances of success with the proposed treatment, the nature of the treatment, whether it is intended to be curative or merely to postpone the danger and death, whether the treatment is absolutely necessary, and others. One is not obligated to undergo a dangerous treatment, but one is permitted to do so. The permissibility to forfeit a short life expectancy in order to achieve more prolonged life applies only with the patient’s consent. That consent is valid and is not considered a form of attempted suicide. Neither is a refusal to submit to treatment considered an act of suicide; the patient has the right to refuse a dangerous procedure. In all situations where a permissive ruling is granted for a patient to endanger his short life expectancy, the ruling should be arrived at after careful reflection and with the approval of the rabbinic authorities acting on the recommendation of the most expert physicians. PMID:26241221

  5. Practice Parameter: Medical Treatment of Infantile Spasms

    PubMed Central

    Mackay, M.T.; Weiss, S.K.; Adams-Webber, T.; Ashwal, S.; Stephens, D.; Ballaban-Gill, K.; Baram, T.Z.; Duchowny, M.; Hirtz, D.; Pellock, J.M.; Shields, W.D.; Shinnar, S.; Wyllie, E.; Snead, O.C.

    2010-01-01

    Objective To determine the current best practice for treatment of infantile spasms in children. Methods Database searches of MEDLINE from 1966 and EMBASE from 1980 and searches of reference lists of retrieved articles were performed. Inclusion criteria were the documented presence of infantile spasms and hypsarrhythmia. Outcome measures included complete cessation of spasms, resolution of hypsarrhythmia, relapse rate, developmental outcome, and presence or absence of epilepsy or an epileptiform EEG. One hundred fifty-nine articles were selected for detailed review. Recommendations were based on a four-tiered classification scheme. Results Adrenocorticotropic hormone (ACTH) is probably effective for the short-term treatment of infantile spasms, but there is insufficient evidence to recommend the optimum dosage and duration of treatment. There is insufficient evidence to determine whether oral corticosteroids are effective. Vigabatrin is possibly effective for the short-term treatment of infantile spasm and is possibly also effective for children with tuberous sclerosis. Concerns about retinal toxicity suggest that serial ophthalmologic screening is required in patients on vigabatrin; however, the data are insufficient to make recommendations regarding the frequency or type of screening. There is insufficient evidence to recommend any other treatment of infantile spasms. There is insufficient evidence to conclude that successful treatment of infantile spasms improves the long-term prognosis. Conclusions ACTH is probably an effective agent in the short-term treatment of infantile spasms. Vigabatrin is possibly effective. PMID:15159460

  6. Medical and surgical treatment of tremors.

    PubMed

    Schneider, Susanne A; Deuschl, Günther

    2015-02-01

    Tremor is a hyperkinetic movement disorder characterized by rhythmic oscillations of one or more body parts. Disease severity ranges from mild to severe with various degrees of impact on quality of life. Essential tremor and parkinsonian tremor are the most common etiologic subtypes. Treatment may be challenging; although several drugs are available, response may be unsatisfactory. For some tremor forms, controlled data are scarce or completely missing and treatment is often based on anecdotal evidence. In this article, we review the current literature on tremor treatment, with a focus on common forms.

  7. Cryptococcosis: epidemiology, fungal resistance, and new alternatives for treatment.

    PubMed

    Gullo, F P; Rossi, S A; Sardi, J de C O; Teodoro, V L I; Mendes-Giannini, M J S; Fusco-Almeida, A M

    2013-11-01

    Cryptococcosis is an important systemic mycosis and the third most prevalent disease in human immunodeficiency virus (HIV)-positive individuals. The incidence of cryptococcosis is high among the 25 million people with HIV/acquired immunodeficiency syndrome (AIDS), with recent estimates indicating that there are one million cases of cryptococcal meningitis globally per year in AIDS patients. In Cryptococcus neoformans, resistance to azoles may be associated with alterations in the target enzyme encoded by the gene ERG11, lanosterol 14α-demethylase. These alterations are obtained through mutations, or by overexpressing the gene encoding. In addition, C. gattii and C. neoformans present a heteroresistance phenotype, which may be related to increased virulence. Other species beyond C. neoformans and C. gattii, such as C. laurentii, have been diagnosed mainly in patients with immunosuppression. Infections of C. albidus have been isolated in cats and marine mammals. Recent evidence suggests that the majority of infections produced by this pathogen are associated with biofilm growth, which is also related with increased resistance to antifungal agents. Therefore, there is a great need to search for alternative antifungal agents for these fungi. The search for new molecules is currently occurring from nanoparticle drugs of plant peptide origin. This article presents a brief review of the literature regarding the epidemiology of cryptococcosis, as well as fungal resistance and new alternatives for treatment.

  8. Easing Chronic Pain: Better Treatments and Medications

    MedlinePlus

    ... chemicals to interrupt relay of pain messages between the brain and other parts of the body; and enzymes injected into lumbar disks. Physical methods Common treatments include physical therapy, biofeedback, acupuncture, electrical stimulation, R.I.C.E. ( ...

  9. Neoadjuvant endocrine treatment in early breast cancer: An overlooked alternative?

    PubMed

    van Dam, P A; van Dam, V C N; Altintas, S; Papadimitriou, K; Rolfo, C; Trinh, X B

    2016-03-01

    During the last decade neoadjuvant endocrine therapy (NET) has moved from being reserved for elderly and frail non-chemotherapy candidates to a primary systemic modality in selected patients with hormone sensitive breast cancer. Neoadjuvant hormonal treatment in patients with hormone receptor positive, HER-2 negative early breast cancer is proven to be an effective and safe option; it is associated with a higher rate of breast conserving surgery (BCS), may reduce the need for adjuvant chemotherapy and enables a delay of surgery for medical or practical reasons. Clinical responses range from 13% to 100% with at least 3 months of NET. Methods of assessing response should include MRI of the breast, particularly in lobular tumours. In studies comparing tamoxifen with aromatase inhibitors (AI), AI proved to be superior in terms of tumour response and rates of BCS. Change in Ki67 is accepted as a validated endpoint for comparing endocrine neoadjuvant agents. Levels of Ki67 during treatment are more closely related to long-term prognosis than pretreatment Ki67. Neoadjuvant endocrine therapy provides a unique opportunity for studies of endocrine responsiveness and the development of new experimental drugs combined with systemic hormonal treatment.

  10. Standard and alternative adjunctive treatments in cardiac rehabilitation.

    PubMed

    Levy, J K

    1993-01-01

    Cardiovascular rehabilitation is the process of restoring functional abilities degraded by a serious cardiovascular event or by a surgical procedure to preempt such an event. Cardiovascular rehabilitation also includes attempts to reverse risk factors that have contributed initially to the disease process. Rehabilitation programs generally comprise disease-related educational components, supervised prescriptive physical exercise, diet counseling and modification, cessation of tobacco use, psychoeducational interventions aimed at adjustment and coping, and relaxation and stress management to lower nonexertion-related sympathetic drive. The presence of so-called coronary-prone behavior patterns can be detected, and special behavioral modifications may be indicated to mitigate these putative risk factors. This paper reviews the roles of these behavioral adjuncts in treating cardiovascular disease and its aftermath, and notes new and unusual approaches to these components of treatment, such as alternative exercises, biofeedback, yoga, and other relaxation methods. Barriers to compliance are acknowledged, and enhancement of compliance is discussed briefly.

  11. Standard and alternative adjunctive treatments in cardiac rehabilitation.

    PubMed Central

    Levy, J K

    1993-01-01

    Cardiovascular rehabilitation is the process of restoring functional abilities degraded by a serious cardiovascular event or by a surgical procedure to preempt such an event. Cardiovascular rehabilitation also includes attempts to reverse risk factors that have contributed initially to the disease process. Rehabilitation programs generally comprise disease-related educational components, supervised prescriptive physical exercise, diet counseling and modification, cessation of tobacco use, psychoeducational interventions aimed at adjustment and coping, and relaxation and stress management to lower nonexertion-related sympathetic drive. The presence of so-called coronary-prone behavior patterns can be detected, and special behavioral modifications may be indicated to mitigate these putative risk factors. This paper reviews the roles of these behavioral adjuncts in treating cardiovascular disease and its aftermath, and notes new and unusual approaches to these components of treatment, such as alternative exercises, biofeedback, yoga, and other relaxation methods. Barriers to compliance are acknowledged, and enhancement of compliance is discussed briefly. PMID:8219823

  12. New medications for the treatment of cocaine dependence.

    PubMed

    Kampman, Kyle M

    2005-12-01

    Cocaine dependence continues to be a significant public health problem in the United States. Although some cocaine- dependent patients will respond well to drug counseling, for many, standard psychosocial treatment is inadequate. Therefore, the development of an effective medication for the treatment of cocaine dependence is a research priority. However, despite many years of research, no medication has emerged as consistently effective for the treatment of cocaine dependence. Progress in the understanding of the neurobiology of cocaine dependence has led to the discovery of several promising medications that have already shown encouraging results in controlled clinical trials. Among more severely addicted patients, propranolol may be helpful in promoting an initial period of stable abstinence. For the prevention of relapse, medications that block cocaine euphoria or reduce cocaine craving have shown promise. Potential relapse-prevention medications include GABAergic medications, such as baclofen, tiagabine, and topiramate, and the glutamatergic medication, modafinil. Surprisingly, an old treatment for alcohol dependence, disulfiram, may also have efficacy for cocaine relapse prevention. Finally, a vaccine capable of stimulating the production of cocaine specific antibodies has shown promise in preliminary studies for the prevention of relapse to cocaine use.

  13. [Recent advances in medical and surgical treatment of ulcerative colitis].

    PubMed

    Sugita, Akira; Koganei, Kazutaka; Tatsumi, Kenji; Futatsuki, Ryo; Kuroki, Hirosuke; Yamada, Kyoko; Arai, Katsuhiko; Fukushima, Tsuneo

    2015-03-01

    Recent advances in both medical and surgical treatment of ulcerative colitis have been remarkable. Changes in medical treatment are mainly good results of therapy with the anti-TNF-α antibody, tacrolimus, and those in surgical treatment are an expansion of the surgical indications to include patients with intractable disease, such as treatment refractoriness and chronic corticosteroid dependence, by a better postoperative clinical course after pouch surgery, improred selection of surgical procedures and the timing of surgery in elderly patients. To offer the optimal treatment for patients with ulcerative colitis, new medical therapies should be analyzed from the standpoint of the efficacy and limitations of effect. Long postoperative clinical course of surgical patients including colitic cancer, prevention of postoperative complications should be also analyzed.

  14. Elderly patients’ participation in emergency medical services when offered an alternative care pathway

    PubMed Central

    Vicente, Veronica; Castren, Maaret; Sjöstrand, Fredrik; Sundström, Birgitta Wireklint

    2013-01-01

    As organizational changes in the healthcare system are in progress, to enhance care quality and reduce costs, it is important to investigate how these changes affect elderly patients’ experiences and their rights to participate in the choice of healthcare. The aim of this study is to describe elderly patients’ lived experience of participating in the choice of healthcare when being offered an alternative care pathway by the emergency medical services, when the individual patient's medical needs made this choice possible. This study was carried out from the perspective of caring science, and a phenomenological approach was applied, where data were analysed for meaning. Data consist of 11 semi-structured interviews with elderly patients who chose a healthcare pathway to a community-based hospital when they were offered an alternative level of healthcare. The findings show that the essence of the phenomenon is described as “There was a ray of hope about a caring encounter and about being treated like a unique human being”. Five meaningful constituents emerged in the descriptions: endurable waiting, speedy transference, a concerned encounter, trust in competence, and a choice based on memories of suffering from care. The conclusion is that patient participation in the choice of a healthcare alternative instead of the emergency department is an opportunity of avoiding suffering from care and being objectified. PMID:23445898

  15. Medical tourism in the backcountry: alternative health and healing in the Arkansas Ozarks.

    PubMed

    Nolan, Justin M; Schneider, Mary Jo

    2011-01-01

    Tourists travel to Arkansas' mountain regions to experience, appreciate, and consume multiple aspects of otherness, including sacred sites and pristine and authentic peoples and environments. A largely unexplored aspect of this consumption of authenticity is alternative medicine, provided to tourists and day travelers in search of physical and emotional restoration. Traditional forms of medicine are deeply rooted in women's social roles as community healers in the region and are perpetuated in part because of the lack of readily accessible forms of so-called modern medicine. Contemporary medical tourism in Arkansas has promoted access to folk health systems, preserving them by incorporating them into tourists' health care services, and also has attracted new and dynamic alternative medical practices while encouraging the transformation of existing forms of traditional medicine. Ultimately, the blend of alternative, folk, and conventional medicine in the Arkansas highlands is evidence of globalizing forces at work in a regional culture. It also serves to highlight a renewed appreciation for the historic continuity and the efficacy of traditional knowledge in the upper South.

  16. Alternative medicine in atrial fibrillation treatment-Yoga, acupuncture, biofeedback and more.

    PubMed

    Kanmanthareddy, Arun; Reddy, Madhu; Ponnaganti, Gopi; Sanjani, Hari Priya; Koripalli, Sandeep; Adabala, Nivedita; Buddam, Avanija; Janga, Pramod; Lakkireddy, Thanmay; Bommana, Sudharani; Vallakati, Ajay; Atkins, Donita; Lakkireddy, Dhanunjaya

    2015-02-01

    The last decade has seen a significant improvement in the management of atrial fibrillation (AF) with the development of newer medications and improvement in catheter ablation techniques. Recurrence of AF remains a significant problem in these patients and medications offer limited supportive role. Complementary and alternative treatment strategies therefore remain a viable option for these AF patients. Several studies have shown improvement in AF symptoms with yoga therapy, acupuncture and biofeedback. There are also several herbal medicine and supplements such as omega-3 fatty acids, antioxidant vitamins, barberry, motherwort, cinchona, Shensongyangxin, hawthorn, Kella and Wenxin Keli that have been evaluated as potential therapeutic options in AF. These studies are however limited by small sample sizes with mixed results. Besides the pharmacological action, metabolism, interactions with other medications and the adverse effects of the herbal medications and supplements remain poorly understood. In spite of the above limitations, complementary therapies remain a promising option in the management of AF and further studies are necessary to validate their safety and efficacy.

  17. Medical prevention and treatment of urinary stones.

    PubMed

    Colussi, G; De Ferrari, M E; Brunati, C; Civati, G

    2000-01-01

    Despite revolutionary developments in minimally invasive methods for the removal of stones in the last 15 years, the medical prevention of urinary stones remains very rewarding, due to the continual increase in the prevalence of nephrolithiasis in western countries, the high recurrence rate of the disease, its complications, discomfort and the costs of lithotripsy. Medical prevention is highly effective (50-95% efficacy in different series) and cost-convenient; its basic elements are appropriate metabolic evaluation, adequate hydration, "common sense" diet, and, in selected cases, drugs of proven efficacy. Clinical-metabolic evaluation should aim at the recognition of specific types of nephrolithiasis, and sort out secondary and/or remediable cases, define urinary risk factors, assess patients' compliance and the side effects of any therapy during follow-up. Hydration has proved effective in clinical trials and population-based observational studies; "fluids" may consist of water (any kind), coffee (caffeinated or decaffeinated), tea, beer and wine; grapefruit juice appears to have an unexplained ill effect. Despite the lack of clinical demonstration that dietary manipulations reduce the recurrences of stones, biochemical and epidemiological data suggest that high sodium, animal protein and sucrose intake increase the risk. Undue reductions in Ca intake also appear to be detrimental both for stone recurrences and bone mineralisation: "adequate" Ca intake (800-1000 mg/day) should be encouraged, but only in food since supplemental Ca, as drugs, appears to increase the risk of stones. Effective drugs are available for cystine, uric acid, infected stones and several secondary causes of Ca nephrolithiasis; in "idiopathic" Ca nephrolithiasis, thiazides, allopurinol, K and K-Mg citrate and possibly neutral K phosphate have been shown to be effective, at least in specific metabolic contexts.

  18. MEDICATION TREATMENT OF DIFFERENT TYPES OF ALCOHOLISM

    PubMed Central

    Johnson, Bankole A.

    2010-01-01

    Alcoholism remain a serious cause of morbidity and mortality, despite progress through neurobiological research in identifying new pharmacological strategies for its treatment. Drugs that affect neural pathways that modulate the activity of the cortico-mesolimbic dopamine system have been shown to alter drinking behavior, presumably because this dopaminergic system is closely associated with rewarding behavior. Ondansetron, naltrexone, topiramate, and baclofen are examples. Subtyping alcoholism in adults into an early-onset type, with chronic symptoms and a strong biological predisposition to the disease, and a late-onset type, typically brought on by psychosocial triggers and associated with mood symptoms, may help in the selection of optimal therapy. Emerging adults with binge-drinking patterns also might be aided by selective treatments. Although preliminary work on the pharmacogenetics of alcoholism and its treatment has been promising, the assignment to treatment still depends on clinical assessment. Brief behavioral interventions that encourage the patient to set goals for a reduction in heavy drinking or abstinence also are part of optimal therapy. PMID:20516163

  19. [Medical treatment of inflammatory intestinal diseases].

    PubMed

    Järnerot, G

    1991-01-01

    What possible treatments are there for inflammatory intestinal diseases, and on what scientific grounds do we treat these patients? A survey shows that the considerable decline in mortality which has occurred as regards ulcerous colitis ensued rather via trial and error than as a result of regular clinical tests.

  20. Customer satisfaction and consumer responsibility: toward an alternative model of medical service quality.

    PubMed

    Pinto, M B; Barber, J C

    1999-01-01

    In the increasingly competitive environment of medical services and patient care, physicians feel a strong pressure for increasing efforts to improve patient satisfaction with the goal of creating a loyal patient base. These steps to promote patient satisfaction have typically involved developing new programs and services, as medical offices seek to attract and keep their patients by continually enhancing service features. While patient satisfaction is a worthy goal, this paper argues that we often make mistakes and incur expensive costs in pursuing satisfaction as an end unto itself. This paper proposes an alternative model, based on creating a doctor-patient therapeutic alliance which has the dual benefits of enhancing patient satisfaction while improving the critical personal relationship between doctors and their patients, so necessary for the delivery of optimal care.

  1. [The medical records of home health care patients: a complement or alternative to an electronic file?].

    PubMed

    Perrot, P; Baudier, F; Schmitt, B

    2005-06-01

    Home health care services for dependant people involve participation and interventions of professionals from the health care, medico-social and social sectors. In order to ensure quality care, the flow of information must appropriately circulate between all of the various care providers. The establishment of an electronic medical file for these patients is a possible solution which has been proposed to be conducted in next years. A paper medical record is the property of the patient and offers the possibility of an alternative and complementary solution. The electronic file would use the existing available file as a starting point, and without any additional organisational structures being implicated, it allows for better coordination of the health, medical and social activities. An experimental implementation of this in the Franch-Comte region of France demonstrated the advantages and benefits of such a tool based on a logic centered upon the individual and the open sharing of practices between professionals in the medical and social sectors.

  2. Medical evaluation and treatment of urolithiasis.

    PubMed

    Nicoletta, Julie A; Lande, Marc B

    2006-06-01

    Nephrolithiasis is responsible for 1 in 1000 to 1 in 7600 pediatric hospital admissions annually throughout the United States. Seventy-five percent of children with nephrolithiasis have an identifiable predisposition to stone formation. This article reviews the different causes and disease states associated with nephrolithiasis in the pediatric population. The initial evaluation and the metabolic evaluation of children with nephrolithiasis are reviewed. Treatment modalities for the different stone types are also described.

  3. Medical tourism: assessing the evidence on treatment abroad.

    PubMed

    Lunt, Neil; Carrera, Percivil

    2010-05-01

    The review focuses on one growing dimension of health care globalisation - medical tourism, whereby consumers elect to travel across borders or to overseas destinations to receive their treatment. Such treatments include cosmetic and dental surgery; cardio, orthopaedic and bariatric surgery; IVF treatment; and organ and tissue transplantation. The review sought to identify the medical tourist literature for out-of-pocket payments, focusing wherever possible on evidence and experience pertaining to patients in mid-life and beyond. Despite increasing media interest and coverage hard empirical findings pertaining to out-of-pocket medical tourism are rare. Despite a number of countries offering relatively low cost treatments we know very little about many of the numbers and key indicators on medical tourism. The narrative review traverses discussion on medical tourist markets, consumer choice, clinical outcomes, quality and safety, and ethical and legal dimensions. The narrative review draws attention to gaps in research evidence and strengthens the call for more empirical research on the role, process and outcomes of medical tourism. In concluding it makes suggestion for the content of such a strategy.

  4. [Cognitive-behavioral treatment of insomnia and its use during withdrawal of hypnotic medication].

    PubMed

    Belleville, Geneviève; Bélanger, Lynda; Morin, Charles M

    2003-01-01

    Insomnia is a widespread health problem that often leads to the use of hypnotic medication. Among the available pharmacological agents to treat insomnia, benzodiazepines (BZD) present some undesirable effects, entailing risks of tolerance and dependence, and increased risk of automobile accidents, falls and fractures in the elderly. Cognitive-behavioral treatment (CBT) of insomnia, which focuses on psychological and behavioral factors that play a role in maintaining sleep-related problems, is efficient to improve sleep in the elderly who suffer from primary insomnia. This treatment may represent an alternative to pharmacotherapy or again be complementary during discontinuation of hypnotic medication. The CBT of insomnia may include different components such as stimulus control, sleep restriction, relaxation, cognitive restructuring and sleep hygiene. For people who are dependent to BZD or other hypnotic medication, a supervised tapering based on attaining successive objectives is generally added to the CBT of insomnia.

  5. [Obligatory treatment: ethical, medical and legal issues].

    PubMed

    Archambault, Jean-Claude

    2006-06-01

    Legislation passed on 30 June 1838 created a medico-administrative and legal framework for forced hospitalization. Updated in 1990, this law has been evaluated twice. The last evaluation, in 2005, recommended a 72-hour observation period before deciding whether hospitalization was necessary. The situation of violent patients remains unclear. On the one hand, the psychiatrist has no means of impinging on these patients if they decide to stop their treatment once outside the hospital. On the other hand, for patients who are declared to be irresponsible, it would be wise to consider the possibility of being able to judge them, and adapt their sentences accordingly.

  6. A review of alternatives to di (2-ethylhexyl) phthalate-containing medical devices in the neonatal intensive care unit

    PubMed Central

    Van Vliet, EDS; Reitano, EM; Chhabra, JS; Bergen, GP; Whyatt, RM

    2012-01-01

    Objective To conduct an extensive literature and toxicological database review on substitute compounds and available alternative medical products to replace polyvinyl chloride (PVC) and/or di(2-ethylhexyl) phthalate (DEHP), and conduct a DEHP-medical inventory analysis at a large metropolitan neonatal intensive care unit (NICU). Study Design A systematic search for DEHP-free alternative products was performed using online databases. An informal audit of a large metropolitan NICU was undertaken in 2005 and 2006; 21 products were identified that could potentially contain DEHP. Availability of DEHP-free alternatives was determined through company websites and phone interviews. Result Two alternative approaches are available for replacing DEHP in NICU medical products: (1) replacement by DEHP-free plasticizers; and (2) replacement of PVC entirely through the use of other polymers. Both approaches seem to provide less harmful substitutes to DEHP, but support PVC-free polymers as the preferred alternative. However, significant data gaps exist, particularly for the alternative polymers. In all, 10 out of 21 (48%) products in the NICU audit were DEHP-free; six consisted of alternative polymers and four of alternative plasticizers. Of the remaining 11 products, only three were available without DEHP at the time of the audit. Conclusion Because of significant data gaps, systematic toxicological testing of DEHP-free alternatives is imperative. Continued development of alternative products is also needed. PMID:21311501

  7. The role of information search in seeking alternative treatment for back pain: a qualitative analysis

    PubMed Central

    2014-01-01

    Background Health consumers have moved away from a reliance on medical practitioner advice to more independent decision processes and so their information search processes have subsequently widened. This study examined how persons with back pain searched for alternative treatment types and service providers. That is, what information do they seek and how; what sources do they use and why; and by what means do they search for it? Methods 12 persons with back pain were interviewed. The method used was convergent interviewing. This involved a series of semi-structured questions to obtain open-ended answers. The interviewer analysed the responses and refined the questions after each interview, to converge on the dominant factors influencing decisions about treatment patterns. Results Persons with back pain mainly search their memories and use word of mouth (their doctor and friends) for information about potential treatments and service providers. Their search is generally limited due to personal, provider-related and information-supply reasons. However, they did want in-depth information about the alternative treatments and providers in an attempt to establish apriori their efficacy in treating their specific back problems. They searched different sources depending on the type of information they required. Conclusions The findings differ from previous studies about the types of information health consumers require when searching for information about alternative or mainstream healthcare services. The results have identified for the first time that limited information availability was only one of three categories of reasons identified about why persons with back pain do not search for more information particularly from external non-personal sources. PMID:24725300

  8. How Feedback Biases Give Ineffective Medical Treatments a Good Reputation

    PubMed Central

    Eriksson, Kimmo; Strimling, Pontus

    2014-01-01

    Background Medical treatments with no direct effect (like homeopathy) or that cause harm (like bloodletting) are common across cultures and throughout history. How do such treatments spread and persist? Most medical treatments result in a range of outcomes: some people improve while others deteriorate. If the people who improve are more inclined to tell others about their experiences than the people who deteriorate, ineffective or even harmful treatments can maintain a good reputation. Objective The intent of this study was to test the hypothesis that positive outcomes are overrepresented in online medical product reviews, to examine if this reputational distortion is large enough to bias people’s decisions, and to explore the implications of this bias for the cultural evolution of medical treatments. Methods We compared outcomes of weight loss treatments and fertility treatments in clinical trials to outcomes reported in 1901 reviews on Amazon. Then, in a series of experiments, we evaluated people’s choice of weight loss diet after reading different reviews. Finally, a mathematical model was used to examine if this bias could result in less effective treatments having a better reputation than more effective treatments. Results Data are consistent with the hypothesis that people with better outcomes are more inclined to write reviews. After 6 months on the diet, 93% (64/69) of online reviewers reported a weight loss of 10 kg or more while just 27% (19/71) of clinical trial participants experienced this level of weight change. A similar positive distortion was found in fertility treatment reviews. In a series of experiments, we show that people are more inclined to begin a diet with many positive reviews, than a diet with reviews that are representative of the diet’s true effect. A mathematical model of medical cultural evolution shows that the size of the positive distortion critically depends on the shape of the outcome distribution. Conclusions Online

  9. Use of medicated drops and oral tablets in glaucoma treatment.

    PubMed

    Greenwell, C; Spillman, D

    1996-04-01

    This paper addresses the many forms of treatment for glaucoma. We studied particularly the topical drops and oral medications that are most frequently prescribed by ophthalmologists, specifically examining the reasons for the side effects experienced by certain patients taking topical drops and oral medications. Some of the side effects and interactions are discussed, and the importance of proper procedure for application of topical eye drops is stressed. Finally, we emphasize that proper drug usage is critical to the well being of the patient.

  10. Medical waste treatment and decontamination system

    DOEpatents

    Wicks, George G.; Schulz, Rebecca L.; Clark, David E.

    2001-01-01

    The invention discloses a tandem microwave system consisting of a primary chamber in which hybrid microwave energy is used for the controlled combustion of materials. A second chamber is used to further treat the off-gases from the primary chamber by passage through a susceptor matrix subjected to additional hybrid microwave energy. The direct microwave radiation and elevated temperatures provide for significant reductions in the qualitative and quantitative emissions of the treated off gases. The tandem microwave system can be utilized for disinfecting wastes, sterilizing materials, and/or modifying the form of wastes to solidify organic or inorganic materials. The simple design allows on-site treatment of waste by small volume waste generators.

  11. [Medical treatment for gastrointestinal stromal tumor (GIST) in Japan].

    PubMed

    Sato, Atsushi; Hamada, Kazuyuki; Imataka, Hiromi

    2012-05-01

    To facilitate an optimal diagnosis and treatment of GIST in Japan, the Japanese Clinical Practice Guideline for GIST was proposed by the GIST Guideline Subcommittee. Multidisciplinary treatment planning is needed(involving pathologists, radiologists, surgeons and medical oncologists)for patients with GIST. Medical treatment is usually selected for unresectable GIST, metastatic GIST at the initial examination, and recurrent GIST. Imatinib is strongly recommended for patients with KIT-positive GIST; the standard dose of imatinib mesylate(Glivec)is 400 mg/day. For patients with imatinib-resistant GIST, Sunitinib (Sutent)is now approved in Japan and is covered by medical insurance. However, high-dose imatinib(>400mg/day)has not yet been approved in Japan.

  12. An update on the medical treatment of Graves' hyperthyroidism.

    PubMed

    Marinò, Michele; Latrofa, Francesco; Menconi, Francesca; Chiovato, Luca; Vitti, Paolo

    2014-11-01

    Medical treatment of Graves' hyperthyroidism is based on the use of thionamides; namely, methimazole and propylthiouracil. In the past, methimazole was preferred by European endocrinologists, whereas propylthiouracil was the first choice for the majority of their North American colleagues. However, because of the recent definition of a better side-effect profile, methimazole is nowadays the first choice world while. Although thionamides are quite effective for the short-term control of Graves' hyperthyroidism, a relatively high proportion of patients relapses after thionamide withdrawal. Other possible medical treatments, include iodine and compounds containing iodine, perchlorate, lithium (as an adjuvant in patients undergoing radioiodine therapy), β-adrenergic antagonists, glucocorticoids, and some new molecules still under investigation. Management of Graves' hyperthyroidism using thionamides as well as the other available medical treatments is here reviewed in detail, with a special mention of situations such as pregnancy and lactation, as well as neonatal and fetal thyrotoxicosis.

  13. Cracked tooth diagnosis and treatment: An alternative paradigm

    PubMed Central

    Mamoun, John S.; Napoletano, Donato

    2015-01-01

    This article reviews the diagnosis and treatment of cracked teeth, and explores common clinical examples of cracked teeth, such as cusp fractures, fractures into tooth furcations, and root fractures. This article provides alternative definitions of terms such as cracked teeth, complete and incomplete fractures and crack lines, and explores the scientific rationale for dental terminology commonly used to describe cracked teeth, such as cracked tooth syndrome, structural versus nonstructural cracks, and vertical, horizontal, and oblique fractures. The article explains the advantages of high magnification loupes (×6–8 or greater), or the surgical operating microscope, combined with co-axial or head-mounted illumination, when observing teeth for microscopic crack lines or enamel craze lines. The article explores what biomechanical factors help to facilitate the development of cracks in teeth, and under what circumstances a full coverage crown may be indicated for preventing further propagation of a fracture plane. Articles on cracked tooth phenomena were located via a PubMed search using a variety of keywords, and via selective hand-searching of citations contained within located articles. PMID:26038667

  14. Implantable photonic devices for improved medical treatments

    NASA Astrophysics Data System (ADS)

    Sheinman, Victor; Rudnitsky, Arkady; Toichuev, Rakhmanbek; Eshiev, Abdyrakhman; Abdullaeva, Svetlana; Egemkulov, Talantbek; Zalevsky, Zeev

    2014-10-01

    An evolving area of biomedical research is related to the creation of implantable units that provide various possibilities for imaging, measurement, and the monitoring of a wide range of diseases and intrabody phototherapy. The units can be autonomic or built-in in some kind of clinically applicable implants. Because of specific working conditions in the live body, such implants must have a number of features requiring further development. This topic can cause wide interest among developers of optical, mechanical, and electronic solutions in biomedicine. We introduce preliminary clinical trials obtained with an implantable pill and devices that we have developed. The pill and devices are capable of applying in-body phototherapy, low-level laser therapy, blue light (450 nm) for sterilization, and controlled injection of chemicals. The pill is also capable of communicating with an external control box, including the transmission of images from inside the patient's body. In this work, our pill was utilized for illumination of the sinus-carotid zone in dog and red light influence on arterial pressure and heart rate was demonstrated. Intrabody liver tissue laser ablation and nanoparticle-assisted laser ablation was investigated. Sterilization effect of intrabody blue light illumination was applied during a maxillofacial phlegmon treatment.

  15. Implantable photonic devices for improved medical treatments.

    PubMed

    Sheinman, Victor; Rudnitsky, Arkady; Toichuev, Rakhmanbek; Eshiev, Abdyrakhman; Abdullaeva, Svetlana; Egemkulov, Talantbek; Zalevsky, Zeev

    2014-01-01

    An evolving area of biomedical research is related to the creation of implantable units that provide various possibilities for imaging, measurement, and the monitoring of a wide range of diseases and intrabody phototherapy. The units can be autonomic or built-in in some kind of clinically applicable implants. Because of specific working conditions in the live body, such implants must have a number of features requiring further development. This topic can cause wide interest among developers of optical, mechanical, and electronic solutions in biomedicine. We introduce preliminary clinical trials obtained with an implantable pill and devices that we have developed. The pill and devices are capable of applying in-body phototherapy, low-level laser therapy, blue light (450 nm) for sterilization, and controlled injection of chemicals. The pill is also capable of communicating with an external control box, including the transmission of images from inside the patient’s body. In this work, our pill was utilized for illumination of the sinus-carotid zone in dog and red light influence on arterial pressure and heart rate was demonstrated. Intrabody liver tissue laser ablation and nanoparticle-assisted laser ablation was investigated. Sterilization effect of intrabody blue light illumination was applied during a maxillofacial phlegmon treatment.

  16. Analytical methods for the determination of DEHP plasticizer alternatives present in medical devices: a review.

    PubMed

    Bernard, L; Décaudin, B; Lecoeur, M; Richard, D; Bourdeaux, D; Cueff, R; Sautou, V

    2014-11-01

    Until 2010, diethylhexylphthalate (DEHP) was the plasticizer most commonly used to soften PVC medical devices (MDs), because of a good efficiency/cost ratio. In flexible plasticized PVC, phthalates are not chemically bound to PVC and they are released into the environment and thus may come into contact with patients. The European Directive 2007/47/CE, classified DEHP as a product with a toxicity risk and restricted its use in MDs. MD manufacturers were therefore forced to quickly find alternatives to DEHP to maintain the elasticity of PVC nutrition tubings, infusion sets and hemodialysis lines. Several replacement plasticizers, so-called "alternative to DEHP plasticizers" were incorporated into the MDs. Nowadays, the risk of exposure to these compounds for hospitalized patients, particularly in situations classified "at risk", has not yet been evaluated, because migrations studies, providing sufficient exposure and human toxicity data have not been performed. To assess the risk to patients of DEHP plasticizer alternatives, reliable analytical methods must be first developed in order to generate data that supports clinical studies being conducted in this area. After a brief introduction of the characteristics and toxicity of the selected plasticizers used currently in MDs, this review outlines recently analytical methods available to determine and quantify these plasticizers in several matrices, allowing the evaluation of potential risk and so risk management.

  17. Use of Complementary and Alternative Medical (CAM) Therapies Among Youth with Mental Health Concerns

    PubMed Central

    Kemper, Kathi J; Gardiner, Paula; Birdee, Gurjeet S.

    2013-01-01

    Background Use of complementary and alternative medical (CAM) therapies is common among adults with mental health concerns, but little is known about CAM use among adolescents with mental health concerns. Methods Data from the 2007 National Health Interview Survey were analyzed for youth from 7–17 years old. The study focused on three common mental health conditions: attention deficit hyperactivity disorder (ADHD), anxiety, and depression. CAM use was identified by criteria from the National Institutes of Health National Center for Complementary and Alternative Medicine (NIH NCCAM). Results In a sample of 5651 individuals, representing seven million youth, with one or more mental health concerns in the past 12 months, 28.9% used one or more types of CAM excluding vitamins/minerals. In contrast, only 11.6% of those without mental health concerns reported CAM use (P<0.05). Among youth with one or more mental health conditions, the most commonly used CAM therapies were mind-body therapies (16.3%) and biologically-based therapies (11%); use was higher for therapies that could be directly accessed (18.6%), than for therapies delivered in groups (11.8%) or through a health professional (10.2%). In the multivariable regression model, demographic factors significantly associated with CAM use were higher household income, higher parental education, having other chronic health conditions, use of prescription medications, and difficulty affording mental health counseling. Conclusion Readily accessible CAM therapies are commonly used by youth with ADHD, depression, and anxiety, particularly those who have co-morbid chronic health conditions, take prescription medications, and difficulty affording counseling. Clinicians can use this data to guide inquiries and counseling. Researchers should explore the longitudinal relationship between access to coordinated care within a medical home and use of CAM therapies among youth with mental health concerns. What’s New Use of CAM is

  18. Recent advances in the medical treatment of breast cancer.

    PubMed

    Vorobiof, Daniel A

    2016-01-01

    Over the past few decades, the systemic therapy of breast cancer (early and advanced) has changed considerably. For the past 40-50 years, and since the discovery and further therapeutic use of tamoxifen, a selective estrogen receptor modulator, breast cancer treatment has become the model for the development and success of tailored medical treatment. Much still needs to be done in improving outcomes for all patients with breast cancer, and especially for those who have advanced breast cancer, a challenging area for medical oncologists. Ongoing international clinical trials are currently evaluating new therapeutic approaches and identifying specific biological subsets that could determine a patient's ability to respond to particular chemotherapeutic drugs.

  19. [Treatment of Cancer Pain and Medical Narcotics].

    PubMed

    Suzuki, Tsutomu

    2015-01-01

    The World Health Organization has reported that when morphine is used to control pain in cancer patients, psychological dependence is not a major concern. Our studies were undertaken to ascertain the modulation of psychological dependence on morphine under a chronic pain-like state in rats. Morphine induced a dose-dependent place preference. We found that inflammatory and neuropathic pain-like states significantly suppressed the morphine-induced rewarding effect. In an inflammatory pain-like state, the suppressive effect was significantly recovered by treatment with a κ-opioid receptor antagonist. In addition, in vivo microdialysis studies clearly showed that the morphine-induced increase in the extracellular levels of dopamine (DA) in the nucleus accumbens (N.Acc.) was significantly decreased in rats pretreated with formalin. This effect was in turn reversed by the microinjection of a specific dynorphin A antibody into the N.Acc. These findings suggest that the inflammatory pain-like state may have caused the sustained activation of the κ-opioidergic system within the N.Acc., resulting in suppression of the morphine-induced rewarding effect in rats. On the other hand, we found that attenuation of the morphine-induced place preference under neuropathic pain may result from a decrease in the morphine-induced DA release in the N.Acc with a reduction in the μ-opioid receptor-mediated G-protein activation in the ventral tegmental area (VTA). Moreover, nerve injury results in the continuous release of endogenous β-endorphin to cause the dysfunction of μ-opioid receptors in the VTA. This paper also provides a review to clarify misunderstandings of opioid analgesic use to control pain in cancer patients.

  20. Measuring What Medical Students Think about Complementary and Alternative Medicine (CAM): A Pilot Study of the "Complementary and Alternative Medicine Survey"

    ERIC Educational Resources Information Center

    Frye, Ann W.; Sierpina, Victor S.; Boisaubin, Eugene V.; Bulik, Robert J.

    2006-01-01

    With increasing national and international support for the development of Complementary and Alternative Medicine (CAM) curricula in American medical schools, it is essential to measure what learners know and believe about CAM in order to assess outcomes of new teaching efforts. This paper describes the development and initial results of a survey…

  1. Patient satisfaction with conventional, complementary, and alternative treatment for cluster headache in a Norwegian cohort

    PubMed Central

    Bekkelund, Svein I.; Ofte, Hilde K.

    2014-01-01

    Abstract Objective. Cluster headache (CH) may cause excruciating pain and not all patients get satisfactory help. Patient dissatisfaction with general practitioners (GPs) and neurologists, and use of complementary and alternative treatment (CAM) may reflect this. The authors studied patient satisfaction with doctors’ treatment and use of CAM in a Norwegian CH cohort. Subjects. A total of 196 subjects with a cluster headache diagnosis were identified in the registers of two neurological departments in North Norway. Design. Of these, 70 with a confirmed diagnosis according to the second edition of the International Classification of Headache Disorders (ICHD-2) completed a comprehensive questionnaire with questions concerning satisfaction with doctors’ treatment, use of CAM, and effect of both treatment regimes. Results. Satisfaction with doctors’ treatment was reported in 44/70 (63%) (GPs) and 50/70 (71%) (neurologists) while 39/70 (56%) were satisfied with both. Too long a time to diagnosis, median four years, was the most commonly reported claim regarding doctors’ treatment. Use of CAM was reported in 27/70 (39%), and 14/70 (20%) reported experience with ≥ 2 CAM. Ten patients reported benefit from CAM (37% of “CAM users”). The average cluster period was longer in CAM-users than others (p = 0.02), but CAM use was not associated with age, education, use of medication, effect of conventional treatment, duration of cluster attacks, or time to diagnosis. Conclusion. About two-thirds of CH patients were satisfied with treatment from either GPs or neurologists, and about one-third had used CAM. Despite experiencing diagnostic delay and severe pain, cluster patients seem in general to be satisfied with doctors’ conventional treatment. PMID:25116790

  2. New developments in the medical treatment of endometriosis.

    PubMed

    Bedaiwy, Mohamed A; Alfaraj, Sukinah; Yong, Paul; Casper, Robert

    2017-03-01

    Endometriosis affects 1 in 10 women of reproductive-age. The current treatments are surgical and hormonal but have limitations, including the risk of recurrence, side effects, contraceptive action for women who desire pregnancy, and cost. New treatments include gonadotropin-releasing hormone analogues, selective progesterone (or estrogen) receptor modulators, aromatase inhibitors, immunomodulators, and antiangiogenic agents. Further research is needed into central sensitization, local neurogenesis, and the genetics of endometriosis to identify additional treatment targets. A wider range of medical options allows for the possibility of precision health and a more personalized treatment approach for women with endometriosis.

  3. [Treatment of persistent postmastectomy pain with 5% Lidocaine medicated plaster].

    PubMed

    Cruto, M E; Baricocchi, E; Battistella, M; Bona, F; Giacoletto, G; Iacobellis, A; Moselli, N; Palomba, G; Sardo, E; Savojardo, M; Suita, L; Zocca, E; Debernardi, F

    2015-04-01

    Persistent postmastectomy pain (PPMP) syndrome is characterized by neuropathic pain that develops following surgery in breast cancer patients. The reported incidence of PPMP ranges between 30% and 50% and is estimated to increase as the number of women surviving cancer continues to rise. Though effective, today's drug treatments are poorly tolerated, limiting their use and reducing adherence to therapy. Since neuropathic pain is localized, international guidelines suggest that topical treatment with 5% Lidocaine medicated plaster either alone or combined with systemic drugs can be considered for pain management. In this retrospective study we reviewed the medical records of 11 patients treated with 5% lidocaine medicated plaster for moderate-to-severe PPMP at our institute between November 2013 and October 2014. Analysis showed that treatment with 5% Lidocaine medicated plaster, either alone or in combination with systemic drugs, achieved significant pain control already after the first week of therapy. The effectiveness and tolerability of 5% Lidocaine medicated plaster we observed suggests that it is a viable option in the management of PPMP.

  4. Risk disclosure in securities exchange and medical treatment contracts.

    PubMed

    Iijima, Yoshihiko

    2009-02-01

    The duty of risk disclosure in medical treatment contracts is examined first through comparison with securities exchange contracts, second, by examining the contract as dealt in judicial precedent, ensued by an analysis and proposal by the author. In both types of contracts, the number of judicial judgments finding for the plaintiff based solely on violation of the duty of risk disclosure is increasing. Different explanations, however, should apply for the increase. In the case of the securities exchange contracts, the duty to inform is understood as a means of providing material for informed choice and self-determination, thus supporting the argument for self-discipline. Whereas, in the case of medical treatment contracts, adding to the argument for self-determination, another line of reasoning is given: disclosure of relevant information as a means by which the medical services secure the life and physical well-being of the patient. The reason the principle of self-determination is not in full play is analyzed as a case in which higher norms of the professional ethics of the medical staff is functioning. Thus, in providing medical information of possible treatments to the patient, the physician is exonerated from legal liability, but remains burdened with the ethical responsibility to provide appropriate care. As the overlap of the two types of responsibility seems not to be fully realized, further investigation and dissemination of findings of this issue is proposed.

  5. Advances in Vitiligo: An Update on Medical and Surgical Treatments.

    PubMed

    Dillon, Alexander B; Sideris, Andrew; Hadi, Ali; Elbuluk, Nada

    2017-01-01

    Vitiligo is one of the most common cutaneous disorders of depigmentation. Although its underlying causes are still being studied and no definitive cure currently exists, recent research has provided insight into pathogenic mechanisms and new treatment options. Objective: The aim of this paper is to provide a comprehensive overview of the medical and surgical therapies for vitiligo with emphasis on the most recent treatment modalities. Design: This review was conducted through a literature search using PubMed and the National institutes of Health's clinicalTrials.gov databases from January 2010 to July 2015. This yielded 86 studies, 12 of which were excluded, and 74 of which were reviewed. Results: Recent studies and ongoing clinical trials indicate that there are many promising new medical and surgical treatment modalities for this chronic condition. Conclusion: A combination of traditional and newer treatments may work synergistically to provide additional improvement in patients' disease state and quality of life.

  6. Glutamatergic medications for the treatment of drug and behavioral addictions

    PubMed Central

    Olive, M. Foster; Cleva, Richard M.; Kalivas, Peter W.; Malcolm, Robert J.

    2011-01-01

    Historically, most pharmacological approaches to the treatment of addictive disorders have utilized either substitution-based methods (i.e., nicotine replacement or opioid maintenance) or have targeted monoaminergic or endogenous opioidergic neurotransmitter systems. However, substantial evidence has accumulated indicating that ligands acting on glutamatergic transmission are also of potential utility in the treatment of drug addiction, as well as various behavioral addictions such as pathological gambling. The purpose of this review is to summarize the pharmacological mechanisms of action and general clinical efficacy of glutamatergic medications that are currently approved or are being investigated for approval for the treatment of addictive disorders. Medications with effects on glutamatergic transmission that will be discussed include acamprosate, N-acetylcysteine, D-cycloserine, gabapentin, lamotrigine, memantine, modafinil, and topiramate. We conclude that manipulation of glutamatergic neurotransmission is relatively young but promising avenue for the development of improved therapeutic agents for the treatment of drug and behavioral addictions. PMID:21536062

  7. Advances in Vitiligo: An Update on Medical and Surgical Treatments

    PubMed Central

    Dillon, Alexander B.; Sideris, Andrew; Hadi, Ali

    2017-01-01

    Vitiligo is one of the most common cutaneous disorders of depigmentation. Although its underlying causes are still being studied and no definitive cure currently exists, recent research has provided insight into pathogenic mechanisms and new treatment options. Objective: The aim of this paper is to provide a comprehensive overview of the medical and surgical therapies for vitiligo with emphasis on the most recent treatment modalities. Design: This review was conducted through a literature search using PubMed and the National institutes of Health’s clinicalTrials.gov databases from January 2010 to July 2015. This yielded 86 studies, 12 of which were excluded, and 74 of which were reviewed. Results: Recent studies and ongoing clinical trials indicate that there are many promising new medical and surgical treatment modalities for this chronic condition. Conclusion: A combination of traditional and newer treatments may work synergistically to provide additional improvement in patients’ disease state and quality of life. PMID:28210378

  8. System of acute medical support to emergency during dental treatment.

    PubMed

    Kawahara, M; Takeshita, T; Akita, S

    1986-01-01

    The Resuscitation Committee of Hiroshima City Dental Association was established in 1983 in order to provide acute medical support in case of emergency during dental treatment at private dental clinics. This Committee is composed of representatives from the Hiroshima City Dental Association, Hiroshima University School of Dentistry, Hiroshima University School of Medicine, Hiroshima City Health Bureau, and Hiroshima City Fire and Ambulance Department. A portable ECG monitor with defibrillator and a resuscitation kit are held in readiness at the Hiroshima University Hospital. In case of emergency during dental treatment at a private dental clinic, we hurry to the clinic with the resuscitation set and give emergency treatment. We have been involved in two cases of emergency since this system started. Both of them recovered without any sequelae. Besides these activities, we give lectures annually to dentists and dental hygienists on the treatment of medical emergencies.

  9. [Alternative treatment forms used by patients with muscular atrophy. A questionnaire study of the use of alternative treatment by 345 patients with muscular atrophy].

    PubMed

    Hunsballe, J M; Mortensen, F V

    1990-04-30

    An investigation about the use of alternative treatment by a group of persons with muscular atrophy revealed that 24% had employed alternative treatment during the period 1.1.1983-1.4.1986. This is probably a greater proportion than in the Danish population as a whole. Patients with muscular atrophy were subdivided into three groups on the basis of their ability to function in daily life. No significant connection was found between the degree of loss of function and alternative treatment as regards the frequencies of alternative treatment and the numbers of treatments employed. A given form form of treatment was most frequently recommended by an unaffected acquaintance. Physical forms of treatment such as zone therapy and chiropractics were employed more frequently than chemical forms of therapy. Less than half of the patients were satisfied with the results of treatment. Treatment was often concluded in a negative manner. Patients considered that, in contrast to the alternative therapist, the doctor performs the best and most thorough examination and provides them with the best information about their condition.

  10. The importance of physics to progress in medical treatment.

    PubMed

    Melzer, Andreas; Cochran, Sandy; Prentice, Paul; MacDonald, Michael P; Wang, Zhigang; Cuschieri, Alfred

    2012-04-21

    Physics in therapy is as diverse as it is substantial. In this review, we highlight the role of physics--occasionally transitioning into engineering--through discussion of several established and emerging treatments. We specifically address minimal access surgery, ultrasound, photonics, and interventional MRI, identifying areas in which complementarity is being exploited. We also discuss some of the fundamental physical principles involved in the application of each treatment to medical practice.

  11. Medical Treatment and Medicinal Charms Mentioned in the Atharvanic Literature

    PubMed Central

    Bhide, V.V.

    1981-01-01

    The ancient Vedic texts Provides us with valuable information and guide lines on various multi-faced aspects of human life. The present discussion is limited to the medical treatment and medicinal charms mentioned in the Atharvanic literature with specific consideration to Kausikasutra for better understanding of the rites and actions mentioned in Atharvanaveda. PMID:22556455

  12. [On proportionate medical actions and extraordinary methods of treatment].

    PubMed

    2003-06-01

    As a general rule, any medical action should be proportionated. That is, the expected benefit of the treatment provided must be commensurate to the diagnosis and prognosis, the therapeutic efforts the suffering caused to the patient, and the eventual risks. Inversely a disproportionate or excessive medical action that will result in no benefit to the patient is technically incorrect and ethically reprebensible. As opposed to ordinary methods of treatment (basic nursing, feeding, hydration, drugs and regular clinical procedures), we reserve the name of "extraordinary methods of treatment" to those medical actions using complex and invasive highcost procedures and equipment that should be urgently indicated in any critically ill patient with a potentially reversible disease. These do not have any indication in terminally ill patients, except in the case of concomitant potentially reversible acute complications. When a DNR (do not resuscitate) order is adopted it should be reassessed periodically. The use, withholding and withdrawal of these extraordinary measures of treatment are subject to a series of medical and ethical requirements, which receive full discussion in this paper.

  13. The Inflammatory Reflex and the Role of Complementary and Alternative Medical Therapies

    PubMed Central

    Oke, Stacey L.; Tracey, Kevin J.

    2015-01-01

    The body’s first defense against invading pathogens or tissue injury is the innate immune system. Since excessive immune responses can be damaging, anti-inflammatory mechanisms function to control the pro-inflammatory response and prevent injury. The cholinergic anti-inflammatory pathway is a neural mechanism that suppresses the innate inflammatory response. Knowledge concerning innervation of the immune system offers a unique opportunity to explore previously unrecognized techniques to treat disease. It also enables consideration of the neurological basis of complementary and alternative medical therapies, such as meditation and acupuncture. This evolving area of research has implications for the pathogenesis of chronic inflammatory conditions including inflammatory bowel disease, rheumatoid arthritis, type 2 diabetes, and other conditions of excessive cytokine release. PMID:19743552

  14. Carotid Artery Stenting, Endarterectomy, or Medical Treatment Alone: The Debate Is Not Over

    PubMed Central

    Kassaian, Seyed Ebrahim; Goodarzynejad, Hamidreza

    2011-01-01

    The management of carotid artery stenosis reduces the risk of stroke and its related deaths. Management options include risk factor modification and medical therapy, carotid endarterectomy (CEA), and carotid artery stenting (CAS). Although several randomized controlled trials (RCTs), mostly conducted in late-1980s and mid-1990s, have proved CEA to be effective in the prevention of ipsilateral ischemic events in selected patients with carotid artery stenosis, aggressive risk factor modification and medical therapy with recently introduced antiplatelet agents, statins, and more effective antihypertensive medications may have reduced compelling indications for immediate surgery in asymptomatic populations. Also recently, due to improvements in percutaneous techniques and carotid stents, CAS has received wide attention as a potential alternative to CEA. Herein, we review the recent data on the management options of carotid artery stenosis and seek to identify the most appropriate treatment strategy in selected patients with carotid artery stenosis. PMID:23074598

  15. Therapeutic alternatives for the treatment of type 1 hepatorenal syndrome: A Delphi technique-based consensus

    PubMed Central

    Arab, Juan P; Claro, Juan C; Arancibia, Juan P; Contreras, Jorge; Gómez, Fernando; Muñoz, Cristian; Nazal, Leyla; Roessler, Eric; Wolff, Rodrigo; Arrese, Marco; Benítez, Carlos

    2016-01-01

    AIM To propose several alternatives treatment of type 1 hepatorenal syndrome (HRS-1) what is the most severe expression of circulatory dysfunction on patients with portal hypertension. METHODS A group of eleven gastroenterologists and nephrologists performed a structured analysis of available literature. Each expert was designated to review and answer a question. They generated draft statements for evaluation by all the experts. Additional input was obtained from medical community. In order to reach consensus, a modified three-round Delphi technique method was used. According to United States Preventive Services Task Force criteria, the quality of the evidence and level of recommendation supporting each statement was graded. RESULTS Nine questions were formulated. The available evidence was evaluated considering its quality, number of patients included in the studies and the consistency of its results. The generated questions were answered by the expert panel with a high level of agreement. Thus, a therapeutic algorithm was generated. The role of terlipressin and norepinephrine was confirmed as the pharmacologic treatment of choice. On the other hand the use of the combination of octreotide, midodrine and albumin without vasoconstrictors was discouraged. The role of several other options was also evaluated and the available evidence was explored and discussed. Liver transplantation is considered the definitive treatment for HRS-1. The present consensus is an important effort that intends to organize the available strategies based on the available evidence in the literature, the quality of the evidence and the benefits, adverse effects and availability of the therapeutic tools described. CONCLUSION Based on the available evidence the expert panel was able to discriminate the most appropriate therapeutic alternatives for the treatment of HRS-1. PMID:27660674

  16. Integration of alternative feedstreams for biomass treatment and utilization

    DOEpatents

    Hennessey, Susan Marie [Avondale, PA; Friend, Julie [Claymont, DE; Dunson, Jr., James B.; Tucker, III, Melvin P.; Elander, Richard T [Evergreen, CO; Hames, Bonnie [Westminster, CO

    2011-03-22

    The present invention provides a method for treating biomass composed of integrated feedstocks to produce fermentable sugars. One aspect of the methods described herein includes a pretreatment step wherein biomass is integrated with an alternative feedstream and the resulting integrated feedstock, at relatively high concentrations, is treated with a low concentration of ammonia relative to the dry weight of biomass. In another aspect, a high solids concentration of pretreated biomass is integrated with an alternative feedstream for saccharifiaction.

  17. The 'Alternative Quality Contract,' based on a global budget, lowered medical spending and improved quality.

    PubMed

    Song, Zirui; Safran, Dana Gelb; Landon, Bruce E; Landrum, Mary Beth; He, Yulei; Mechanic, Robert E; Day, Matthew P; Chernew, Michael E

    2012-08-01

    Seven provider organizations in Massachusetts entered the Blue Cross Blue Shield Alternative Quality Contract in 2009, followed by four more organizations in 2010. This contract, based on a global budget and pay-for-performance for achieving certain quality benchmarks, places providers at risk for excessive spending and rewards them for quality, similar to the new Pioneer Accountable Care Organizations in Medicare. We analyzed changes in spending and quality associated with the Alternative Quality Contract and found that the rate of increase in spending slowed compared to control groups, more so in the second year than in the first. Overall, participation in the contract over two years led to savings of 2.8 percent (1.9 percent in year 1 and 3.3 percent in year 2) compared to spending in nonparticipating groups. Savings were accounted for by lower prices achieved through shifting procedures, imaging, and tests to facilities with lower fees, as well as reduced utilization among some groups. Quality of care also improved compared to control organizations, with chronic care management, adult preventive care, and pediatric care within the contracting groups improving more in year 2 than in year 1. These results suggest that global budgets with pay-for-performance can begin to slow underlying growth in medical spending while improving quality of care.

  18. Impact of Alternative Medical Device Approval Processes on Costs and Health

    PubMed Central

    George, Benjamin P.; Venkataraman, Vinayak; Dorsey, E. Ray; Johnston, S. Claiborne

    2014-01-01

    Background Medical devices are often introduced prior to randomized-trial evidence of efficacy and this slows completion of trials. Alternative regulatory approaches include restricting device use outside of trials prior to trial evidence of efficacy (like the drug approval process) or restricting out-of-trial use but permitting coverage within trials such as Medicare’s Coverage with Study Participation (CSP). Methods We compared the financial impact to manufacturers and insurers of three regulatory alternatives: (1) limited regulation (current approach), (2) CSP, and (3) restrictive regulation (like the current drug approval process). Using data for patent foramen ovale closure devices, we modeled key parameters including recruitment time, probability of device efficacy, market adoption, and device cost/price to calculate profits to manufacturers, costs to insurers, and overall societal impact on health. Results For manufacturers, profits were greatest under CSP—driven by faster market adoption of effective devices—followed by restrictive regulation. Societal health benefit in total quality-adjusted life years was greatest under CSP. Insurers’ expenditures for ineffective devices were greatest with limited regulation. Findings were robust over a reasonable range of probabilities of trial success. Conclusions Regulation restricting out-of-trial device use and extending limited insurance coverage to clinical trial participants may balance manufacturer and societal interests. PMID:25185975

  19. The use of an alternative light source to detect semen in clinical forensic medical practice.

    PubMed

    Lincoln, C A; McBride, P M; Turbett, G R; Garbin, C D; MacDonald, E J

    2006-05-01

    One of the primary aims of forensic examination in sexual offences is to detect and recover biological material that will link the offender with the complainant. One potentially valuable method by which trace biological evidence may be identified in other forensic settings is via the use of an Alternate Light Source (ALS). The aim of this study was to determine whether or not there was any potential benefit in using an ALS as an adjunct in sexual assault examinations to aid the detection of forensically relevant areas on the body which are not identifiable on visual inspection for sampling. We present two case reports, which illustrate the potential value of using an ALS in clinical forensic medical practice as an adjunct in sexual assault examinations to detect potentially forensically useful areas of skin to sample for semen. Prior to introducing the ALS into our clinical forensic medical practice, we undertook a number of simple laboratory studies to determine a protocol for its use. Semen is known to fluoresce using an ALS at a wavelength of 450 nm. Although we did not conduct a rigorous scientific evaluation of the technique, we evaluated the use of an ALS to detect semen on a range of inanimate surfaces as well as human skin. On all surfaces, visibility of fluorescence was increased by reduced distance of light source from the surface and increased concentration of semen on the surface, but was not noticeably affected by the angle at which the light source was held in relation to the surface.

  20. Differences in maintenance of response upon discontinuation across medication treatments in attention-deficit/hyperactivity disorder.

    PubMed

    Buitelaar, Jan; Asherson, Philip; Soutullo, Cesar; Colla, Michael; Adams, David H; Tanaka, Yoko; Haynes, Virginia S; Escobar, Rodrigo; Upadhyaya, Himanshu

    2015-10-01

    The attention-deficit/hyperactivity disorder (ADHD) treatment literature has been focused on onset-of-effect and short-term effect size, with little exploration of ADHD symptoms upon medication discontinuation. The objective of this narrative review and analysis was to better understand the relapse of ADHD symptoms upon discontinuation of medication treatment in children, adolescents, and adults with ADHD who have responded to medication treatment and to explore differences among different medications in maintaining treatment response. Randomized withdrawal studies of dexmethylphenidate hydrochloride (d-MPH), methylphenidate modified-release (MPH-LA), lisdexamphetamine dimesylate (LDX), guanfacine extended-release (GXR), and atomoxetine (ATX) in both children/adolescents and adults with ADHD were reviewed. The percentage of relapse was significantly higher and the time-to-relapse significantly shorter with placebo compared to active treatment in patients who were previously stable on 5 weeks to 1 year of active treatment, suggesting clinically significant benefit with continued long-term pharmacotherapy. However, percentage of relapse at each time point studied after discontinuing stimulants and GXR appears substantially higher than observed when discontinuing ATX, suggesting longer maintenance of response after discontinuing ATX than after stimulants and GXR. Additionally, slope of relapse percentages over time appears to be more rapid with stimulants or GXR than with ATX. These differences in maintenance of response among ATX, GXR, and stimulants may reflect differences in mechanisms of action and persistence of the medication effect. Alternatively, they may be due to methodological differences, including study design and response/relapse definitions. Continued investigation is needed regarding factors that affect risk of symptom relapse upon discontinuation of pharmacotherapy.

  1. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the american heart association.

    PubMed

    Brook, Robert D; Appel, Lawrence J; Rubenfire, Melvyn; Ogedegbe, Gbenga; Bisognano, John D; Elliott, William J; Fuchs, Flavio D; Hughes, Joel W; Lackland, Daniel T; Staffileno, Beth A; Townsend, Raymond R; Rajagopalan, Sanjay

    2013-06-01

    Many antihypertensive medications and lifestyle changes are proven to reduce blood pressure. Over the past few decades, numerous additional modalities have been evaluated in regard to their potential blood pressure-lowering abilities. However, these nondietary, nondrug treatments, collectively called alternative approaches, have generally undergone fewer and less rigorous trials. This American Heart Association scientific statement aims to summarize the blood pressure-lowering efficacy of several alternative approaches and to provide a class of recommendation for their implementation in clinical practice based on the available level of evidence from the published literature. Among behavioral therapies, Transcendental Meditation (Class IIB, Level of Evidence B), other meditation techniques (Class III, Level of Evidence C), yoga (Class III, Level of Evidence C), other relaxation therapies (Class III, Level of Evidence B), and biofeedback approaches (Class IIB, Level of Evidence B) generally had modest, mixed, or no consistent evidence demonstrating their efficacy. Between the noninvasive procedures and devices evaluated, device-guided breathing (Class IIA, Level of Evidence B) had greater support than acupuncture (Class III, Level of Evidence B). Exercise-based regimens, including aerobic (Class I, Level of Evidence A), dynamic resistance (Class IIA, Level of Evidence B), and isometric handgrip (Class IIB, Level of Evidence C) modalities, had relatively stronger supporting evidence. It is the consensus of the writing group that it is reasonable for all individuals with blood pressure levels >120/80 mm Hg to consider trials of alternative approaches as adjuvant methods to help lower blood pressure when clinically appropriate. A suggested management algorithm is provided, along with recommendations for prioritizing the use of the individual approaches in clinical practice based on their level of evidence for blood pressure lowering, risk-to-benefit ratio, potential

  2. Medical students’ knowledge, attitude, and practice of complementary and alternative medicine: a pre-and post-exposure survey in Majmaah University, Saudi Arabia

    PubMed Central

    Al Mansour, Mohammed Abdullah; Al-Bedah, Abdullah MN; AlRukban, Mohammed Othman; Elsubai, Ibrahim S; Mohamed, Elsadiq Yousif; El Olemy, Ahmed Tawfik; Khalil, Asim AH; Khalil, Mohamed KM; Alqaed, Meshari Saleh; Almudaiheem, Abdullah; Mahmoud, Waqas Sami; Medani, Khalid Altohami; Qureshi, Naseem Akhtar

    2015-01-01

    Background Evidently, complementary and alternative medicine (CAM) is a recognized medical practice that efficiently uses multiple treatment therapies and techniques in the prevention and management of a variety of human disorders. Many medical schools have integrated CAM curriculum in medical education system worldwide. Research in knowledge, attitude, and practice (KAP) of diverse health professionals exposed to CAM courses is important from many perspectives including improvement in KAP and teaching skills of faculty, together with capacity building and curriculum development. Objective and setting This pre- and post-design cross-sectional study aimed to assess CAM-KAP of two intakes of medical students in Majmaah University, Saudi Arabia. Methods The second-year medical students of the first (year 2012–2013) and second (year 2013–2014) intake (n=26 and 39, respectively) were selected for this study. A reliable, 16-item self-administered questionnaire was distributed among all the students for answering before and after the 48-hour CAM course. The data were analyzed using appropriate statistical test of significance. Results Medical students’ knowledge and attitude toward CAM significantly improved across some subitems of CAM questionnaire with a positive trend in the rest of its items including their views on CAM practices. Conclusion CAM course tends to have a positive impact on KAP of medical students. The preliminary results of this study call for further research with a larger sample in academic settings across the nation. PMID:26082671

  3. Inactivation of Geobacillus stearothermophilus spores by alkaline hydrolysis applied to medical waste treatment.

    PubMed

    Pinho, Sílvia C; Nunes, Olga C; Lobo-da-Cunha, Alexandre; Almeida, Manuel F

    2015-09-15

    Although alkaline hydrolysis treatment emerges as an alternative disinfection/sterilization method for medical waste, information on its effects on the inactivation of biological indicators is scarce. The effects of alkaline treatment on the resistance of Geobacillus stearothermophilus spores were investigated and the influence of temperature (80 °C, 100 °C and 110 °C) and NaOH concentration was evaluated. In addition, spore inactivation in the presence of animal tissues and discarded medical components, used as surrogate of medical waste, was also assessed. The effectiveness of the alkaline treatment was carried out by determination of survival curves and D-values. No significant differences were seen in D-values obtained at 80 °C and 100 °C for NaOH concentrations of 0.5 M and 0.75 M. The D-values obtained at 110 °C (2.3-0.5 min) were approximately 3 times lower than those at 100 °C (8.8-1.6 min). Independent of the presence of animal tissues and discarded medical components, 6 log10 reduction times varied between 66 and 5 min at 100 °C-0.1 M NaOH and 110 °C-1 M NaOH, respectively. The alkaline treatment may be used in future as a disinfection or sterilization alternative method for contaminated waste.

  4. Novel Virtual Environment for Alternative Treatment of Children with Cerebral Palsy

    PubMed Central

    de Oliveira, Juliana M.; Fernandes, Rafael Carneiro G.; Pinto, Cristtiano S.; Pinheiro, Plácido R.; Ribeiro, Sidarta

    2016-01-01

    Cerebral palsy is a severe condition usually caused by decreased brain oxygenation during pregnancy, at birth or soon after birth. Conventional treatments for cerebral palsy are often tiresome and expensive, leading patients to quit treatment. In this paper, we describe a virtual environment for patients to engage in a playful therapeutic game for neuropsychomotor rehabilitation, based on the experience of the occupational therapy program of the Nucleus for Integrated Medical Assistance (NAMI) at the University of Fortaleza, Brazil. Integration between patient and virtual environment occurs through the hand motion sensor “Leap Motion,” plus the electroencephalographic sensor “MindWave,” responsible for measuring attention levels during task execution. To evaluate the virtual environment, eight clinical experts on cerebral palsy were subjected to a questionnaire regarding the potential of the experimental virtual environment to promote cognitive and motor rehabilitation, as well as the potential of the treatment to enhance risks and/or negatively influence the patient's development. Based on the very positive appraisal of the experts, we propose that the experimental virtual environment is a promising alternative tool for the rehabilitation of children with cerebral palsy. PMID:27403154

  5. Novel Virtual Environment for Alternative Treatment of Children with Cerebral Palsy.

    PubMed

    de Oliveira, Juliana M; Fernandes, Rafael Carneiro G; Pinto, Cristtiano S; Pinheiro, Plácido R; Ribeiro, Sidarta; de Albuquerque, Victor Hugo C

    2016-01-01

    Cerebral palsy is a severe condition usually caused by decreased brain oxygenation during pregnancy, at birth or soon after birth. Conventional treatments for cerebral palsy are often tiresome and expensive, leading patients to quit treatment. In this paper, we describe a virtual environment for patients to engage in a playful therapeutic game for neuropsychomotor rehabilitation, based on the experience of the occupational therapy program of the Nucleus for Integrated Medical Assistance (NAMI) at the University of Fortaleza, Brazil. Integration between patient and virtual environment occurs through the hand motion sensor "Leap Motion," plus the electroencephalographic sensor "MindWave," responsible for measuring attention levels during task execution. To evaluate the virtual environment, eight clinical experts on cerebral palsy were subjected to a questionnaire regarding the potential of the experimental virtual environment to promote cognitive and motor rehabilitation, as well as the potential of the treatment to enhance risks and/or negatively influence the patient's development. Based on the very positive appraisal of the experts, we propose that the experimental virtual environment is a promising alternative tool for the rehabilitation of children with cerebral palsy.

  6. Breast cancer in BRCA mutation carriers: medical treatment.

    PubMed

    Milani, Andrea; Geuna, Elena; Zucchini, Giorgia; Aversa, Caterina; Martinello, Rossella; Montemurro, Filippo

    2016-10-01

    About 10% of breast cancers are associated with the inheritance of autosomal dominant breast cancer susceptibility alleles BRCA1 and BRCA2. Until recently, the medical management of BRCA mutation-associated breast cancer has not differed from that of the sporadic breast cancer counterpart. However, there is mounting evidence that this molecular alteration confers sensitivity or resistance to systemic therapies that can be exploited in terms of medical management. For example, studies support the use of platinum salts chemotherapy in BRCA mutated cancers. Moreover, a number of targeted therapies are showing activity in BRCA mutation carriers. Above all, BRCA defective tumor cells are particularly sensitive to Poly(ADP-ribose) polymerase (PARP) inhibitors. This review will summarize the state of the art of the medical treatment of breast cancer in BRCA mutation carriers, with a particular focus on chemotherapies and targeted therapies.

  7. Use of Complementary and Alternative Medicine (CAM) for Treatment among African-Americans: A Multivariate Analysis

    PubMed Central

    Barner, Jamie C.; Bohman, Thomas M.; Brown, Carolyn M.; Richards, Kristin M.

    2009-01-01

    Background Complementary and alternative medicine (CAM) use is substantial among African-Americans; however, research on characteristics of African-Americans who use of CAM to treat specific conditions is scarce. Objective To determine what predisposing, enabling, need, and disease state factors are related to CAM use for treatment among a nationally representative sample of African-Americans. Methods A cross-sectional study design was employed using the 2002 National Health Interview Survey (NHIS). A nationwide representative sample of adult (≥ 18 years) African-Americans who used CAM in the past 12 months (n= 16,113,651 weighted; n=2,952 unweighted) were included. The Andersen Healthcare Utilization Model served the framework with CAM use for treatment as the main outcome measure. Independent variables included: predisposing (e.g., age, gender, education), enabling (e.g., income, employment, access to care); need (e.g., health status, physician visits, prescription medication use); and disease state (i.e., most prevalent conditions among African-Americans) factors. Multivariate logistic regression was used to address the study objective. Results Approximately one in five (20.2%) CAM past 12 month users used CAM to treat a specific condition. Ten of the 15 CAM modalities were used primarily for treatment by African-Americans. CAM for treatment was significantly (p<0.05) associated with the following factors: graduate education, smaller family size, higher income, region (northeast, midwest, west more likely than south), depression/anxiety, more physician visits, less likely to engage in preventive care, more frequent exercise behavior, more activities of daily living (ADL) limitations, and neck pain. Conclusions Twenty percent of African-Americans who used CAM in the past year were treating a specific condition. Alternative medical systems, manipulative and body-based therapies, as well as folk medicine, prayer, biofeedback, and energy/Reiki were used most often

  8. Temporal patterns of adherence to medications and behavioral treatment and their relationship to patient characteristics and treatment response

    PubMed Central

    Gueorguieva, Ralitza; Wu, Ran; Krystal, John H.; Donovan, Dennis; O’Malley, Stephanie S.

    2013-01-01

    Background The primary analyses of the COMBINE study revealed significant naltrexone and Combined Behavioral Intervention (CBI) main effects on drinking outcomes but failed to find additional benefits of the combination of treatments. Investigating differences in patterns of adherence over time may shed light on the treatment effects in COMBINE. The goals of the study were to identify trajectories of medication adherence and participation in CBI, to estimate predictive and moderating effects of adherence trajectories on drinking outcomes and to characterize subjects in adherence trajectories. The results of these analyses may suggest approaches to improving adherence in order to ultimately improve treatment outcome. Methods We used a trajectory-based approach to identify patterns of treatment adherence separately for naltrexone, acamprosate and CBI adherence. Logistic regression and general linear models assessed associations among adherence trajectories, drinking outcomes and patient characteristics. Results Three trajectories of adherence were identified for each treatment: “excellent adherers”, “late non-adherers” and “early non-adherers” and there was good agreement among adherence trajectories with different treatments. “Excellent adherers” had significantly higher percent days abstinent (PDA) and lower percent heavy drinking days (PHDD). CBI significantly decreased PHDD for subjects on acamprosate in the “early non-adherers with medication” trajectory (p=0.01). Either naltrexone or acamprosate was associated with lower PHDD than placebo for “early non-adherers with CBI” (p<0.01). Receiving active medication decreased the likelihood to be in the excellent medication adherence trajectory. Younger age, greater drinking severity, dissatisfaction with the medicine and session frequency, adverse events and lack of benefit were related to less favorable medication adherence trajectories. “Excellent adherers with CBI” were significantly

  9. Technical Training: Development of Instructional Treatment Alternatives. Final Report.

    ERIC Educational Resources Information Center

    Sorensen, Philip H.; Pennell, Roger

    This report was written to provide guidance in the development and evaluation of alternative instructional approaches that hold promise of improving instructional effectiveness. The main focus of the report is on how to identify and test interactive relationships between individual differences among learners and instructional conditions or…

  10. Could peracetic acid be an alternative treatment in aquaculture?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Peracetic acid (PAA) is an antimicrobial disinfectant used in agriculture, food processing and medical facilities. It has recently been tested as a means to control infestations of Ichthyophthirius multifiliis and Saprolegnia parasitica. Free-swimming theronts of I. multifiliis can be eliminated u...

  11. Recent advances in the medical treatment of breast cancer

    PubMed Central

    Vorobiof, Daniel A.

    2016-01-01

    Over the past few decades, the systemic therapy of breast cancer (early and advanced) has changed considerably. For the past 40–50 years, and since the discovery and further therapeutic use of tamoxifen, a selective estrogen receptor modulator, breast cancer treatment has become the model for the development and success of tailored medical treatment. Much still needs to be done in improving outcomes for all patients with breast cancer, and especially for those who have advanced breast cancer, a challenging area for medical oncologists. Ongoing international clinical trials are currently evaluating new therapeutic approaches and identifying specific biological subsets that could determine a patient’s ability to respond to particular chemotherapeutic drugs. PMID:27990275

  12. Multidimensional Treatment Foster Care: An Alternative to Residential Treatment for High Risk Children and Adolescents*

    PubMed Central

    Fisher, Philip A.; Gilliam, Kathryn S.

    2017-01-01

    This paper describes the Multidimensional Treatment Foster Care program (MTFC), an evidence based approach for providing psychotherapeutic treatment for very troubled children and adolescents that is an alternative to residential care. Versions of the MTFC program have been developed and validated for young children with a history of maltreatment as well as for older children and adolescents who are involved with the youth justice system. In the paper we describe the development of the MTFC program and its foundations in the social learning model that originated at the Oregon Social Learning Center in the 1960’s and 70’s. We present information about program elements. We then review the research that has been conducted on MTFC. PMID:28250708

  13. Medical futility, treatment withdrawal and the persistent vegetative state.

    PubMed Central

    Mitchell, K R; Kerridge, I H; Lovat, T J

    1993-01-01

    Why do we persist in the relentless pursuit of artificial nourishment and other treatments to maintain a permanently unconscious existence? In facing the future, if not the present world-wide reality of a huge number of persistent vegetative state (PVS) patients, will they be treated because of our ethical commitment to their humanity, or because of an ethical paralysis in the face of biotechnical progress? The PVS patient is cut off from the normal patterns of human connection and communication, with a life unlike other forms of human existence. Why the struggle to justify ending a life which, it is said, has suffered an irreversible loss of the content of consciousness? Elsewhere, the authors have addressed the ethical controversies and confusion engendered by ambiguous terminology, misuse of medical facts and the differing interpretations of what constitutes 'effective' treatment: in particular, the issue of whether in fact artificial nutrition and hydration is a medical treatment, or simply part of the obligatory care owed to all patients, permanently unconscious or not. In this paper, we intend to argue that recent analyses of medical futility, its meaning and ethical implications, despite an absence of public consensus, permit some tentative re-evaluation of our ethical obligations to the PVS patient. PMID:8331640

  14. Current medical treatments of dyspepsia and irritable bowel syndrome.

    PubMed

    Camilleri, Michael; Tack, Jan F

    2010-09-01

    Dyspepsia is a highly prevalent condition characterized by symptoms originating in the gastroduodenal region without underlying organic disorder. Treatment modalities include acid-suppressive drugs, gastroprokinetic drugs, Helicobacter pylori eradication therapy, tricyclic antidepressants, and psychological therapies. Irritable bowel syndrome is a multifactorial, lower functional gastrointestinal disorder involving disturbances of the brain-gut axis. The pathophysiology provides the basis for pharmacotherapy: abnormal gastrointestinal motor functions, visceral hypersensitivity, psychosocial factors, intraluminal changes, and mucosal immune activation. Medications targeting chronic constipation or diarrhea may also relieve irritable bowel syndrome. Novel approaches to treatment require approval, and promising agents are guanylate cyclase cagonists, atypical benzodiazepines, antibiotics, immune modulators, and probiotics.

  15. Medical Treatments of Hidradenitis Suppurativa: More Options, Less Evidence.

    PubMed

    van der Zee, Hessel H; Gulliver, Wayne P

    2016-01-01

    Hidradenitis suppurativa is a common debilitating skin disease that has been neglected by science. The disease is getting more and more attention, reflected by the rising number of scientific publications. There is a clear need for effective treatment. We are still at the beginning of improving care for these patients as demonstrated by the low levels of evidence for the medical treatments. Many of these therapies showed promising results, but are still waiting to be validated in randomized, controlled trials. Much more research is needed to strengthen the Level of Evidence for these therapies and thus improve patient care.

  16. Brief Report: Alternative Approaches to the Development of Effective Treatments for Autism.

    ERIC Educational Resources Information Center

    Rimland, Bernard; Baker, Sidney M.

    1996-01-01

    The most widely used "alternative" biomedical treatments for autism are reviewed, including: nutritional supplements, especially megadose vitamin B6 and magnesium; treatment of food allergies and intolerances; treatment of microbial infections; and treatment of immune system dysfunction. The Defeat Autism Now! project is briefly…

  17. Withdrawal and withholding of medical treatment: Czech medical law at the crossroads.

    PubMed

    Peterková, Helena

    2011-06-01

    The making of an end of life decision represents worldwide one of the most difficult issues that physicians can be confronted with --not only should it be regarded as consisting of medical and legal aspects, but ethics and moral values are present as well. Furthermore, it shall not be supposed that the economic parameter is negligible, unfortunately even to the contrary. The fact that the decision is often made by physicians under pressure caused by a system of limited resources (and therefore it can not avoid being distorted) must be kept in mind. At any rate , according to Czech law under which neither assisted suicide nor euthanasia is allowed, the legality and legitimacy of withdrawal and withholding of medical treatment is based on the argument of informed consent of the patient, advanced directives and the standard of lege artis treatment. These also shall be pleaded as defences in eventual criminal proceedings.

  18. Surface Modification of Medical Polyurethane by Plasma Treatment

    NASA Astrophysics Data System (ADS)

    Li, Dejun; Zhao, Jie; Gu, Hanqing; Lu, Mozhu; Ding, Fuqing; Hu, Jianfang

    1992-02-01

    The wettability and surface structure of plasma treatment on medical polyurethane were studied. Two kinds of gas, N2, Ar, were used to create the low-temperature plasma under low pressure. The wettability was investigated by means of the sessile drop method using water, the results show that the contact angle of water decreases from 78.8° to 61.9° as the treatment time increases. The results of electron spectroscopy for chemical analysis indicate that original chemical bonds were broken up after plasma treatment, which was the main reason for the surface modification. At same time, the results of electron spinning resonance show that the amounts of radicals did not increase significantly after treatment, which is advantageous to clinical practice of polyurethane.

  19. Policies pertaining to complementary and alternative medical therapies in a random sample of 39 academic health centers.

    PubMed

    Cohen, Michael H; Sandler, Lynne; Hrbek, Andrea; Davis, Roger B; Eisenberg, David M

    2005-01-01

    This research documents policies in 39 randomly selected academic medical centers integrating complementary and alternative medical (CAM) services into conventional care. Twenty-three offered CAM services-most commonly, acupuncture, massage, dietary supplements, mind-body therapies, and music therapy. None had written policies concerning credentialing practices or malpractice liability. Only 10 reported a written policy governing use of dietary supplements, although three sold supplements in inpatient formularies, one in the psychiatry department, and five in outpatient pharmacies. Thus, few academic medical centers have sufficiently integrated CAM services into conventional care by developing consensus-written policies governing credentialing, malpractice liability, and dietary supplement use.

  20. Complementary and alternative medical therapy utilization by people with chronic fatiguing illnesses in the United States

    PubMed Central

    Jones, James F; Maloney, Elizabeth M; Boneva, Roumiana S; Jones, Ann-Britt; Reeves, William C

    2007-01-01

    Background Chronic fatiguing illnesses, including chronic fatigue syndrome (CFS), pose a diagnostic and therapeutic challenge. Previous clinical reports addressed the utilization of health care provided to patients with CFS by a variety of practitioners with other than allopathic training, but did not examine the spectrum of complementary and alternative medicine (CAM) therapies used. This study was designed to measure CAM therapy use by persons with fatiguing illnesses in the United States population. Methods During a random-digit dialing survey to estimate the prevalence of CFS-like illness in urban and rural populations from different geographic regions of the United States, we queried the utilization of CAM including manipulation or body-based therapies, alternative medical systems, mind-body, biologically-based, and energy modalities. Results Four hundred forty fatigued and 444 non-fatigued persons from 2,728 households completed screening. Fatigued subjects included 53 persons with prolonged fatigue, 338 with chronic fatigue, and 49 with CFS-like illness. Mind-body therapy (primarily personal prayer and prayer by others) was the most frequently used CAM across all groups. Among women, there was a significant trend of increasing overall CAM use across all subgroups (p-trend = 0.003). All categories of CAM use were associated with significantly poorer physical health scores, and all but one (alternative medicine systems) were associated with significantly poorer mental health scores. People with CFS-like illness were significantly more likely to use body-based therapy (chiropractic and massage) than non-fatigued participants (OR = 2.52, CI = 1.32, 4.82). Use of body-based therapies increased significantly in a linear trend across subgroups of non-fatigued, prolonged fatigued, chronic fatigued, and CFS-like subjects (p-trend = 0.002). People with chronic fatigue were also significantly more likely to use body-based therapy (OR = 1.52, CI = 1.07, 2.16) and mind

  1. Assault in medical law: revisiting the boundaries of informed consent to medical treatment in South Africa.

    PubMed

    Wilson, Maria C I

    2009-05-01

    This article focuses on assault as a cause of action in medical law, with particular emphasis on the requirements for informed consent, both under common law and under the National Health Act 2003 (Sth Africa). In particular, the test for consent, adopted in Castell v De Greef 1994 (4) SA 408 (C), is analysed in detail. It is noted that the wording of this test for informed consent mirrors the wording of the test for negligence laid down in the Australian case of Rogers v Whitaker (1992) 175 CLR 479. Further, the relationship between the delictual elements of wrongfulness and fault in assault is discussed. It is argued that in South African law a valid consent to medical treatment requires knowledge not only of the general nature of medical treatment but also of the consequences of the treatment and, in determining which consequences should be disclosed to a patient, the constitutional rights to equality and self-determination support the application of a subjective patient-centred test for informed consent. However, it is also proposed that the broad right of a patient to information is reined in at the fault element of assault, so that a limited requirement of consciousness of wrongfulness on the part of the defendant negates liability for delictual assault.

  2. Intranasal delivery of antiepileptic medications for treatment of seizures.

    PubMed

    Wermeling, Daniel P

    2009-04-01

    Acute isolated seizure, repetitive or recurrent seizures, and status epilepticus are all deemed medical emergencies. Mortality and worse neurologic outcome are directly associated with the duration of seizure activity. A number of recent reviews have described consensus statements regarding the pharmacologic treatment protocols for seizures when patients are in pre-hospital, institutional, and home-bound settings. Benzodiazepines, such as lorazepam, diazepam, midazolam, and clonazepam are considered to be medications of first choice. The rapidity by which a medication can be delivered to the systemic circulation and then to the brain plays a significant role in reducing the time needed to treat seizures and reduce opportunity for damage to the CNS. Speed of delivery, particularly outside of the hospital, is enhanced when transmucosal routes of delivery are used in place of an intravenous injection. Intranasal transmucosal delivery of benzodiazepines is useful in reducing time to drug administration and cessation of seizures in the pre-hospital setting, when actively seizing patients arrive in the emergency room, and at home where caregivers treat their dependents. This review summarizes factors to consider when choosing a benzodiazepine for intranasal administration, including formulation and device considerations, pharmacology and pharmacokinetic/pharmacodynamic profiles. A review of the most relevant clinical studies in epilepsy patients will provide context for the relative success of this technique with a number of benzodiazepines and relatively less sophisticated nasal preparations. Neuropeptides delivered intranasally, crossing the blood-brain barrier via the olfactory system, may increase the availability of medications for treatment of epilepsy. Consequently, there remains a significant unmet medical need to serve the pharamcotherapeutic requirements of epilepsy patients through commercial development and marketing of intranasal antiepileptic products.

  3. Whole complementary and alternative medical systems and complexity: creating collaborative relationships.

    PubMed

    Verhoef, Marja; Koithan, Mary; Bell, Iris R; Ives, John; Jonas, Wayne

    2012-01-01

    In recent years, investigators have discovered significant limitations in applying biomedical cause-effect assumptions and using conventional efficacy study designs to assess the clinical outcomes of whole systems of complementary and alternative medicine (WS-CAM). A group of WS-CAM researchers has been working collaboratively since 2001 to address the limitations of studies evaluating WS-CAM and discern ways to conduct research that would capture the complexity of such systems and the synergistic effects between the various elements of the system and would take into account treatment individualization and/or the patient-centered nature of treatment systems. In 2009, 14 complexity scientists from systems biology, psychology and the social sciences were invited to attend a workshop with these CAM scientists to (a) identify and discuss analytical techniques that can be used to study phenomena from a complex/nonlinear dynamical sciences perspective, (b) establish working relationships with these researchers, and (c) develop working research projects/ protocols to collaboratively study patient-centered responses to CAM treatments. This paper provides an overview of the workshop goals and outcomes, introducing this special issue of Forschende Komplementärmedizin.

  4. Acceptability of Alternative Treatments for Deviant Child Behavior.

    ERIC Educational Resources Information Center

    Kazdin, Alan E.

    1980-01-01

    Cases of deviant child behavior were described to 88 undergraduate students along with four different treatments (reinforcement of incompatible behavior, time out from reinforcement, drug therapy, and electric shock). Reinforcement of incompatible behavior was more acceptable than other treatments which followed, in order, time out from…

  5. Self-medication with drugs and complementary and alternative medicines in Alexandria, Egypt: prevalence, patterns and determinants.

    PubMed

    El-Nimr, N A; Wahdan, I M H; Wahdan, A M H; Kotb, R E

    2015-06-09

    This study aimed to describe the prevalence, pattern and reasons for self-medication among adults in Alexandria, Egypt. In a community-based survey during 2012, a representative sample of 1100 adults completed a predesigned interview questionnaire on self-medication practices by drugs and complementary or alternative medicines (CAM). A majority of them practised self-medication (86.4%), mostly using both drugs and CAM (77.5%). The most commonly used drugs were analgesics (96.7%), and cough and cold preparations (81.9%), but 53.9% of respondents reported self-medication with antibiotics. The most frequently used CAM were herbs (91.6%), followed by spiritual healing (9.4%) and cupping and acupuncture (6.4%). CAM improved the condition according to 95.2% of users. Logistic regression analysis revealed that age, occupation and the presence of chronic conditions were the independent factors significantly affecting the practice of self-medication with drugs.

  6. Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

    ERIC Educational Resources Information Center

    Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

    2005-01-01

    TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

  7. The Teaching of Complementary and Alternative Medicine in U.S. Medical Schools: A Survey of Course Directors.

    ERIC Educational Resources Information Center

    Brokaw, James J.; Tunnicliff, Godfrey; Raess, Beat U.; Saxon, Dale W.

    2002-01-01

    Surveyed medical schools to gauge the current state of complementary and alternative medicine (CAM) instruction by gathering details about the specific topics being taught and the objectives behind the instruction. Found that a wide variety of topics are being taught under the umbrella of CAM; for the most part, the instruction appears to be…

  8. 78 FR 3005 - Creating an Alternative Approval Pathway for Certain Drugs Intended to Address Unmet Medical Need...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-15

    ... HUMAN SERVICES Food and Drug Administration Creating an Alternative Approval Pathway for Certain Drugs Intended to Address Unmet Medical Need; Public Hearing; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public hearing; request for comments. SUMMARY: The Food and...

  9. Treatment of inflammatory bowel disease: a review of medical therapy.

    PubMed

    Kozuch, Patricia L; Hanauer, Stephen B

    2008-01-21

    Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases of the gastrointestinal tract. While a cure remains elusive, both can be treated with medications that induce and maintain remission. With the recent advent of therapies that inhibit tumor necrosis factor (TNF) alpha the overlap in medical therapies for UC and CD has become greater. Although 5-ASA agents have been a mainstay in the treatment of both CD and UC, the data for their efficacy in patients with CD, particularly as maintenance therapy, are equivocal. Antibiotics may have a limited role in the treatment of colonic CD. Steroids continue to be the first choice to treat active disease not responsive to other more conservative therapy; non-systemic steroids such as oral and rectal budesonide for ileal and right-sided CD and distal UC respectively are also effective in mild-moderate disease. 6-mercaptopurine (6-MP) and its prodrug azathioprine are steroid-sparing immunomodulators effective in the maintenance of remission of both CD and UC, while methotrexate may be used in both induction and maintenance of CD. Infliximab and adalimumab are anti-TNF agents approved in the US and Europe for the treatment of Crohn's disease, and infliximab is also approved for the treatment of UC.

  10. Treatment of inflammatory bowel disease: A review of medical therapy

    PubMed Central

    Kozuch, Patricia L; Hanauer, Stephen B

    2008-01-01

    Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases of the gastrointestinal tract. While a cure remains elusive, both can be treated with medications that induce and maintain remission. With the recent advent of therapies that inhibit tumor necrosis factor (TNF) alpha the overlap in medical therapies for UC and CD has become greater. Although 5-ASA agents have been a mainstay in the treatment of both CD and UC, the data for their efficacy in patients with CD, particularly as maintenance therapy, are equivocal. Antibiotics may have a limited role in the treatment of colonic CD. Steroids continue to be the first choice to treat active disease not responsive to other more conservative therapy; non-systemic steroids such as oral and rectal budesonide for ileal and right-sided CD and distal UC respectively are also effective in mild-moderate disease. 6-mercaptopurine (6-MP) and its prodrug azathioprine are steroid-sparing immunomodulators effective in the maintenance of remission of both CD and UC, while methotrexate may be used in both induction and maintenance of CD. Infliximab and adalimumab are anti-TNF agents approved in the US and Europe for the treatment of Crohn's disease, and infliximab is also approved for the treatment of UC. PMID:18200659

  11. Recent advances in the medical treatment of Cushing's disease.

    PubMed

    Fleseriu, Maria

    2014-01-01

    Cushing's disease is a condition of hypercortisolism caused by an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma. While rare, it is associated with significant morbidity and mortality, which suggests that early and aggressive intervention is required. The primary, definitive therapy for patients with Cushing's disease in the majority of patients is pituitary surgery, generally performed via a transsphenoidal approach. However, many patients will not achieve remission or they will have recurrences. The consequences of persistent hypercortisolism are severe and, as such, early identification of those patients at risk of treatment failure is exigent. Medical management of Cushing's disease patients plays an important role in achieving long-term remission after failed transsphenoidal surgery, while awaiting effects of radiation or before surgery to decrease the hypercortisolemia and potentially reducing perioperative complications and improving outcome. Medical therapies include centrally acting agents, adrenal steroidogenesis inhibitors and glucocorticoid receptor blockers. Furthermore, several new agents are in clinical trials. To normalize the devastating disease effects of hypercortisolemia, it is paramount that successful patient disease management includes individualized, multidisciplinary care, with close collaboration between endocrinologists, neurosurgeons, radiation oncologists, and general surgeons. This commentary will focus on recent advances in the medical treatment of Cushing's, with a focus on newly approved ACTH modulators and glucocorticoid receptor blockers.

  12. Infection prevention and control in deployed military medical treatment facilities.

    PubMed

    Hospenthal, Duane R; Green, Andrew D; Crouch, Helen K; English, Judith F; Pool, Jane; Yun, Heather C; Murray, Clinton K

    2011-08-01

    Infections have complicated the care of combat casualties throughout history and were at one time considered part of the natural history of combat trauma. Personnel who survived to reach medical care were expected to develop and possibly succumb to infections during their care in military hospitals. Initial care of war wounds continues to focus on rapid surgical care with debridement and irrigation, aimed at preventing local infection and sepsis with bacteria from the environment (e.g., clostridial gangrene) or the casualty's own flora. Over the past 150 years, with the revelation that pathogens can be spread from patient to patient and from healthcare providers to patients (including via unwashed hands of healthcare workers, the hospital environment and fomites), a focus on infection prevention and control aimed at decreasing transmission of pathogens and prevention of these infections has developed. Infections associated with combat-related injuries in the recent operations in Iraq and Afghanistan have predominantly been secondary to multidrug-resistant pathogens, likely acquired within the military healthcare system. These healthcare-associated infections seem to originate throughout the system, from deployed medical treatment facilities through the chain of care outside of the combat zone. Emphasis on infection prevention and control, including hand hygiene, isolation, cohorting, and antibiotic control measures, in deployed medical treatment facilities is essential to reducing these healthcare-associated infections. This review was produced to support the Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update contained in this supplement of Journal of Trauma.

  13. ORTHODONTIC TREATMENT ALTERNATIVE TO A CLASS III SUBDIVISION MALOCCLUSION

    PubMed Central

    Janson, Guilherme; de Souza, José Eduardo Prado; Barros, Sérgio Estelita Cavalcante; Andrade, Pedro; Nakamura, Alexandre Yudi

    2009-01-01

    Class III malocclusions are considered one of the most complex and difficult orthodontic problems to diagnose and treat. Skeletal and/or dental asymmetries in patients presenting with Class III malocclusions can worsen the prognosis. Recognizing the dentoalveolar and skeletal characteristics of subdivision malocclusions and their treatment possibilities is essential for a favorable nonsurgical correction. Therefore, this article presents a nonsurgical asymmetric extraction approach to Class III subdivision malocclusion treatment which can significantly improve the occlusal and facial discrepancies. PMID:19668997

  14. The influence of globalization on medical regulation: a descriptive analysis of international medical graduates registered through alternative licensure routes in Ontario

    PubMed Central

    Yen, Wendy; Hodwitz, Kathryn; Thakkar, Niels; Martimianakis, Maria Athina (Tina); Faulkner, Dan

    2016-01-01

    The increasing globalization of the medical profession has influenced health policy, health human resource planning, and medical regulation in Canada. Since the early 2000s, numerous policy initiatives have been created to facilitate the entry of international medical graduates (IMGs) into the Canadian workforce. In Ontario, the College of Physicians and Surgeons of Ontario (CPSO) developed alternative licensure routes to increase the ability of qualified IMGs to obtain licenses to practice. The current study provides demographic and descriptive information about the IMGs registered through the CPSO’s alternative licensure routes between 2000 and 2012. An analysis of the characteristics and career trajectories of all IMGs practicing in the province sheds light on broader globalization trends and raises questions about the future of health human resource planning in Canada. As the medical profession becomes increasingly globalized, health policy and regulation will continue to be influenced by trends in international migration, concerns about global health equity, and the shifting demographics of the Canadian physician workforce. Implications for future policy development in the complex landscape of medical education and practice are discussed. PMID:28344705

  15. [General recommendations for medical treatment after heart transplantation].

    PubMed

    Guidon, A; Reverdin, S; Yarol, N; Yerly, P; Tozzi, P; Meyer, P; Hullin, R

    2014-05-28

    Heart transplantation remains the treatment of choice in selected patients with severe heart failure (HF) despite optimal medical therapy. Since long-term survival after HTX is improving, there is a growing need for evidence-based strategies that reduce long-term mortality resulting from both immunological and non-immunological risk. This manuscript summarizes recommendations for treatment of transplant vasculopathy, malignancy after transplantation, and prevention of corticosteroid induced bone disease. Based on actual understanding of cardiovascular risk factors in the population, preservation of renal function, prevention and treatment of hyperlipidemia and diabetes, as well as blood pressure control play an important role in the long-term follow-up after heart transplantation.

  16. Treatment: Types of Blood Pressure Medications | NIH MedlinePlus the Magazine

    MedlinePlus

    ... High Blood Pressure Treatment: Types of Blood Pressure Medications Past Issues / Fall 2011 Table of Contents Treatment: Types of Blood Pressure Medications Here’s a rundown on the main types of ...

  17. 7 CFR 110.5 - Availability of records to facilitate medical treatment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... pesticide required to be maintained under § 110.3 is necessary to provide medical treatment or first aid to... when necessary to provide medical treatment or first aid to an individual who may have been exposed...

  18. 7 CFR 110.5 - Availability of records to facilitate medical treatment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... pesticide required to be maintained under § 110.3 is necessary to provide medical treatment or first aid to... when necessary to provide medical treatment or first aid to an individual who may have been exposed...

  19. 7 CFR 110.5 - Availability of records to facilitate medical treatment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... pesticide required to be maintained under § 110.3 is necessary to provide medical treatment or first aid to... when necessary to provide medical treatment or first aid to an individual who may have been exposed...

  20. 7 CFR 110.5 - Availability of records to facilitate medical treatment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... pesticide required to be maintained under § 110.3 is necessary to provide medical treatment or first aid to... when necessary to provide medical treatment or first aid to an individual who may have been exposed...

  1. Novel medical imaging technologies for disease diagnosis and treatment

    NASA Astrophysics Data System (ADS)

    Olego, Diego

    2009-03-01

    New clinical approaches for disease diagnosis, treatment and monitoring will rely on the ability of simultaneously obtaining anatomical, functional and biological information. Medical imaging technologies in combination with targeted contrast agents play a key role in delivering with ever increasing temporal and spatial resolution structural and functional information about conditions and pathologies in cardiology, oncology and neurology fields among others. This presentation will review the clinical motivations and physics challenges in on-going developments of new medical imaging techniques and the associated contrast agents. Examples to be discussed are: *The enrichment of computer tomography with spectral sensitivity for the diagnosis of vulnerable sclerotic plaque. *Time of flight positron emission tomography for improved resolution in metabolic characterization of pathologies. *Magnetic particle imaging -a novel imaging modality based on in-vivo measurement of the local concentration of iron oxide nano-particles - for blood perfusion measurement with better sensitivity, spatial resolution and 3D real time acquisition. *Focused ultrasound for therapy delivery.

  2. Is biological treatment a viable alternative for micropollutant removal in drinking water treatment processes?

    PubMed

    Benner, Jessica; Helbling, Damian E; Kohler, Hans-Peter E; Wittebol, Janneke; Kaiser, Elena; Prasse, Carsten; Ternes, Thomas A; Albers, Christian N; Aamand, Jens; Horemans, Benjamin; Springael, Dirk; Walravens, Eddy; Boon, Nico

    2013-10-15

    In western societies, clean and safe drinking water is often taken for granted, but there are threats to drinking water resources that should not be underestimated. Contamination of drinking water sources by anthropogenic chemicals is one threat that is particularly widespread in industrialized nations. Recently, a significant amount of attention has been given to the occurrence of micropollutants in the urban water cycle. Micropollutants are bioactive and/or persistent chemicals originating from diverse sources that are frequently detected in water resources in the pg/L to μg/L range. The aim of this review is to critically evaluate the viability of biological treatment processes as a means to remove micropollutants from drinking water resources. We first place the micropollutant problem in context by providing a comprehensive summary of the reported occurrence of micropollutants in raw water used directly for drinking water production and in finished drinking water. We then present a critical discussion on conventional and advanced drinking water treatment processes and their contribution to micropollutant removal. Finally, we propose biological treatment and bioaugmentation as a potential targeted, cost-effective, and sustainable alternative to existing processes while critically examining the technical limitations and scientific challenges that need to be addressed prior to implementation. This review will serve as a valuable source of data and literature for water utilities, water researchers, policy makers, and environmental consultants. Meanwhile this review will open the door to meaningful discussion on the feasibility and application of biological treatment and bioaugmentation in drinking water treatment processes to protect the public from exposure to micropollutants.

  3. Complementary and alternative treatment for neck pain: chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais.

    PubMed

    Plastaras, Christopher T; Schran, Seth; Kim, Natasha; Sorosky, Susan; Darr, Deborah; Chen, Mary Susan; Lansky, Rebecca

    2011-08-01

    Of the multitude of treatment options for the management of neck pain, no obvious single treatment modality has been shown to be most efficacious. As such, the clinician should consider alternative treatment modalities if a modality is engaging, available, financially feasible, potentially efficacious, and is low risk for the patient. As evidence-based medicine for neck pain develops, the clinician is faced with the challenge of which treatments to encourage patients to pursue. Treatment modalities explored in this article, including chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais, represent reasonable complementary and alternative medicine methods for patients with neck pain.

  4. [Alternative splicing regulation: implications in cancer diagnosis and treatment].

    PubMed

    Martínez-Montiel, Nancy; Rosas-Murrieta, Nora; Martínez-Contreras, Rebeca

    2015-04-08

    The accurate expression of the genetic information is regulated by processes like mRNA splicing, proposed after the discoveries of Phil Sharp and Richard Roberts, who demonstrated the existence of intronic sequences, present in almost every structural eukaryotic gene, which should be precisely removed. This intron removal is called "splicing", which generates different proteins from a single mRNA, with different or even antagonistic functions. We currently know that alternative splicing is the most important source of protein diversity, given that 70% of the human genes undergo splicing and that mutations causing defects in this process could originate up to 50% of genetic diseases, including cancer. When these defects occur in genes involved in cell adhesion, proliferation and cell cycle regulation, there is an impact on cancer progression, rising the opportunity to diagnose and treat some types of cancer according to a particular splicing profile.

  5. Matlab Tools: An Alternative to Planning Systems in Brachytherapy Treatments

    SciTech Connect

    Herrera, Higmar

    2006-09-08

    This work proposes the use of the Matlab environment to obtain the treatment dose based on the reported data by Krishnaswamy and Liu et al. The comparison with reported measurements is showed for the Amersham source model. For the 3M source model, measurements with TLDs and a Monte Carlo simulation are compared to the data obtained by Matlab. The difference for the Amersham model is well under the 15% recommended by the IAEA and for the 3M model, although the difference is greater, the results are consistent. The good agreement to the reported data allows the Matlab calculations to be used in daily brachytherapy treatments.

  6. Investigational medications for treatment of patients with Alzheimer disease.

    PubMed

    Potter, Pamela E

    2010-09-01

    Development of effective treatments for patients with Alzheimer disease has been challenging. Currently approved treatments include acetylcholinesterase inhibitors and the N-methyl-D-aspartate receptor antagonist memantine hydrochloride. To investigate treatments in development for patients with Alzheimer disease, the author conducted a review of the literature. New approaches for treatment or prevention focus on several general areas, including cholinergic receptor agonists, drugs to decrease β-amyloid and tau levels, antiinflammatory agents, drugs to increase nitric oxide and cyclic guanosine monophosphate levels, and substances to reduce cell death or promote cellular regeneration. The author focuses on medications currently in clinical trials. Cholinergic agents include orthostatic and allosteric muscarinic M1 agonists and nicotinic receptor agonists. Investigational agents that target β-amyloid include vaccines, antibodies, and inhibitors of β-amyloid production. Anti-inflammatory agents, including nonsteroidal anti-inflammatory drugs, the natural product curcumin, and the tumor necrosis factor α inhibitor etanercept, have also been studied. Some drugs currently approved for other uses may also show promise for treatment of patients with Alzheimer disease. Results of clinical trials with many of these investigational drugs have been disappointing, perhaps because of their use with patients in advanced stages of Alzheimer disease. Effective treatment may need to begin earlier-before neurodegeneration becomes severe enough for symptoms to appear.

  7. Medical treatment of acute poisoning with organophosphorus and carbamate pesticides.

    PubMed

    Jokanović, Milan

    2009-10-28

    Organophosphorus compounds (OPs) are used as pesticides and developed as warfare nerve agents such as tabun, soman, sarin, VX and others. Exposure to even small amounts of an OP can be fatal and death is usually caused by respiratory failure. The mechanism of OP poisoning involves inhibition of acetylcholinesterase (AChE) leading to inactivation of the enzyme which has an important role in neurotransmission. AChE inhibition results in the accumulation of acetylcholine at cholinergic receptor sites, producing continuous stimulation of cholinergic fibers throughout the nervous systems. During more than five decades, pyridinium oximes have been developed as therapeutic agents used in the medical treatment of poisoning with OP. They act by reactivation of AChE inhibited by OP. However, they differ in their activity in poisoning with pesticides and warfare nerve agents and there is still no universal broad-spectrum oxime capable of protecting against all known OP. In spite of enormous efforts devoted to development of new pyridinium oximes as potential antidotes against poisoning with OP only four compounds so far have found its application in human medicine. Presently, a combination of an antimuscarinic agent, e.g. atropine, AChE reactivator such as one of the recommended pyridinium oximes (pralidoxime, trimedoxime, obidoxime and HI-6) and diazepam are used for the treatment of OP poisoning in humans. In this article the available data related to medical treatment of poisoning with OP pesticides are reviewed and the current recommendations are presented.

  8. Miami Treatment Alternatives to Street Crime Project: A Review and Analysis of Performance, Accomplishment and Impact.

    ERIC Educational Resources Information Center

    Dade County Dept. of Drug Programs, Miami, FL.

    This report, submitted as an appeal for continuation of funds, summarizes the achievements of the Miami Treatment Alternatives to Street Crime (TASC) project. The project is designed to identify drug-abusing arrestees and divert them to either jail treatment or one of the Miami community's drug treatment programs. Included in this report are cost…

  9. An Alternating Treatment Comparison of Minimal and Maximal Opposition Sound Selection in Turkish Phonological Disorders

    ERIC Educational Resources Information Center

    Topbas, Seyhun; Unal, Ozlem

    2010-01-01

    A single-subject alternating treatment design in combination with a staggered multiple baseline model across subjects was implemented with two 6:0 year-old girls, monozygotic twins, who were referred to a university clinic for evaluation and treatment. The treatment programme was structured according to variants of "minimal pair contrast…

  10. Use of Complementary and Alternative Medicine (CAM) Treatments by Parents of Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Christon, Lillian M.; Mackintosh, Virginia H.; Myers, Barbara J.

    2010-01-01

    Parents of children with autism spectrum disorders (ASDs) may elect to use complementary and alternative medicine (CAM) treatments with their children in place of, or in addition to, conventional treatments. CAM treatments are controversial and understudied and, for most, the efficacy has not been established. The current study (n = 248) examined…

  11. Infrared beak treatment: an alternative to conventional beak trimming

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Infrared lasers have been widely used in human medicine and its results are reliable, predictable and reproducible. Infrared lasers have recently been designed with the expressed purpose of providing a less painful, more precise beak treatment compared with conventional beak trimming. This study was...

  12. An Overview of Shiraz Emergency Medical Services, Dispatch to Treatment

    PubMed Central

    Peyravi, Mahmoudreza; Örtenwal, Per; Djalali, Ahmadreza; Khorram-Manesh, Amir

    2013-01-01

    Background Advanced ambulance service (Emergency Medical Services/EMS) is considered to be an integral part of emergency medical care as the first assets responding to emergencies and disasters in the prehospital setting in most developed countries. Objectives The aim of this study was to evaluate the current situation of Shiraz’s EMS by comparing data obtained during two different time periods. Materials and Methods This is a retrospective analytic and comparative study in which data obtained from Shiraz EMS during two one-year periods (21st of March 2011 to 20th of March 2012 and 22nd of September 1999 to 21st of September 2000) were compared. Furthermore, these data were also compared with available data from Gothenburg’s EMS (2010). Results Of 84084 missions performed by Shiraz EMS during one year trauma cases were the most common [39282 (46.7%)]. The most common cause of trauma was road traffic accidents (RTA) (27257; 76.5%). Near 56% of all patients were transported to hospitals; some 47% by ambulances and 8.8% by private cars. Around 36.2% of patients received definitive medical treatment at the scene. While there was an increase in response and evacuation times, the number of deaths at scene before ambulance arrival decreased. Conclusions Although Shiraz’s EMS has expanded during last decade and the mortality rate at scene has decreased, the number of RTA-related trauma cases, along with the response and evacuation time, has increased. More than one third of the patients received definitive treatment and could be dismissed directly from the scene. Standardized triage and treatment protocols are needed to improve the EMS activity. PMID:24616794

  13. Complementary and alternative medicine for the treatment of bronchiolitis in infants: A systematic review

    PubMed Central

    2017-01-01

    Background Bronchiolitis is a common cause of hospitalization among infants. The limited effectiveness of conventional medication has prompted the use of complementary and alternative medicine (CAM) as alternative or adjunctive therapy for the management of bronchiolitis. Aims To determine the effectiveness and safety of CAM for the treatment of bronchiolitis in infants aged less than 2 years. Methods A systematic electronic search was performed in Medline, Embase, CINAHL, AMED, and Cochrane Central Register of Controlled Trials (CENTRAL) from their respective inception to June 30, 2016 for studies evaluating CAM as an intervention to treat bronchiolitis in infants (1 month to 2 years of age). The CAM could be any form of treatment defined by the National Center for Complementary and Integrative Health (NCCIH) and was utilized either as a single agent or adjunctive therapy. The predefined primary outcome was length of hospital stay. Secondary outcomes were time to resolution of bronchiolitis symptoms, adverse events, and all other clinical outcomes reported by the included studies. Results The review identified 11 studies (8 randomized controlled trials and 3 cohort studies) examining four herbal preparations and four supplements used either as adjunctive or alternative therapy for bronchiolitis in 904 infants. Most studies were of moderate quality. Among six studies reporting on length of stay, a significant benefit was found for Chinese herbal medicine compared to ribavirin in one cohort study (n = 66) and vitamin D compared to placebo in one randomized controlled trial (n = 89). Studies of Chinese herbal medicine (4 studies, n = 365), vitamin D (1 study, n = 89), N-acetylcysteine (1 study, n = 100), and magnesium (2 studies, n = 176) showed some benefits with respect to clinical severity scores, oxygen saturation, and other symptoms, although data were sparse for any single intervention and the outcomes assessed and reported varied across studies. Only five

  14. 'Waiting for Godot': a commonsense approach to the medical treatment of endometriosis.

    PubMed

    Vercellini, Paolo; Crosignani, PierGiorgio; Somigliana, Edgardo; Viganò, Paola; Frattaruolo, Maria Pina; Fedele, Luigi

    2011-01-01

    Conservative surgical treatment for symptomatic endometriosis is frequently associated with only partial relief of pelvic pain or its recurrence. Therefore, medical therapy constitutes an important alternative or complement to surgery. However, no available compound is cytoreductive, and suppression instead of elimination of implants is the only realistic objective of pharmacological intervention. Because this implies prolonged periods of treatments, only medications with a favourable safety/tolerability/efficacy/cost profile should be chosen. In the past few years, innumerable new drugs for endometriosis, which would interfere with several hypothesized pathogenic mechanisms, have been studied and their use foreseen. However, robust evidence of in vivo safety and efficacy is lacking and, at the moment, the principal modality to interfere with endometriosis metabolism is still hormonal manipulation. Regrettably, in spite of consistent demonstration of a major effect on pain even in patients with deeply infiltrating lesions, progestins are underestimated and dismissed in favour of more scientifically fashionable and up-to-the-minute alternatives. Moreover, oral contraceptives (OCs) dramatically reduce the rate of post-operative endometrioma recurrence and should now be considered an essential part of long-term therapeutic strategies in order to limit further damage to future fertility. Finally, women who have used OC for prolonged periods will be protected from an increased risk of endometriosis-associated ovarian cancer. To avoid the several subtle modalities for distorting facts and orientating opinions in favour of specific compounds, progestins and monophasic OC used continuously are here proposed as the reference comparator in all future randomized controlled trials on medical treatment for endometriosis.

  15. The Clinical Application of Hydrogen as a Medical Treatment.

    PubMed

    Iida, Atsuyoshi; Nosaka, Nobuyuki; Yumoto, Tetsuya; Knaup, Emily; Naito, Hiromichi; Nishiyama, Chihiro; Yamakawa, Yasuaki; Tsukahara, Kohei; Terado, Michihisa; Sato, Keiji; Ugawa, Toyomu; Nakao, Atsunori

    2016-10-01

    In recent years, it has become evident that molecular hydrogen is a particularyl effective treatment for various disease models such as ischemia-reperfusion injury; as a result, research on hydrogen has progressed rapidly. Hydrogen has been shown to be effective not only through intake as a gas, but also as a liquid medication taken orally, intravenously, or locally. Hydrogen's effectiveness is thus multifaceted. Herein we review the recent research on hydrogen-rich water, and we examine the possibilities for its clinical application. Now that hydrogen is in the limelight as a gaseous signaling molecule due to its potential ability to inhibit oxidative stress signaling, new research developments are highly anticipated.

  16. Medically Inappropriate or Futile Treatment: Deliberation and Justification 1

    PubMed Central

    Misak, Cheryl J.; White, Douglas B.; Truog, Robert D.

    2016-01-01

    This paper reframes the futility debate, moving away from the question “Who decides when to end what is considered to be a medically inappropriate or futile treatment?” and toward the question “How can society make policy that will best account for the multitude of values and conflicts involved in such decision-making?” It offers a pragmatist moral epistemology that provides us with (1) a clear justification of why it is important to take best standards, norms, and physician judgment seriously and (2) a clear justification of why ample opportunity must be made for patients, families, and society to challenge those standards and norms. PMID:26681796

  17. Brain Games as a Potential Nonpharmaceutical Alternative for the Treatment of ADHD

    ERIC Educational Resources Information Center

    Wegrzyn, Stacy C.; Hearrington, Doug; Martin, Tim; Randolph, Adriane B.

    2013-01-01

    Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed childhood neurobehavioral disorder, affecting approximately 5.5 million children, of which approximately 66% take ADHD medication daily. This study investigated a potential nonpharmaceutical alternative to address the academic engagement of 5th through 11th grade…

  18. Approval of Alternative Test Method for Puerto Nuevo Wastewater Treatment Plant, San Juan, Puerto Rico Memorandum

    EPA Pesticide Factsheets

    This December 2008 memorandum is from Conniesue Oldham of the Measurement Technology Group to Marcus E. Kantz in EPA Region 2. This memorandum is regarding a request to use an alternative test method at the Puerto Neuvo wastewater treatment plant

  19. Guidance: Demonstrating Compliance with the Land Disposal Restrictions (LDR) Alternative Soil Treatment Standards

    EPA Pesticide Factsheets

    This guidance provides suggestions and perspectives on how members of the regulated community, states, and the public can demonstrate compliance with the alternative treatment standards for certain contaminated soils that will be land disposed.

  20. Evaluation of alternative treatments for spent fuel rod consolidation wastes and other miscellaneous commercial transuranic wastes

    SciTech Connect

    Ross, W.A.; Schneider, K.J.; Oma, K.H.; Smith, R.I.; Bunnell, L.R.

    1986-05-01

    Eight alternative treatments (and four subalternatives) are considered for both existing commercial transuranic wastes and future wastes from spent fuel consolidation. Waste treatment is assumed to occur at a hypothetical central treatment facility (a Monitored Retrieval Storage facility was used as a reference). Disposal in a geologic repository is also assumed. The cost, process characteristics, and waste form characteristics are evaluated for each waste treatment alternative. The evaluation indicates that selection of a high-volume-reduction alternative can save almost $1 billion in life-cycle costs for the management of transuranic and high-activity wastes from 70,000 MTU of spent fuel compared to the reference MRS process. The supercompaction, arc pyrolysis and melting, and maximum volume reduction alternatives are recommended for further consideration; the latter two are recommended for further testing and demonstration.

  1. Tomorrow`s energy today for cities and counties -- Alternative wastewater treatment: Advanced Integrated Pond systems

    SciTech Connect

    Not Available

    1993-10-01

    This report provides a discussion of the design, construction, operation, and maintenance of the Advanced Integrated Pond System as an alternative for other more costly municipal waste water treatment plants.

  2. SELENIUM TREATMENT/REMOVAL ALTERNATIVES DEMONSTRATION PROJECT - MINE WASTE TECHNOLOGY PROGRAM ACTIVITY III, PROJECT 20

    EPA Science Inventory

    This document is the final report for EPA's Mine WAste Technology Program (MWTP) Activity III, Project 20--Selenium Treatment/Removal Alternatives Demonstration project. Selenium contamination originates from many sources including mining operations, mineral processing, abandoned...

  3. 20 CFR 30.400 - What are the basic rules for obtaining medical treatment?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... treatment may include treatment of the underlying primary cancer when it is medically necessary or related to treatment of the secondary cancer; however, payment for medical treatment of the underlying... treatment? 30.400 Section 30.400 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT...

  4. Propolis as an alternative treatment for cutaneous warts.

    PubMed

    Zedan, Hatem; Hofny, Eman R M; Ismail, Sahar A

    2009-11-01

    Warts are common problems affecting adults and children. Multiple treatment options are available, but no single therapy stands out as uniformly effective. Propolis and Echinacea are relatively safe immunomodulators with antiviral properties. The purpose of this study was to assess the efficacy of Propolis and Echinacea in treating different types of warts. In a single-blind, randomized, 3-months trial, 135 patients with different types of warts received oral Propolis, Echinacea, or placebo. In patients with plane and common warts treated with Propolis, cure was achieved in 75% and 73% of patients, respectively. These results were significantly better than those associated with Echinacea treatment or placebo. We conclude that Propolis is an effective and safe immunomodulating therapy for plane and common warts.

  5. Passive mine drainage treatment: an effective low-cost alternative

    SciTech Connect

    Holm, J.D.

    1985-12-01

    Two prototype Passive Mine Drainage Treatment Systems have been designed and constructed in Colorado. These projects have addressed acid mine drainage from inactive coal mines. Metal removal for both systems is accomplished using simulated peat bogs composed of sphagnum moss and hypnum moss retained by loose rock check dams. Acid neutralization is accomplished using crushed limestone filled channels. Neutralization and aeration are enhanced with drop structures and waterfalls placed in the drainage channel. Preliminary water quality results show dramatic treatment effects with the PMDT system. This investigation presents cost data for design and construction of the two PMDT systems. Cost projections for periodic maintenance requirements are provided along with a suggested method for financing maintenance costs. Performance data for the first system installed are presented. 14 references, 1 figure, 2 tables.

  6. Odanacatib: an emerging novel treatment alternative for postmenopausal osteoporosis.

    PubMed

    Schultz, Thomas C; Valenzano, Jonathan P; Verzella, Jessica L; Umland, Elena M

    2015-11-01

    Odanacatib represents a novel treatment option in the approach of postmenopausal women. Postmenopausal women with osteoporosis experience a disturbance in bone remodeling wherein bone resorption exceeds bone formation. Cathepsin K is a lysosomal cysteine protease found primarily in osteoclasts that plays a major role in the breakdown of bone via its collagenase properties. Targeting a new area of pathophysiology, odanacatib inhibits cathepsin K to reduce bone resorption while preserving bone formation. Phase II and III trials have shown efficacy in increasing bone mineral density in the target treatment group. Overall, safety studies have found odanacatib to be well-tolerated and comparable to placebo; however, some imbalances in adverse events have been observed in the Phase III trials. Current and future studies will analyze the long-term ability of odanacatib in preventing bone fracture.

  7. What if endoscopic hemostasis fails? Alternative treatment strategies: interventional radiology.

    PubMed

    Nanavati, Sujal M

    2014-12-01

    Since the 1960s, interventional radiology has played a role in the management of gastrointestinal bleeding. What began primarily as a diagnostic modality has evolved into much more of a therapeutic tool. And although the frequency of gastrointestinal bleeding has diminished thanks to management by pharmacologic and endoscopic methods, the need for additional invasive interventions still exists. Transcatheter angiography and intervention is a fundamental step in the algorithm for the treatment of gastrointestinal bleeding.

  8. Proven Alternatives for Aboveground Treatment of Arsenic in Groundwater

    DTIC Science & Technology

    2002-10-01

    nanofiltration and reverse osmosis treatment systems, both of which have been used to treat arsenic. Although nanofiltration and reverse osmosis are...UF) • Nanofiltration (NF) • Reverse osmosis (RO) Technology Description and Principles Contaminated Water Membranes RejectRecycle Effluent Model of a...Membrane Filtration System 5.0 MEMBRANE FILTRATION FOR ARSENIC There are four types of membrane processes: reverse osmosis (RO), nanofiltration (NF

  9. Comprehensive life cycle inventories of alternative wastewater treatment systems.

    PubMed

    Foley, Jeffrey; de Haas, David; Hartley, Ken; Lant, Paul

    2010-03-01

    Over recent decades, the environmental regulations on wastewater treatment plants (WWTP) have trended towards increasingly stringent nutrient removal requirements for the protection of local waterways. However, such regulations typically ignore other environmental impacts that might accompany apparent improvements to the WWTP. This paper quantitatively defines the life cycle inventory of resources consumed and emissions produced in ten different wastewater treatment scenarios (covering six process configurations and nine treatment standards). The inventory results indicate that infrastructure resources, operational energy, direct greenhouse gas (GHG) emissions and chemical consumption generally increase with increasing nitrogen removal, especially at discharge standards of total nitrogen <5 mgN L(-1). Similarly, infrastructure resources and chemical consumption increase sharply with increasing phosphorus removal, but operational energy and direct GHG emissions are largely unaffected. These trends represent a trade-off of negative environmental impacts against improved local receiving water quality. However, increased phosphorus removal in WWTPs also represents an opportunity for increased resource recovery and reuse via biosolids applied to agricultural land. This study highlights that where biosolids displace synthetic fertilisers, a negative environmental trade-off may also occur by increasing the heavy metals discharged to soil. Proper analysis of these positive and negative environmental trade-offs requires further life cycle impact assessment and an inherently subjective weighting of competing environmental costs and benefits.

  10. INTRAPERITONEAL DEXTROSE ADMINISTRATION AS AN ALTERNATIVE EMERGENCY TREATMENT FOR HYPOGLYCEMIC YEARLING CALIFORNIA SEA LIONS (ZALOPHUS CALIFORNIANUS).

    PubMed

    Fravel, Vanessa A; Van Bonn, William; Gulland, Frances; Rios, Carlos; Fahlman, Andreas; Graham, James L; Havel, Peter J

    2016-03-01

    The Marine Mammal Center (TMMC) cares for malnourished California sea lion (CSL) (Zalophus californianus) pups and yearlings every year. Hypoglycemia is a common consequence of malnutrition in young CSLs. Administering dextrose during a hypoglycemic crisis is vital to recovery. Traditional veterinary approaches to treat hypoglycemia pose therapeutic challenges in otariids, as vascular access and catheter maintenance can be difficult. The current approach to a hypoglycemic episode at TMMC is to administer dextrose intravenously (i.v.) by medically trained personnel. Intraperitoneal (i.p.) dextrose administration is an attractive alternative to i.v. administration because volunteer staff with basic training can administer treatment instead of waiting for trained staff to treat. This study compares the effects of i.v., i.p., and no dextrose administration on serum glucose and insulin in clinically healthy, euglycemic CSL yearlings. Three groups of animals, consisting of five sea lions each, were treated with 500 mg/kg dextrose using one of the following routes: i.v., i.p., or no dextrose (control). A jugular catheter was placed, and blood samples were collected at times 0, 5, 15, 30, 60, 120, 180, and 240 min after dextrose administration. I.v. dextrose administration resulted in an increase of serum glucose concentrations from a baseline level of approximately 150 mg/dl to a peak of approximately 350 mg/dl. The resulting hyperglycemia persisted for approximately 2 hr and was associated with an attenuated plasma insulin response compared with most terrestrial mammals. Intraperitoneal dextrose administration resulted in increases of serum glucose to approximately 200 mg/dl, which gradually declined to baseline by 2 hr after dextrose administration. These data suggest that the initial treatment of a hypoglycemic crisis in young malnourished CSLs can be accomplished with i.p. dextrose, thus enabling minimally trained volunteer staff to respond immediately to a crisis

  11. Characteristics of opiate users leaving detoxification treatment against medical advice.

    PubMed

    Kenne, Deric R; Boros, Alec P; Fischbein, Rebecca L

    2010-07-01

    Substance-dependent patients leaving against medical advice (AMA) pose a unique challenge to detoxification programs. Most notably, AMA patients fail to access residential or outpatient treatment needed after detoxification and often return to detoxification treatment multiple times which has deleterious results for the patient and is taxing to the healthcare system. Using retrospective data from 89 daily opiate-using detoxification patients completing detoxification and 95 patients leaving AMA, we sought to identify patient characteristics useful in predicting AMA discharges from detoxification. Bivariate analyses indicated that AMA patients reported drug use did not impair their health, were injection drug users, younger and had fewer previous treatment admissions. Binomial logistic regression indicated that AMA patients were more likely to be unemployed and report that drug use did not impair their health. Patients completing detoxification were less likely to be injection drug users and less likely to be self-referred to treatment. Identifying patients at risk of leaving AMA provides an opportunity for clinicians to intervene in an effort to increase treatment engagement for these patients.

  12. Treatment of tuberculosis in Turkey in terms of medical ethics.

    PubMed

    Demir, Müge; Örnek Büken, Nüket

    2015-09-01

    Having a history as old as the history of humanity, Tuberculosis (TB) is a serious disease and it is regarded as an important a public health problem not only for its medical aspect but also for its social and ethical aspects. As a result of the discovery of the cure for TB and the improvement of humans' living conditions, the TB problem was believed to be solved and a relaxation in the battle against TB was observed around the world by 1980s. World Health Organization (WHO) declared a state of emergency for the battle against TB in 1993. According to the "Global Tuberculosis Control 2014" which was published by WHO, TB remains one of the world's deadliest communicable diseases. This article argues that tuberculosis is one of the most important neglected topics in medical ethics as regards individual obligations to avoid infecting others, coercive social distancing measures, third-party notification, health workers' duty to treat contagious patients, and justice.The purpose of this article is provide a picture of the current situation of TB treatment in Turkey in terms of medical ethics.

  13. Mechanisms for alternative treatments in Parkinson's disease: acupuncture, tai chi, and other treatments.

    PubMed

    Ghaffari, Bijan D; Kluger, Benzi

    2014-06-01

    At least 40% of patients with Parkinson's disease (PD) use one or more forms of alternative therapy (AT) to complement standard treatments. This article reviews the commonest forms of AT for PD, including acupuncture, tai chi, yoga, mindfulness, massage, herbal medicine, and cannabis. We discuss the current evidence for the clinical efficacy of each AT and discuss potential mechanisms, including those suggested by animal and human studies. With a few notable exceptions, none of the treatments examined were investigated rigorously enough to draw definitive conclusions about efficacy or mechanism. Tai chi, acupuncture, Mucuna pruriens, cannabinoids, and music therapy have all been proposed to work through specific mechanisms, although current evidence is insufficient to support or refute these claims, with the possible exception of Mucuna pruriens (which contains levodopa). It is likely that most ATs predominantly treat PD patients through general mechanisms, including placebo effects, stress reduction, and improved mood and sleep, and AT may provide patients with a greater locus of control regarding their illness.

  14. Bronchiolitis obliterans syndrome after lung transplantation: medical treatment.

    PubMed

    Verleden, G M

    2000-04-01

    Obliterative bronchiolitis (OB) or the clinical correlate bronchiolitis obliterans syndrome (BOS) is the main cause of late morbidity and mortality after heart-lung and lung transplantation. Although several risk factors for the development of OB/BOS have already been identified, very effective preventive therapy remains Utopian, although there has been much improvement in recent years. This paper attempts to summarize current experience in the medical treatment of OB/BOS, either by tackling the known risk factors for the development of OB/BOS or by changing the immunosuppressive drug regimen for treating established OB/BOS. The current treatment options, however, are rather anecdotal and mostly single-centre experiences. Therefore, multicentre studies are definitely needed to try to identify the most appropriate drug regimen either to prevent and to treat obliterative bronchiolitis/bronchiolitis obliterans syndrome.

  15. Endoscopic mucosectomy: an alternative treatment for superficial esophageal cancer.

    PubMed

    Lambert, R

    2000-01-01

    Recent trends in the management of superficial esophageal cancer consist of improved detection, pretherapeutic staging and reliable criteria for curative endoscopic therapy. The endoscopic treatment is legitimate when the cancer is at an early stage, intra-epithelial or microinvasive (m1 or m2) and N0. Submucosal cancer should not be treated with a curative intent by endotherapy. Concerning squamous cell cancer, the oriental and occidental pathologists include high-grade dysplasia in the same group as intramucosal cancer. The distinction is however maintained for adenocarcinoma in the Barrett's esophagus. Indications of endoscopic rather than surgical treatment rely on: (1) the small size of the tumor (not more than 2 cm in diameter); (2) the endoscopic morphology in the type 0 of the Japanese classification with the flat subtypes IIa and IIb rather than type IIc--there is high risk of submucosal invasion for the polypoid (type I) or ulcerated superficial cancer (type III); and (3) the endoscopic ultrasound staging, with confirmed integrity of the hyperechoic submucosal layer. The high-frequency (20 MHz) miniprobe is preferred to the standard (7.5 MHz) instrument. The elective procedure for tumor eradication is endoscopic mucosectomy. The technique is associated with a 6.8% risk of severe complications (hemorrhage or perforation) and a recurrence rate of 3%-7%. The 5-year survival rate is similar to that of surgery (over 80%). In the small group of patients with superficial esophageal cancer (less than 10% of the disease) endoscopic treatment may now be proposed in about 30% of cases, surgery is preferred for submucosal cancer and for neoplasia with a large surface. Areas of high-grade dysplasia in the Barrett's esophagus offer a new and increasing sector of indications. The concurrent endoscopic procedure of destruction--photodynamic therapy--is preferred for the destruction of lesions with poorly delineated limits.

  16. [Calcitonin as an alternative treatment for root resorption].

    PubMed

    Pierce, A; Berg, J O; Lindskog, S

    1989-01-01

    Inflammatory root resorption is a common finding following trauma and will cause eventual destruction of the tooth root if left untreated. This study examined the effects of intrapulpal application of calcitonin, a hormone known to inhibit osteoclastic bone resorption, on experimental inflammatory root resorption induced in monkeys. Results were histologically evaluated using a morphometric technique and revealed that calcitonin was an effective medicament for the treatment of inflammatory root resorption. It was concluded that this hormone could be a useful therapeutic adjunct in difficult cases of external root resorption.

  17. Surrogate motherhood as a medical treatment procedure for women's infertility.

    PubMed

    Jovic, Olga S

    2011-03-01

    The content of this work is conceived on the research of the consequences of surrogate motherhood as a process of assisted procreation, which represent a way of parenthood in cases when it is not possible to realize parenthood through a natural way. Surrogate motherhood is a process in which a woman (surrogate mother) agrees to carry a pregnancy with the intent to give the child to the couple with whom she has made a contract on surrogate maternity after the birth. This process of conception and birth makes the determination of the child's origin on its mother's side hard to determine, because of the distinction of the genetic and gestation phases of the two women. The concept of surrogate motherhood is to appear in two forms, depending on the existence or the non-existence of the genetic link between the surrogate mother and the child she gives birth to. There are gestation (full) and genetic (partial) surrogates each with different modalities and legal and ethical implications. In Serbia, Infertility Treatment and the Bio-medically Assisted Procreation Act from 2009 explicitly forbids surrogate motherhood, despite the fact that an infertile couple decides to use it, as a rule, after having tried all other treatment procedures, in cases when there is a diagnosis but the conventional treatment applied has not produced the desired results. Given the fact that no one has the right to ignore the sufferings of people who cannot procreate naturally, the medical practice and legal science in our country plead for a formulation of a legal framework in which to apply surrogate motherhood as an infertility treatment, under particular conditions.

  18. National Patterns of Medication Treatment for Depression, 1987 to 2001.

    PubMed

    Stafford, Randall S.; MacDonald, Ellen A.; Finkelstein, Stan N.

    2001-12-01

    BACKGROUND: We investigated trends in antidepressant use, as well as broader changes in depression treatment, following the availability of selective serotonin reuptake inhibitors (SSRIs). METHOD: Using data from the National Disease and Therapeutic Index, a nationally representative survey of U.S. office-based physicians conducted by IMS HEALTH, we analyzed trends in antidepressant prescribing patterns from 1987 through the third quarter of 2001. Annual sample sizes of physician visits by patients reported to have depression ranged from 3901 visits in 1987 to 6639 in 1998. Outcomes examined included the frequency of depression visits, the likelihood of antidepressant therapy, and the use of specific medications. RESULTS: The estimated national number of physician visits by patients with depression increased from 14.4 million visits in 1987 to 24.5 million in 2001 (annualized). The rate of antidepressant medication treatment in these patients also increased from 70% in 1987 to 89% in 2001. In 1987, tricyclic antidepressants were prescribed to 47% of patients with depression. The most common individual antidepressants were amitriptyline (14%), trazodone (12%), doxepin (8%), and desipramine (6%). In 1989, a year after its introduction, fluoxetine was prescribed to 21% of patients with depression. The introduction of other SSRIs led aggregate SSRI use to grow to 38% in 1992, 60% in 1996, and 69% in 2000. In 2001, sertraline (18%), paroxetine (16%), fluoxetine (14%), citalopram (13%), and bupropion (9%) were the leading antidepressants, while tricyclics were used in only 2% of patients. The use of benzodiazepines in depression declined from 21% of patients in 1987 to 8% in 2001. CONCLUSION: The increasing therapeutic dominance of SSRIs may have contributed to other changes in depression treatment, including declining benzodiazepine use, increased aggregate antidepressant treatment rates, and increased reporting of depression.

  19. Extracorporeal staple technique: an alternative approach to the treatment of critical colostomy stenosis

    PubMed Central

    Skokowski, Jarosław; Kalinowska, Aleksandra

    2015-01-01

    We describe an extracorporeal staple technique used to treat severe colostomy stenosis under analgo-sedation, thus avoiding relaparotomy. The surgery is performed under short-term sedation. The orifice of the stoma is widened and overgrowing skin is excised. The volume and diameter of the stoma are assessed. The anvil of a circular stapler device is inserted into the lumen of the colostomy. First bowel layers and then skin are closed with purse-string sutures. One firing of the stapler is used to reshape the stoma. The procedure takes around 20–30 min. One circular stapler is used. The patient can be discharged the same day or a day after surgery. No complications were noted in operated patients. At 6- and 12-month follow-ups, a slight narrowing of the colostomy was visible, but no recurrence of the stricture was noted. The described technique is an interesting, easy and safe alternative to previous methods of treatment for stenosed end-colostomy. Importantly, it is an extra-abdominal procedure and may be offered to patients with a history of multiple abdominal operations or with serious coexisting medical conditions in the one-day surgery setting. PMID:26240635

  20. Alternative for Anti-TNF Antibodies for Arthritis Treatment

    PubMed Central

    Paquet, Joseph; Henrionnet, Christel; Pinzano, Astrid; Vincourt, Jean-Baptiste; Gillet, Pierre; Netter, Patrick; Chary-Valckenaere, Isabelle; Loeuille, Damien; Pourel, Jacques; Grossin, Laurent

    2011-01-01

    Tumor necrosis factor-α (TNF-α), a proinflammatory cytokine, plays a key role in the pathogenesis of many inflammatory diseases, including arthritis. Neutralization of this cytokine by anti-TNF-α antibodies has shown its efficacy in rheumatoid arthritis (RA) and is now widely used. Nevertheless, some patients currently treated with anti-TNF-α remain refractory or become nonresponder to these treatments. In this context, there is a need for new or complementary therapeutic strategies. In this study, we investigated in vitro and in vivo anti-inflammatory potentialities of an anti-TNF-α triplex-forming oligonucleotide (TFO), as judged from effects on two rat arthritis models. The inhibitory activity of this TFO on articular cells (synoviocytes and chondrocytes) was verified and compared to that of small interfering RNA (siRNA) in vitro. The use of the anti-TNF-α TFO as a preventive and local treatment in both acute and chronic arthritis models significantly reduced disease development. Furthermore, the TFO efficiently blocked synovitis and cartilage and bone destruction in the joints. The results presented here provide the first evidence that gene targeting by anti-TNF-α TFO modulates arthritis in vivo, thus providing proof-of-concept that it could be used as therapeutic tool for TNF-α-dependent inflammatory disorders. PMID:21811249

  1. Alternative for anti-TNF antibodies for arthritis treatment.

    PubMed

    Paquet, Joseph; Henrionnet, Christel; Pinzano, Astrid; Vincourt, Jean-Baptiste; Gillet, Pierre; Netter, Patrick; Chary-Valckenaere, Isabelle; Loeuille, Damien; Pourel, Jacques; Grossin, Laurent

    2011-10-01

    Tumor necrosis factor-α (TNF-α), a proinflammatory cytokine, plays a key role in the pathogenesis of many inflammatory diseases, including arthritis. Neutralization of this cytokine by anti-TNF-α antibodies has shown its efficacy in rheumatoid arthritis (RA) and is now widely used. Nevertheless, some patients currently treated with anti-TNF-α remain refractory or become nonresponder to these treatments. In this context, there is a need for new or complementary therapeutic strategies. In this study, we investigated in vitro and in vivo anti-inflammatory potentialities of an anti-TNF-α triplex-forming oligonucleotide (TFO), as judged from effects on two rat arthritis models. The inhibitory activity of this TFO on articular cells (synoviocytes and chondrocytes) was verified and compared to that of small interfering RNA (siRNA) in vitro. The use of the anti-TNF-α TFO as a preventive and local treatment in both acute and chronic arthritis models significantly reduced disease development. Furthermore, the TFO efficiently blocked synovitis and cartilage and bone destruction in the joints. The results presented here provide the first evidence that gene targeting by anti-TNF-α TFO modulates arthritis in vivo, thus providing proof-of-concept that it could be used as therapeutic tool for TNF-α-dependent inflammatory disorders.

  2. 78 FR 21631 - Fiscal Year 2013 Cost of Hospital and Medical Care Treatment Furnished by the Department of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-11

    ... BUDGET Fiscal Year 2013 Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Medical Treatment Facilities; Certain Rates Regarding Recovery From Tortiously Liable Third... the cost of inpatient medical services furnished by military treatment facilities through...

  3. The enduring effects of psychodynamic treatments vis-a-vis alternative treatments: A multilevel longitudinal meta-analysis

    NASA Astrophysics Data System (ADS)

    Kivlighan, D. Martin, III

    Although evidence suggests that the benefits of psychodynamic treatments are sustained over time, presently it is unclear whether these sustained benefits are superior to non-psychodynamic treatments. Additionally, the extant literature comparing the sustained benefits of psychodynamic treatments compared to alternative treatments is limited with methodological shortcomings. The purpose of the current study was to conduct a rigorous test of the growth of the benefits of psychodynamic treatments relative to alternative treatments across distinct domains of change (i.e., all outcome measures, targeted outcome measures, non-targeted outcome measures, and personality outcome measures). To do so, the study employed strict inclusion criteria to identify randomized clinical trials that directly compared at least one bona fide psychodynamic treatment and one bona fide non-psychodynamic treatment. Hierarchical linear modeling (Raudenbush, Bryk, Cheong & Congdon, du Toit, 2011) was used to longitudinally model the impact of psychodynamic treatments compared to non-psychodynamic treatments at post-treatment and to compare the growth (i.e., slope) of effects beyond treatment completion. Findings from the present meta-analysis indicated that psychodynamic treatments and non-psychodynamic treatments were equally efficacious at post-treatment and at follow-up for combined outcomes ( k = 20), targeted outcomes (k =19), non-targeted outcomes (k =17), and personality outcomes (k =6). Clinical implications, directions for future research, and limitations are discussed.

  4. Acute treatment of mania: an update on new medications.

    PubMed

    Gajwani, Prashant; Kemp, David E; Muzina, David J; Xia, Guohua; Gao, Keming; Calabrese, Joseph R

    2006-12-01

    Acute mania is frequently a medical emergency requiring hospitalization for behavioral control, rapid resolution of irritability, agitation, de-escalation of mood, and decreasing of risk-taking behavior. Lithium efficacy in the management of acute mania was reported in 1949 and approved by the US Food and Drug Administration (FDA) in 1970. Chlorpromazine, from the class of typical antipsychotics, was approved for treatment of bipolar disorder in 1973. Typical antipsychotics were frequently used alone and as adjunct for the treatment of bipolar mania for the next 2 decades. Divalproex was approved by the FDA for the treatment of acute mania in 1994. Since the approval of olanzapine in 2000, all five atypical antipsychotics, namely risperidone (2003), quetiapine (2004), ziprasidone (2004), and aripiprazole (2004), have been approved by the FDA for the management of acute mania. Clozapine is the only atypical antipsychotic not FDA approved for any phase of bipolar disorder. This article will systematically review some of the major studies published, randomized controlled monotherapy, and adjunct therapy trials involving five atypical antipsychotics and newer anticonvulsants for the treatment of acute bipolar mania.

  5. Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances.

    PubMed

    Ito, Tetsuhide; Igarashi, Hisato; Jensen, Robert T

    2012-12-01

    Pancreatic neuroendocrine tumors (pNETs) comprise with gastrointestinal carcinoids, the main groups of gastrointestinal neuroendocrine tumors (GI-NETs). Although these two groups of GI-NETs share many features including histological aspects; over-/ectopic expression of somatostatin receptors; the ability to ectopically secrete hormones/peptides/amines which can result in distinct functional syndromes; similar approaches used for tumor localization and some aspects of treatment, it is now generally agreed they should be considered separate. They differ in their pathogenesis, hormonal syndromes produced, many aspects of biological behaviour and most important, in their response to certain anti-tumour treatment (chemotherapy, molecular targeted therapies). In this chapter the clinical features of the different types of pNETs will be considered as well as aspects of their diagnosis and medical treatment of the hormone-excess state. Emphasis will be on controversial areas or recent advances. The other aspects of the management of these tumors (surgery, treatment of advanced disease, tumor localization) are not dealt with here, because they are covered in other chapters in this volume.

  6. Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances

    PubMed Central

    Ito, Tetsuhide; Igarashi, Hisato; Jensen, Robert T.

    2013-01-01

    Pancreatic neuroendocrine tumors (pNETs) comprise with gastrointestinal carcinoids, the main groups of gastrointestinal neuroendocrine tumors (GI-NETs). Although these two groups of GI-NETs share many features including histological aspects; over-/ectopic expression of somatostatin receptors; the ability to ectopically secrete hormones/peptides/amines which can result in distinct functional syndromes; similar approaches used for tumor localization and some aspects of treatment, it is now generally agreed they should be considered separate. They differ in their pathogenesis, hormonal syndromes produced, many aspects of biological behavior and most important, in their response to certain anti-tumor treatment (chemotherapy, molecular targeted therapies). In this chapter the clinical features of the different types of pNETs will be considered as well as aspects of their diagnosis and medical treatment of the hormone-excess state. Emphasis will be on controversial areas or recent advances. The other aspects of the management of these tumors (surgery, treatment of advanced disease, tumor localization) are not dealt with here, because they are covered in other chapters in this volume. PMID:23582916

  7. Phyllanthus niruri as a promising alternative treatment for nephrolithiasis.

    PubMed

    Boim, Mirian A; Heilberg, Ita P; Schor, Nestor

    2010-01-01

    In spite of considerable efforts to identify effective treatments for urolithiasis, this is a goal yet to be achieved. This review summarizes experimental and clinical data evaluating the effect of the plant Phyllanthus niruri, a plant with worldwide distribution, as a potential agent to prevent and/or to treat urolithiasis The review is based on data from the literature and on the results obtained by our group from either in vivo/in vitro experiments or clinical studies. Phyllanthus niruri has been shown to interfere with many stages of stone formation, reducing crystals aggregation, modifying their structure and composition as well as altering the interaction of the crystals with tubular cells leading to reduced subsequent endocytosis. The clinical beneficial effects of Phyllanthus niruri may be related to ureteral relaxation, helping to eliminate calculi or to clear fragments following lithotripsy, or also to a putative reduction of the excretion of urinary crystallization promoters such as calcium. No adverse renal, cardiovascular, neurological or toxic effects have been detected in either of these studies. Altogether, these studies suggest a preventive effect of Phyllanthus niruri in stone formation or elimination, but still longer-term randomized clinical trials are necessary to confirm its therapeutic properties.

  8. 20 CFR 30.400 - What are the basic rules for obtaining medical treatment?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... was filed. In situations where the occupational illness or covered illness is a secondary cancer, such treatment may include treatment of the underlying primary cancer when it is medically necessary or related to treatment of the secondary cancer; however, payment for medical treatment of the...

  9. 20 CFR 30.400 - What are the basic rules for obtaining medical treatment?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... secondary cancer, such treatment may include treatment of the underlying primary cancer when it is medically necessary or related to treatment of the secondary cancer; however, payment for medical treatment of the underlying primary cancer under these circumstances does not constitute a determination by OWCP that...

  10. 20 CFR 30.400 - What are the basic rules for obtaining medical treatment?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... secondary cancer, such treatment may include treatment of the underlying primary cancer when it is medically necessary or related to treatment of the secondary cancer; however, payment for medical treatment of the underlying primary cancer under these circumstances does not constitute a determination by OWCP that...

  11. 20 CFR 30.400 - What are the basic rules for obtaining medical treatment?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... secondary cancer, such treatment may include treatment of the underlying primary cancer when it is medically necessary or related to treatment of the secondary cancer; however, payment for medical treatment of the underlying primary cancer under these circumstances does not constitute a determination by OWCP that...

  12. Simultaneous Synthesis of Treatment Effects and Mapping to a Common Scale: An Alternative to Standardisation

    ERIC Educational Resources Information Center

    Ades, A. E.; Lu, Guobing; Dias, Sofia; Mayo-Wilson, Evan; Kounali, Daphne

    2015-01-01

    Objective: Trials often may report several similar outcomes measured on different test instruments. We explored a method for synthesising treatment effect information both within and between trials and for reporting treatment effects on a common scale as an alternative to standardisation Study design: We applied a procedure that simultaneously…

  13. Effects of Treatment Integrity Failures during Differential Reinforcement of Alternative Behavior: A Translational Model

    ERIC Educational Resources Information Center

    Pipkin, Claire St. Peter; Vollmer, Timothy R.; Sloman, Kimberly N.

    2010-01-01

    Differential reinforcement of alternative behavior (DRA) is used frequently as a treatment for problem behavior. Previous studies on treatment integrity failures during DRA suggest that the intervention is robust, but research has not yet investigated the effects of different types of integrity failures. We examined the effects of two types of…

  14. [The PEG-dilemma - pleading for an ethically responsible medical treatment].

    PubMed

    Löser, Chr

    2013-05-01

    Within the 32 years of its existence our attitude towards artificial enteral nutrition via PEG-tubes has changed in a fundamental way: in our modern understanding nutrition via PEG is supportive, early, preventive, and in many cases temporary. PEG-feeding is not an alternative but a possible supplement to normal oral food intake and requires an individual medical indication as well as an ethical justification. This does not follow standardised algorithmic thinking but is decided on an individual base taking personal wishes, resources, and needs of the individual patient into account. Nutrition via PEG-tube is not a terminal basic or even symbolic treatment at the end of life. The present dilemma of the PEG is that the public discussion primarily focus one-sided on the problems of PEG-placement in multimorbid, elderly, and/or demented patients or patients in end-stage tumour diseases where indeed PEG-placement is neither medically nor ethically justified - we still place PEG-tubes to often in the wrong patients! On the other hand we still consider supportive and in many cases temporary nutrition via PEG too rare and even too late in those patients which clearly could benefit from an early, supportive, and preventive PEG-treatment on the base of our present evidence-based scientific knowledge - we still consider PEG-treatment not adequately and in most cases too late in the right patients! Placing a PEG-tube is not the second last step before death and physicians have to accept the ethically given limits of medical treatment by realizing our modern understanding of the benefits and limits of supportive artificial nutrition via PEG.

  15. Medical Treatments for Endometriosis-Associated Pelvic Pain

    PubMed Central

    Luppi, Stefania; Ricci, Giuseppe

    2014-01-01

    The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies. PMID:25165691

  16. Increasing The Supply of Medical Personnel: Needs and Alternatives. Evaluative Studies Series.

    ERIC Educational Resources Information Center

    Steward, Charles T., Jr.; Siddayao, Corazon M.

    This paper considers medical personnel shortages, especially the shortage of physicians, and the different ways to alleviate these shortages. Chapter I gives a brief history (1963-1972) of legislation intended to increase medical manpower supply and Chapter II discusses the causes of the shortage, analyzing the elements affecting demand for…

  17. Use of Alternative Medications for Menopause-Related Symptoms in Three Major Ethnic Groups of Ipoh, Perak, Malaysia.

    PubMed

    Ohn Mar, Saw; Malhi, Fatehpal; Syed Rahim, Syed Hamid; Chua, Chin Tong; Sidhu, Sarjeet Singh; Sandheep, Sugathan

    2015-11-01

    This cross-sectional study investigated the use of alternative medications to alleviate menopause-related symptoms among Malay, Chinese, and Indian women of Ipoh city. The prevalence, types, effectiveness, and associated factors were determined. The prevalence of alternative medication use was 41.4%. Evening primrose oil (EPO) was the most popular medication used (18.1%), followed by soy-based products (12.3%), green tea (6.8%), and gingko (5.8%). The medication was reported to be highly effective by 58.3% of soya bean diet users and 41.1% of EPO users. Significant variables associated with the use were Chinese or Indian ethnicity (P < .001), age between 50 and 54 years (P < .01), lower self-health rating (P < .05), education level of diploma or professional degree (P < .05), employment as professionals or entrepreneurs (P < .05), and the use of hormone replacement therapy (P < .05). Regression analysis showed that Chinese and Indians had significantly higher odds for the use than Malays (Chinese: odds ratio [OR] = 4.33, 95% confidence interval [CI] = 2.392-7.837; Indians: OR = 3.248, 95% CI = 1.586-6.654).

  18. Advances in medical revascularisation treatments in acute ischemic stroke.

    PubMed

    Asadi, H; Yan, B; Dowling, R; Wong, S; Mitchell, P

    2014-01-01

    Urgent reperfusion of the ischaemic brain is the aim of stroke treatment and there has been ongoing research to find a drug that can promote vessel recanalisation more completely and with less side effects. In this review article, the major studies which have validated the use and safety of tPA are discussed. The safety and efficacy of other thrombolytic and anticoagulative agents such as tenecteplase, desmoteplase, ancrod, tirofiban, abciximab, eptifibatide, and argatroban are also reviewed. Tenecteplase and desmoteplase are both plasminogen activators with higher fibrin affinity and longer half-life compared to alteplase. They have shown greater reperfusion rates and improved functional outcomes in preliminary studies. Argatroban is a direct thrombin inhibitor used as an adjunct to intravenous tPA and showed higher rates of complete recanalisation in the ARTTS study with further studies which are now ongoing. Adjuvant thrombolysis techniques using transcranial ultrasound are also being investigated and have shown higher rates of complete recanalisation, for example, in the CLOTBUST study. Overall, development in medical therapies for stroke is important due to the ease of administration compared to endovascular treatments, and the new treatments such as tenecteplase, desmoteplase, and adjuvant sonothrombolysis are showing promising results and await further large-scale clinical trials.

  19. Robotic 3D scanner as an alternative to standard modalities of medical imaging.

    PubMed

    Chromy, Adam; Zalud, Ludek

    2014-01-01

    There are special medical cases, where standard medical imaging modalities are able to offer sufficient results, but not in the optimal way. It means, that desired results are produced with unnecessarily high expenses, with redundant informations or with needless demands on patient. This paper deals with one special case, where information useful for examination is the body surface only, inner sight into the body is needless. New specialized medical imaging device is developed for this situation. In the Introduction section, analysis of presently used medical imaging modalities is presented, which declares, that no available imaging device is best fitting for mentioned purposes. In the next section, development of the new specialized medical imaging device is presented, and its principles and functions are described. Then, the parameters of new device are compared with present ones. It brings significant advantages comparing to present imaging systems.

  20. 33 CFR 149.685 - May a medical treatment room be used for other purposes?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... other purposes? A medical treatment room may be used as a sleeping space if the room meets the requirements of this subpart for both medical treatment rooms and sleeping spaces. It may also be used as an office. However, when used for medical purposes, the room may not be used as a sleeping space or...

  1. 33 CFR 149.685 - May a medical treatment room be used for other purposes?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... other purposes? A medical treatment room may be used as a sleeping space if the room meets the requirements of this subpart for both medical treatment rooms and sleeping spaces. It may also be used as an office. However, when used for medical purposes, the room may not be used as a sleeping space or...

  2. 75 FR 35493 - Guidance for Industry on Systemic Lupus Erythematosus-Developing Medical Products for Treatment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ... Systemic Lupus Erythematosus--Developing Medical Products for Treatment; Availability AGENCY: Food and Drug... availability of a guidance for industry entitled ``Systemic Lupus Erythematosus--Developing Medical Products..., therapeutic biological products, and medical devices for the treatment of systemic lupus erythematosus...

  3. Current Medications for the Treatment of Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Vaughan, Brigette S.; Roberts, Holly J.; Needelman, Howard

    2009-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is common among children. Fortunately, ADHD is highly treatable with medication. The purpose of this article is to serve as a primer on medication treatment for ADHD for school psychologists. The article discusses the available stimulant and nonstimulant medication for the treatment of ADHD.…

  4. 33 CFR 149.685 - May a medical treatment room be used for other purposes?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... other purposes? A medical treatment room may be used as a sleeping space if the room meets the requirements of this subpart for both medical treatment rooms and sleeping spaces. It may also be used as an office. However, when used for medical purposes, the room may not be used as a sleeping space or...

  5. 33 CFR 149.685 - May a medical treatment room be used for other purposes?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... other purposes? A medical treatment room may be used as a sleeping space if the room meets the requirements of this subpart for both medical treatment rooms and sleeping spaces. It may also be used as an office. However, when used for medical purposes, the room may not be used as a sleeping space or...

  6. 33 CFR 149.685 - May a medical treatment room be used for other purposes?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... other purposes? A medical treatment room may be used as a sleeping space if the room meets the requirements of this subpart for both medical treatment rooms and sleeping spaces. It may also be used as an office. However, when used for medical purposes, the room may not be used as a sleeping space or...

  7. 33 CFR 149.680 - What are the requirements for medical treatment rooms?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false What are the requirements for medical treatment rooms? 149.680 Section 149.680 Navigation and Navigable Waters COAST GUARD, DEPARTMENT... Design and Equipment Medical Treatment Rooms § 149.680 What are the requirements for medical...

  8. Thermal treatment of medical waste in a rotary kiln.

    PubMed

    Bujak, J

    2015-10-01

    This paper presents the results of a study of an experimental system with thermal treatment (incineration) of medical waste conducted at a large complex of hospital facilities. The studies were conducted for a period of one month. The processing system was analysed in terms of the energy, environmental and economic aspects. A rotary combustion chamber was designed and built with the strictly assumed length to inner diameter ratio of 4:1. In terms of energy, the temperature distribution was tested in the rotary kiln, secondary combustion (afterburner) chamber and heat recovery system. Calorific value of medical waste was 25.0 MJ/kg and the thermal efficiency of the entire system equalled 66.8%. Next, measurements of the pollutant emissions into the atmosphere were performed. Due to the nature of the disposed waste, particular attention was paid to the one-minute average values of carbon oxide and volatile organic compounds as well as hydrochloride, hydrogen fluoride, sulphur dioxide and total dust. Maximum content of non-oxidized organic compounds in slag and bottom ash were also verified during the analyses. The best rotary speed for the combustion chamber was selected to obtain proper afterburning of the bottom slag. Total organic carbon content was 2.9%. The test results were used to determine the basic economic indicators of the test system for evaluating the profitability of its construction. Simple payback time (SPB) for capital expenditures on the implementation of the project was 4 years.

  9. Censored data treatment using additional information in intelligent medical systems

    NASA Astrophysics Data System (ADS)

    Zenkova, Z. N.

    2015-11-01

    Statistical procedures are a very important and significant part of modern intelligent medical systems. They are used for proceeding, mining and analysis of different types of the data about patients and their diseases; help to make various decisions, regarding the diagnosis, treatment, medication or surgery, etc. In many cases the data can be censored or incomplete. It is a well-known fact that censorship considerably reduces the efficiency of statistical procedures. In this paper the author makes a brief review of the approaches which allow improvement of the procedures using additional information, and describes a modified estimation of an unknown cumulative distribution function involving additional information about a quantile which is known exactly. The additional information is used by applying a projection of a classical estimator to a set of estimators with certain properties. The Kaplan-Meier estimator is considered as an estimator of the unknown cumulative distribution function, the properties of the modified estimator are investigated for a case of a single right censorship by means of simulations.

  10. Meta-analysis of osteoporosis: fracture risks, medication and treatment.

    PubMed

    Liu, W; Yang, L-H; Kong, X-C; An, L-K; Wang, R

    2015-08-01

    Osteoporosis is a brittle bone disease that can cause fractures mostly in older men and women. Meta-analysis is the statistical method which is applied in the frame work for the assessment of results obtained from various research studies conducted in several years. A meta-analysis of osteoporotic fracture risk with medication non-adherence has been described to assess the bone fracture risk among patients non-adherent versus adherent to therapy for osteoporosis by many researchers. Osteoporosis therapy reduces the risk of fracture in clinical trials, and real-world adherence to therapy which is suboptimal and can reduce the effectiveness of intervention. The methods of Medline, Embase, and CINAHL were literature searched for these observational studies from year 1998 to 2009, and up to 2015. The results of meta-analysis of osteoporosis research on fractures of postmenopausal women and men are presented. The use of bisphosphonate therapy for osteoporosis has been described with other drugs. The authors, design, studies (women %), years (data), follow-up (wks), fractures (types), and compliance or persistence results from years 2004 to 2009 from are shown in a brief table. The meta-analysis studies have been reviewed from other researchers on osteoporosis and fractures, medications and treatments.

  11. Catatonia in autistic spectrum disorders: a medical treatment algorithm.

    PubMed

    Fink, Max; Taylor, Michael A; Ghaziuddin, Neera

    2006-01-01

    Autism is a developmental syndrome with an unknown biology and inadequate therapeutics. Assessing the elements of the syndrome for the presence of depression, psychosis, mania, or catatonia, offers opportunities for systematic intervention. Since almost all descriptions of autism highlight the presence of motor symptoms that characterize catatonia, an assessment for this eminently treatable syndrome is recommended for all patients considered to be autistic. A minimum examination includes a catatonia rating scale and for those patients with defined catatonia, a lorazepam test. For those whose catatonia responds to lorazepam, high dose lorazepam therapy is recommended. If this fails, electroconvulsive therapy is recommended. The assessment and treatment of catatonia offers positive medical therapy for the victims of autism and their families.

  12. Use of medical, surgical and complementary treatments among women with fibroids

    PubMed Central

    Jacoby, Vanessa L; Jacoby, Alison; Learman, Lee A; Schembri, Michael; Gregorich, Steven E; Jackson, Rebecca; Kuppermann, Miriam

    2015-01-01

    Objective To examine the use of medical management, uterus-preserving surgery (UPS), and complementary treatments among women with uterine fibroids. Study design Prospective cohort study of 933 premenopausal women ages 31-54 years with symptomatic fibroids who participated in the Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives (SOPHIA) for an average of 4.3 years (SD 2.5 years). Incident use of fibroid treatments was determined through annual interviews. Linear regression models were used to compare changes in fibroid-related symptoms among women who underwent UPS versus those who did not undergo surgery. Results Participants were racially and ethnically diverse, with a mean age of 43 years. During study follow-up, 531 participants (57%) did not undergo UPS or hysterectomy, 250 (27%) had at least one UPS, and 152 (16%) underwent hysterectomy. Complementary and alternative treatments were commonly used, including exercise (45%), diet (34%), herbs (37%), and acupuncture (16%): participants reported significant symptom improvement and few side effects with these interventions. In multivariable linear regression models, women who did not undergo surgery during the study reported improvement in dyspareunia (p<.001), pelvic pain (p<.001), and menstrual cramps (p<.001). However, women who underwent UPS reported greater overall resolution of “pelvic problems” compared with women who did not have surgical treatment (difference in change score 1.18 on a 4-point Likert scale, p<.001). Conclusion UPS are effective treatments for women with fibroids, but many women use hormonal or complementary treatments and report significant symptom improvement without surgical intervention. PMID:25445104

  13. [The use of a synthetic analog of prostaglandin E1 for medical treatment of first trimester pregnancy failure].

    PubMed

    Houminer, Aryeh; Kopernic, Gideon; Hagay, Zion

    2009-07-01

    First trimester failure is a common event accruing in 15-20% of pregnancies that has traditionally been treated by surgical curettage. An alternate therapy is medical treatment using misoprostol, a synthetic analog of prostaglandin E1. Numerous studies have been carried out comparing treatment by misoprostol with a placebo. They have found a significant advantage to misoprostol mode of treatment. Other studies comparing surgical and medical treatment found the surgical treatment to be superior to the latter. It must be noted that the medical mode of treatment was indeed found to be successful in over 80% of cases. No significant differences were noted in the complication rates of the two groups. Misoprostol therapy has been found to be effective when administered orally or vaginally, although vaginal therapy is slightly superior. No large scale studies have been carried out to date testing the safety of this treatment in patients with a scarred uterus (due to Cesarean section or hysterotomy). However, on the basis of reported facts, it seems plausibLe to suggest misoprostoL treatment for these patients.

  14. Complementary and Alternative Medicine Modalities for the Treatment of Irritable Bowel Syndrome: Facts or Myths?

    PubMed Central

    2010-01-01

    Due to unsatisfactory results from conventional treatment of irritable bowel syndrome (IBS), complementary and alternative medicine (CAM) modalities are increasingly popular treatment alternatives. Unfortunately, most CAM clinical trials have been of poor quality, and the efficacies of these therapies have not been adequately elucidated, even through systematic reviews or meta-analyses. There is also a general lack of understanding of their mechanisms of action. Currently, insufficient evidence exists to support the use of traditional Chinese medicine, acupuncture, meditation, and reflexology for treatment of IBS. However, there is some evidence supporting the use of peppermint oil and gut-directed hypnotherapy for IBS treatment. Due to mounting evidence of the microbiologic and immunologic basis of IBS, probiotics and exclusion diets are also becoming promising treatment modalities. This paper will review the current literature on various CAM practices for IBS treatment and appraise their advantages and disadvantages in clinical practice. PMID:21437019

  15. Alternative Approaches to Conventional Treatment of Acute Uncomplicated Urinary Tract Infection in Women

    PubMed Central

    Foxman, Betsy; Buxton, Miatta

    2013-01-01

    The increasing resistance of uropathogens to antibiotics, and recognition of generally self-limiting nature of uncomplicated urinary tract infection (UTI) suggests that it is time to reconsider empirical treatment of UTI using antibiotics. Identifying new and effective strategies to prevent recurrences and alterative treatment strategies are a high priority. We review the recent literature regarding the effects of functional food products, probiotics, vaccines, and alternative treatments on treating and preventing UTI. PMID:23378124

  16. Acute renal failure secondary to ingestion of alternative medication in a patient with breast cancer.

    PubMed

    Gulia, S; Gota, V; Kumar, Sangita D; Gupta, Sudeep

    2015-01-01

    Complementary and alternative medicine (CAM) use among cancer patients is widely prevalent and often underreported. Advanced stage of disease is significantly associated with CAM use. The concurrent use of alternative medicines and chemotherapy drugs has the potential to lead to toxicities as well as altered therapeutic activity due to unknown interactions. We report a case of early breast cancer who presented to us with non-oliguric acute renal failure related concurrent use of Ayurvedic medicines and adjuvant anthracycline based.

  17. Epidemiology and treatment of depression in patients with chronic medical illness

    PubMed Central

    J. Katon, Wayne.

    2011-01-01

    There is a bidirectional relationship between depression and chronic medical disorders. The adverse health risk behaviors and psychobiological changes associated with depression increase the risk for chronic medical disorders, and biological changes and complications associated with chronic medical disorders may precipitate depressive episodes. Comorbid depression is associated with increased medical symptom burden, functional impairment, medical costs, poor adherence to self-care regimens, and increased risk of morbidity and mortality in patients with chronic medical disorders. Depression may worsen the course of medical disorders because of its effect on proinflammatory factors, hypothalamic-pituitary axis, autonomic nervous system, and metabolic factors, in addition to being associated with a higher risk of obesity, sedentary lifestyle, smoking, and poor adherence to medical regimens. Both evidence-based psychotherapies and antidepressant medication are efficacious treatments for depression. Collaborative depression care has been shown to be an effective way to deliver these treatments to large primary care populations with depression and chronic medical illness. PMID:21485743

  18. Crisis intervention program: an alternative to inpatient psychiatric treatment for children.

    PubMed

    Blumberg, Samuel H

    2002-03-01

    This study evaluated the impact of a Crisis Intervention program as an alternative to use of psychiatric treatment beds for young children. A multidisciplinary community-based intervention was utilized, including family therapy, psychiatric intervention, and school consultations. The impact of the service was evaluated in relation to the use of psychiatric treatment beds by the population of children eligible for Medicaid or uninsured. In comparison to an historical control group, the program resulted in a 23% reduction in the use of psychiatric treatment beds. A cost-minimization analysis indicated that in addition to the program reducing the use of psychiatric treatment beds, the cost of treatment was also slightly reduced.

  19. Imagining alternative professional identities: reconfiguring professional boundaries between nursing students and medical students.

    PubMed

    Langendyk, Vicki; Hegazi, Iman; Cowin, Leanne; Johnson, Maree; Wilson, Ian

    2015-06-01

    The transition of a medical student or a nursing student into a health care practitioner requires many changes. Among these is the development of an appropriate professional identity, which assists in the establishment of a sound base for professional practice and therefore should be a focus for health professions educators. There is evidence, however, that medical education and nursing education face challenges in guiding students' development of appropriate professional identities. In medicine, there is concern that medical education may contribute to the development of professional identities that alienate patients rather than identities that are patient centered. The nursing profession struggles with poor retention rates in the workforce, which have been attributed in part to discrepancies between the professional identities that students develop during nursing school and the realities of professional practice.In this Perspective, the authors explore the importance of and the pedagogical strategies used to facilitate professional identity formation for medical and nursing students. They argue that medical and nursing educators aim to instill in their students strong occupational identities which may perpetuate hierarchical disciplinary boundaries. They suggest that health professions educators should move beyond current disciplinary silos and create interprofessional education opportunities for medical students and nursing students to learn together to facilitate the development of the collaborative interprofessional identities necessary for the delivery of high-quality, patient-centered health care.

  20. Selective laser trabeculoplasty compared with medical treatment for the initial management of open angle glaucoma or ocular hypertension.

    PubMed

    Pérez, Efraín; Rada, Gabriel; Maul, Eugenio

    2015-12-16

    Selective laser trabeculoplasty is a relatively new therapeutic alternative for the management of open angle glaucoma and ocular hypertension. On the other hand, medical treatment has robust data supporting its efficacy and has progressed in last decades with the introduction of prostaglandin analogues. To compare these two therapies, we searched Epistemonikos database, which is maintained by screening 30 databases, and identified four systematic reviews including four randomized and one non-randomized clinical trial. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded that selective laser trabeculoplasty leads to a smaller absolute intraocular pressure reduction than medical treatment. However, it is not clear if there are differences in treatment success rate or need of additional antiglaucomatous interventions, because the quality of the evidence is low.

  1. Medication assisted treatment of drug abuse and dependence: global availability and utilization.

    PubMed

    Kresina, Thomas F

    2007-01-01

    Clinical trials and clinical studies, using patented drugs and drugs off patent, provide data that impact the best treatment practices for substance abuse and dependence. In the United States, medications have been approved for use in the treatment of both alcohol and opioid dependence. Medications are used in the detoxification from drug abuse and dependence in the symptomatic relief of withdrawal. For long term treatment or medical maintenance treatment, medications eliminate the physiological effects of drug use by blocking drug-receptor binding in the brain. Therefore, patented drugs showing interactions with neurotransmitters in the brain, are attractive candidates for treatment efficacy trials. An effective long term treatment paradigm for reducing drug dependence is the combinatorial use of medications that block the effects of drug use with behavior change counseling and psychotherapy. Medications used for the long term treatment of opioid dependence are methadone, buprenorphine, and naltrexone. Pharmacotherapies used in the treatment of alcohol dependence include acamprosate, antabuse and naltrexone. A reliable indicator for successful treatment of drug dependence is time in treatment. Patients remain in long term treatment when they perceive that their health care environment is supportive and non-stigmatizing and with a good patient-provider relationship where their needs are identified and met. Additional medications are needed for individual comprehensive substance abuse treatment plans, particularly for individuals who abuse stimulants. Patented drugs remain an important source of candidate pharmacotherapies comprising medication assistant treatment, part of a comprehensive treatment plan for drug dependence that addresses the medical, social, and psychological needs of the patient. Adapting this drug treatment paradigm globally requires identifying and testing new drug candidates while building and changing programs to patient centered treatment

  2. Paternalism and factitious disorder: medical treatment in illness deception.

    PubMed

    Fry, Anthony; Gergel, Tania L

    2016-08-01

    The primary aims are to consider whether a range of paternalistic medical interventions can be justified in the treatment of factitious disorder (FD) and to show that the particularities of FD and its management make it an ideal phenomenon to highlight the difficulties of balancing respect for self-determination, responsibility and duty of care in psychiatry. FD is usually classified as a mental disorder involving deliberate and hidden feigning or inducement of illness, in order to achieve patient status. Both the nature of the disorder and the approach to treatment are controversial and under-researched. It is argued that FD should be classified as a mental disorder; may well expose the patient to extreme risk; can warrant paternalistic interventions, in order to fulfil duty of care. Moreover, treatment of FD is inherently paternalistic and therefore raises interesting questions about justifications and type of paternalistic interventions in psychiatry both for FD and in general. A brief account of key questions concerning psychiatry and paternalism is followed by some case histories of FD, the clinical dilemmas posed and the question of how this disorder might warrant paternalistic interventions. In order to answer this question, two things are considered: the legitimacy and character of FD as a mental disorder; possible frameworks for and types of paternalistic interventions. To conclude, it is argued that there are no compelling reasons for rejecting the use of paternalistic interventions for FD, but that further investigation of FD and type and frameworks for psychiatric paternalism, in relation to FD and other mental disorders, are urgently needed.

  3. 78 FR 69694 - Changing Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of Obesity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-20

    ... Devices in the Treatment of Obesity and Metabolic Diseases: How To Estimate and Reward True Patient... ``Changing Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of Obesity and... medical devices for the treatment of morbid obesity and other metabolic diseases and evolving...

  4. Alternating hemiplegia of childhood: successful treatment with topiramate and flunarizine, a case report.

    PubMed

    Aishworiya, R; Low, P S; Tay, S K H

    2011-01-01

    Alternating hemiplegia of childhood (AHC) is a rare neurological disorder which usually presents before 18 months of age and is characterised by recurrent alternating episodes of hemiparesis. A single effective treatment for this condition is yet to be established; flunarizine is currently the most widely used but with varying degrees of success. An 18-month-old child presented with AHC and treatment with a combination of topiramate and flunarizine made a significant difference in controlling the frequency and severity of the attacks. This possibly allowed a better developmental outcome than in most children with this condition. Topiramate combined with flunarizine for treating AHC has much potential for further research.

  5. What do we do after an implant fails? A review of treatment alternatives for failed implants.

    PubMed

    Machtei, Eli E

    2013-01-01

    The problem of failed implants cannot be overlooked. The purpose of this paper is to explore treatment alternatives for failed implants and their strengths and shortcomings. A comprehensive literature search was performed using PubMed and a manual search. Only five studies were identified that explored treatment in sites where implants had failed. In all five studies, the treatment alternative tested was the placement of a new implant in the failed site. The overall survival rate for such implants ranged from 71% to 92.3%. Four other alternatives are also discussed in light of data derived from other studies on the survival of various treatment strategies. These include: a continuation of the original plan using the remaining implants, modification of treatment to a tooth-supported fixed partial denture (FPD) or to a hybrid tooth-implant? supported FPD, or modification to a removable prosthesis. The selection of an appropriate alternative for failed implants is complex and involves biologic, mechanical, and psychologic considerations along with financial aspects. This should be a team decision with the patient's opinion included.

  6. Waste management system alternatives for treatment of wastes from spent fuel reprocessing

    SciTech Connect

    McKee, R.W.; Swanson, J.L.; Daling, P.M.; Clark, L.L.; Craig, R.A.; Nesbitt, J.F.; McCarthy, D.; Franklin, A.L.; Hazelton, R.F.; Lundgren, R.A.

    1986-09-01

    This study was performed to help identify a preferred TRU waste treatment alternative for reprocessing wastes with respect to waste form performance in a geologic repository, near-term waste management system risks, and minimum waste management system costs. The results were intended for use in developing TRU waste acceptance requirements that may be needed to meet regulatory requirements for disposal of TRU wastes in a geologic repository. The waste management system components included in this analysis are waste treatment and packaging, transportation, and disposal. The major features of the TRU waste treatment alternatives examined here include: (1) packaging (as-produced) without treatment (PWOT); (2) compaction of hulls and other compactable wastes; (3) incineration of combustibles with cementation of the ash plus compaction of hulls and filters; (4) melting of hulls and failed equipment plus incineration of combustibles with vitrification of the ash along with the HLW; (5a) decontamination of hulls and failed equipment to produce LLW plus incineration and incorporation of ash and other inert wastes into HLW glass; and (5b) variation of this fifth treatment alternative in which the incineration ash is incorporated into a separate TRU waste glass. The six alternative processing system concepts provide progressively increasing levels of TRU waste consolidation and TRU waste form integrity. Vitrification of HLW and intermediate-level liquid wastes (ILLW) was assumed in all cases.

  7. 38 CFR 21.6242 - Resources for provision of medical treatment, care and services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Temporary... primary resources for the provision of medical treatment, care and services for program participants...

  8. Prevalence, Types and Determinants of Complementary and Alternative Medications among Health Clinic Clients

    ERIC Educational Resources Information Center

    Almousa, H.; Rabie, Faten M.; Alsamghan, Awad S.; Alsaluli, Mobarak; Albqami, Sultan; Almusa, Mona; Al-shahrani, Areej

    2015-01-01

    Complementary and Alternative Medicine (CAM) covers a wide range of over 100 healing approaches, philosophies and therapeutic modalities that are not provided by conventional medicine. Objectives: The study was aimed at identifying the prevalence, types and determinants of CAM use, sources of information about CAM that patients usually depend upon…

  9. Complementary and Alternative Medicine: Comparison of Current Knowledge, Attitudes and Interest among German Medical Students and Doctors

    PubMed Central

    Münstedt, Karsten; Harren, Hildegard; von Georgi, Richard; Hackethal, Andreas

    2011-01-01

    Although it has been agreed that complementary and alternative medicine (CAM) should be included in the German medical curriculum, there is no consensus on which methods and how it should be taught. This study aimed to assess needs for CAM education by evaluating current knowledge, attitudes and interests of medical students, general physicians and gynecologists. Two instruments based on established and validated questionnaires were developed. One was given to seventh semester medical students and the other to office-based doctors. Data were analyzed by bivariate correlation and cross-tabulation. Altogether 550 questionnaires were distributed—280 to doctors and 270 to medical students. Completed questionnaires were returned by 80.4% of students and 78.2% of doctors. Although 73.8% (160/219) of doctors and 40% (87/217) of students had already informed themselves about CAM, neither group felt that they knew much about CAM. Doctors believed that CAM was most useful in general medicine, supportive oncology, pediatrics, dermatology and gynecology, while students believed that dermatology, general medicine, psychiatry and rheumatology offered opportunities; both recommended that CAM should be taught in these areas. Both groups believed that CAM should be included in medical education; however, they believed that CAM needed more investigation and should be taught “critically". German doctors and students would like to be better informed about CAM. An approach which teaches fundamental competences to students, chooses specific content based on evidence, demographics and medical conditions and provides students with the skills they need for future learning should be adopted. PMID:19098296

  10. A Study of Alternate Approaches to Utilization Review of Laboratory Services within an Army Medical Center

    DTIC Science & Technology

    1983-06-06

    Iron, serum; Iron Binding Capacity Acid Phosphatase, Prostatic Fraction Total Alcohol, medical 17-Keto- steriods Al dosterone Lactic Acid Anikacin LOH...serum Glucose Tolerance Test Uric acid, urine HBs AG Uroporphyrlne, urine HCG Vitamin 812 Hydroycortico- steriods (17-OH) VMA (Vanillyl Mandelic Acid

  11. Rural Medical Service Funding: Issues and Alternatives. Rural Information Center Publication Series, No. 7.

    ERIC Educational Resources Information Center

    Kane, John D. H., III, Comp.; Leuci, Mary Simon, Comp.

    By almost any definition, rural America has been medically underserved. This bibliography includes materials available from the National Agricultural Library's (NAL) Rural Information Center. The listed materials include approximately 36 books and monographs, 106 articles, and the names and addresses of 17 related associations. Certain local…

  12. A Handbook for Group Discussion Leaders: Alternatives to Lecturing Medical Students to Death.

    ERIC Educational Resources Information Center

    Whitman, Neal A.; Schwenk, Thomas L.

    A guide for group discussion leaders that may be useful for medical school teachers is presented. One objective is to help the teacher know when group discussion is appropriate. It is suggested that both the lecture method and group discussion can facilitate cognitive learning but at different levels, and that group discussions are helpful if…

  13. Oral Mycostatin as a possible alternative treatment for intractable Ménière's disease: preliminary cohort study.

    PubMed

    Leong, A C; Pothier, D D; Rutka, J A

    2014-03-19

    Background: The potential efficacy of antifungal agents (e.g. Mycostatin) in treating acute attacks of Ménière's disease was first suggested in 1983 but few data have been published. Oral Mycostatin has been used as second-line medical treatment for intractable Ménière's disease at our institution for many years. Objective: This preliminary cohort study investigated the role of oral Mycostatin in intractable Ménière's disease. Methods: A retrospective review of patients with intractable Ménière's disease who started oral Mycostatin treatment between 2010 and 2012 was conducted. Results: Of 256 patients presenting with vertiginous disorders, 26 had definite Ménière's disease and had not responded to standard first-line treatment. Following oral Mycostatin treatment, improvements were reported for vertigo (n = 8), aural fullness (n = 7), tinnitus (n = 3) and subjective hearing loss (n = 3). Half of those with symptom improvement persisted with oral Mycostatin for two years and continued to remain asymptomatic. Conclusion: The use of oral Mycostatin to alleviate symptoms of intractable Ménière's disease showed promising results in this case series. Mycostatin may offer a safe and useful alternative for the management of Ménière's disease for patients with chronic unremitting symptoms in whom first-line treatment options have failed.

  14. Knowledge and Attitudes towards Complementary and Alternative Medicine among Senior Medical Students in King Abdulaziz University, Saudi Arabia

    PubMed Central

    Bashawri, Jamil; Bakarman, Marwan A.

    2016-01-01

    Objectives. This study assessed the knowledge and attitudes regarding complementary and alternative medicine (CAM) in medical students in Saudi Arabia. Furthermore, it evaluated their views on the incorporation of CAM in their medical syllabus. Methods. The study was conducted by selecting a cross-sectional sample of senior medical students in the Faculty of Medicine. A validated and reliable self-administered questionnaire was used to explore the knowledge, attitude, and benefits of CAM. It was distributed to a sample of 273 students. Results. The study included 242 students, making the response rate 88.6%. Only two-thirds of students (62.4%) were aware of acupuncture principles and only 17.4% recognized that chiropractic is associated with pain management. The knowledge of common herbs such as St. John's Wort, Echinacea, and Ginkgo biloba was limited among the students. Older students had a positive CAM attitude compared to younger students (p = 0.027). Conclusion. Students attitudes toward CAM learning were encouraging regardless of their limited knowledge on the subject. A high percentage of students agreed that CAM in combination with conventional therapy is beneficial in treating unusual cases, but the choice of CAM should be based on evidence. Furthermore, medical students are still reluctant to have CAM practitioners in their referral network. PMID:27066102

  15. Traditional, complementary and alternative medical systems and their contribution to personalisation, prediction and prevention in medicine—person-centred medicine

    PubMed Central

    2012-01-01

    Traditional, complementary and alternative medical (TCAM) systems contribute to the foundation of person-centred medicine (PCM), an epistemological orientation for medical science which places the person as a physical, psychological and spiritual entity at the centre of health care and of the therapeutic process. PCM wishes to broaden the bio-molecular reductionistic approach of medical science towards an integration that allows people, doctors, nurses, health-care professionals and patients to become the real protagonists of the health-care scene. The doctor or caregiver needs to act out of empathy to meet the unique value of each human being, which unfolds over the course of a lifetime from conception to natural death. Knowledge of the human being should not be instrumental to economic or political interests, ideology, theories or religious dogma. Research needs to be broadened with methodological tools to investigate person-centred medical interventions. Salutogenesis is a fundamental principle of PCM, promoting health and preventing illness by strengthening the individual's self-healing abilities. TCAM systems also give tools to predict the insurgence of illness and treat it before the appearance of overt organic disease. A task of PCM is to educate people to take better care of their physical, psychological and spiritual health. Health-care education needs to be broadened to give doctors and health-care workers of the future the tools to act in innovative and highly differentiated ways, always guided by deep respect for individual autonomy, personal culture, religion and beliefs. PMID:23126628

  16. Medical treatment of nystagmus and ocular motor disorders.

    PubMed

    Carlow, T J

    1986-01-01

    An increased compendium of drugs useful in ocular motor system dysfunction has expanded our capacity to treat selected ocular motility disorders. Adjunctive therapeutic modes (e.g., Fresnel prisms and orthoptic exercises) can also be beneficial. PAN and see-saw nystagmus can be treated with baclofen. Downbeat nystagmus may respond to clonazepam therapy, and prisms may help if the nystagmus can be modified with convergence. Congenital nystagmus may respond minimally to drugs (e.g., baclofen), but prisms or surgical procedures, or both, are still the primary treatment modalities. Innovar may be helpful in patients with severe, incapacitating vestibular disorders, and scopolamine alone or in combination with promethazine may be beneficial in patients with milder ambulatory acute peripheral vestibular disorders. Benign positional vertigo is best treated initially with positional exercises before drug therapy is instituted. Opsoclonus and ocular flutter have been treated successfully with corticosteroids, propranolol, and clonazepam, while microflutter, an extremely rare disorder, can resolve with baclofen. Although therapy with carbamazepine, 5-hydroxtryptophan, and scopolamine has been useful in selected patients with ocular palatal myoclonus, most do not respond to drug treatment. It is not usually necessary to treat voluntary nystagmus, but Fresnel prism lenses should be remembered in refractory patients. Potentially reversible and pseudointernuclear ophthalmoplegias also were discussed. Orthoptic exercises can be beneficial in posttraumatic internuclear ophthalmoplegia. Selected supranuclear palsies can be improved completely with the proper drug regimen. Lastly, superior oblique myokymia can be treated successfully with carbamazepine, with tight surveillance for possible adverse side effects. Descriptive phenomenology and pathophysiological localization must be correlated with brain stem neurochemistry and neuropharmacology to medically treat additional ocular

  17. Preventive Services by Medical and Dental Providers and Treatment Outcomes

    PubMed Central

    Kranz, A.M.; Rozier, R.G.; Preisser, J.S.; Stearns, S.C.; Weinberger, M.; Lee, J.Y.

    2014-01-01

    Objective: Nearly all state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children; yet, little is known about how treatment outcomes compare with children visiting dentists. This study compared the association between the provider of preventive services (PCP, dentist, or both) with Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment. Methods: We conducted a retrospective study of young children enrolled in North Carolina Medicaid during 2000 to 2006. The annual number of CRT and CRT payments per child between the ages of 3 and 5 yr were estimated with a zero-inflated negative binomial regression and a hurdle model, respectively. Models were adjusted for relevant child- and county-level characteristics and used propensity score weighting to address observed confounding. Results: We examined 41,453 children with > 1 preventive oral health visit from a PCP, dentist, or both before their third birthday. Unadjusted annual mean CRT and payments were lowest among children who had only PCP visits (CRT = 0.87, payment = $172) and higher among children with only dentist visits (CRT = 1.48, payment = $234) and both PCP and dentist visits (CRT = 1.52, payment = $273). Adjusted results indicated that children who had dentist visits (with or without PCP visits) had significantly more CRT and higher CRT payments per year during the ages of 3 and 4 yr than children who had only PCP visits. However, these differences attenuated each year after age 3 yr. Conclusions: Because of children’s increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by PCPs may lead to a greater reduction in CRT than dentist visits alone. This study supports guidelines and reimbursement policies that allow preventive dental visits based on individual needs. PMID:24891593

  18. Diagnosis and medical treatment of neuropathic pain in leprosy 1

    PubMed Central

    Arco, Rogerio Del; Nardi, Susilene Maria Tonelli; Bassi, Thiago Gasperini; Paschoal, Vania Del Arco

    2016-01-01

    ABSTRACT Objective: to identify the difficulties in diagnosing and treating neuropathic pain caused by leprosy and to understand the main characteristics of this situation. Methods: 85 patients were treated in outpatient units with reference to leprosy and the accompanying pain. We used a questionnaire known as the Douleur Neuropathic 4 test and we conducted detailed neurological exams. As a result, 42 patients were excluded from the study for not having proved their pain. Results: Out of the 37 patients that experienced pain, 22 (59.5%) had neuropathic pain (or a mixture of this pain and their existing pain) and of these 90.8% considered this pain to be moderate or severe. 81.8% of the sample suffered with this pain for more than 6 months. Only 12 (54.5%) of the patients had been diagnosed with neuropathic pain and in almost half of these cases, this pain had not been diagnosed. With reference to medical treatment (n=12) for neuropathic pain, 5 (41.6%) responded that they became better. For the other 7 (58.4%) there were no changes in relation to the pain or in some cases the pain worsened in comparison to their previous state. Statistical analysis comparing improvements in relation to the pain amongst the patients that were treated (n=12) and those that were not, showed significant differences (value p=0.020). Conclusion: we noted difficulties in diagnosing neuropathic pain for leprosy in that almost half of the patients that were studied had not had their pain diagnosed. We attributed this to some factors such as the non-adoption of the appropriate protocols which led to inadequate diagnosis and treatment that overlooked the true picture. PMID:27508904

  19. Assessment of wastewater treatment alternatives for small communities: An analytic network process approach.

    PubMed

    Molinos-Senante, María; Gómez, Trinidad; Caballero, Rafael; Hernández-Sancho, Francesc; Sala-Garrido, Ramón

    2015-11-01

    The selection of the most appropriate wastewater treatment (WWT) technology is a complex problem since many alternatives are available and many criteria are involved in the decision-making process. To deal with this challenge, the analytic network process (ANP) is applied for the first time to rank a set of seven WWT technology set-ups for secondary treatment in small communities. A major advantage of ANP is that it incorporates interdependent relationships between elements. Results illustrated that extensive technologies, constructed wetlands and pond systems are the most preferred alternatives by WWT experts. The sensitivity analysis performed verified that the ranking of WWT alternatives is very stable since constructed wetlands are almost always placed in the first position. This paper showed that ANP analysis is suitable to deal with complex decision-making problems, such as the selection of the most appropriate WWT system contributing to better understand the multiple interdependences among elements involved in the assessment.

  20. An alternative treatment approach to gingival recession: gingiva-colored partial porcelain veneers: a clinical report.

    PubMed

    Capa, Nuray

    2007-08-01

    This clinical report describes the treatment of excessive gingival recession involving maxillary right and left central incisors in a 30-year-old woman. The loss of the gingival soft tissue caused an increase in crown length. Gingiva-colored partial porcelain laminate veneers were applied to imitate the lost gingiva and to provide a natural anatomical tooth length. This method may be a minimally invasive alternative treatment method for gingival soft tissue loss, providing esthetic results and patient satisfaction.

  1. Alzheimer's disease and language impairments: social intervention and medical treatment.

    PubMed

    Klimova, Blanka; Maresova, Petra; Valis, Martin; Hort, Jakub; Kuca, Kamil

    2015-01-01

    Communication is very important for people to be successfully integrated into social environment and make and maintain relationship. Particularly, language difficulties lead to social exclusion of the people affected with Alzheimer's disease (AD) and contribute to a significant decrease in the quality of their life and also have a big impact on their family members who in most cases become their caregivers who need to communicate with their loved ones in order to meet their needs. Therefore, the goal of this study is to describe language impairments in the individual phases of AD and discuss their improvement with respect to AD on the basis of literature review. The authors of this article use traditional research methods in order to achieve the goal set mentioned earlier. First, a method of literature review of available sources describing language impairments in the individual phases of AD is exploited. Second, to show how informal caregivers and relevant drugs can successfully intervene in the improvement of these language impairments, a method of comparison of different research studies exploring such social intervention and medical treatment is used.

  2. Novel class of medications, orexin receptor antagonists, in the treatment of insomnia - critical appraisal of suvorexant.

    PubMed

    Norman, Jessica L; Anderson, Sarah L

    2016-01-01

    Insomnia, a highly prevalent disorder, can be detrimental to patients' overall health and worsen existing comorbidities. Patients may have acute episodes of insomnia related to a traumatic event, but more commonly insomnia occurs chronically. While proper sleep hygiene and behavioral therapy play important roles in the nonpharmacologic management of short-term and chronic insomnia, medications may also be required. Historically, insomnia has been treated with agents such as benzodiazepines, nonbenzodiazepine receptor agonists, and melatonin agonists. Dual orexin receptor antagonists represent a new class of medications for the treatment of insomnia, which block the binding of wakefulness-promoting neuropeptides orexin A and orexin B to their respective receptor sites. Suvorexant (Belsomra) is the first dual orexin receptor antagonist to be approved in the US and Japan and has demonstrated efficacy in decreasing time to sleep onset and increasing total sleep time. Its unique mechanism of action, data to support efficacy and safety over 12 months of use, and relative lack of withdrawal effects when discontinued may represent an alternative for patients with chronic insomnia who cannot tolerate or do not receive benefit from more traditional sleep agents. Suvorexant is effective and well tolerated, but precautions exist for certain patient populations, including females, obese patients, and those with respiratory disease. Suvorexant has only been studied vs placebo, and hence it is unknown how it directly compares with other medications approved by the US Food and Drug Administration for insomnia. Suvorexant is not likely to replace benzodiazepines or nonbenzodiazepine receptor antagonists as a first-line sleep agent but does represent a novel option for the treatment of patients with chronic insomnia.

  3. Alternatives to Incarceration: Prevention or Treatment. Monograph on Youth in the 1990s. Issue #4.

    ERIC Educational Resources Information Center

    Richards, Anthony, Ed.; Bocarro, Jason, Ed.

    The articles in this collection address various definitions, viewpoints, and treatments for youth at risk and youth offenders. Articles not only examine alternatives to incarceration, but also provide examples of value-forming experiences beneficial to all young people. The articles and authors are: (1) "Introduction" (Anthony Richards); (2) "The…

  4. Old and New Controversies in the Alternative Treatment of Attention-Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Rojas, Neal L.; Chan, Eugenia

    2005-01-01

    Use of complementary and alternative medicine (CAM) for treatment of attention-deficit hyperactivity disorder (ADHD) has become widespread in both referral and primary care populations. We review the purported mechanism of action and available evidence for selected CAM therapies for ADHD. Enduring controversies, such as elimination of artificial…

  5. Imagining the Alternatives to Life Prolonging Treatments: Elders' Beliefs about the Dying Experience

    ERIC Educational Resources Information Center

    Winter, Laraine; Parker, Barbara; Schneider, Melissa

    2007-01-01

    Deciding for or against a life-prolonging treatment represents a choice between prolonged life and death. When the death alternative is not described, individuals must supply their own assumptions. How do people imagine the experience of dying? The authors asked 40 elderly people open-ended questions about dying without 4 common life-prolonging…

  6. Growth of asthmatic children during treatment with alternate-day steriods.

    PubMed

    Reimer, L G; Morris, H G; Ellis, E F

    1975-04-01

    The effects of specific doses of alternate-day treatment with prednisone on linear growth were evaluated in children with severe asthma. It was found that even the control patients who did not receive steroid therapy had heights that were significantly lower than those of normal children of the same age and sex. The average severity of growth suppression in children who received alternate-day or intermittent treatment with steriods did not differ from that of asthmatic control patients. However, evaluation of individual patterns of growth during the follow-up period revealed that children who received small doses of alternate-day treatment (mean dose of prednisone, 9 mg. q.o.d.; range, 2.5 to 14 mg.) had acceleration of growth, whereas children who received larger treatment doses (mean dose of prednisone, 30 mg. q.o.d.; range, 18 to 58 mg.) had further suppression of growth during the period of study. Additionally, patients who had previously been treated with daily corticosteroids failed to demonstrate "catch-up" growth after introduction of an alternate-day program (mean dose of prednisone, 17 mg. q.o.d.).

  7. 40 CFR 268.49 - Alternative LDR treatment standards for contaminated soil.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Treatment Standards § 268.49 Alternative LDR... soil that exhibits a characteristic of hazardous waste, or exhibited a characteristic of hazardous waste at the time it was generated, into a land disposal unit. The following chart describes whether...

  8. Treatment of acquired periodic alternating nystagmus with memantine: a case report.

    PubMed

    Kumar, Anil; Thomas, Shery; McLean, Rebecca; Proudlock, Frank A; Roberts, Eryl; Boggild, Mike; Gottlob, Irene

    2009-01-01

    We report a case of acquired periodic alternating nystagmus associated with common variable immunodeficiency and cutaneous sarcoid. The patient was initially treated with baclofen with minimal subjective improvement. We found a significant improvement in the patient's symptoms and nystagmus intensity after treatment with memantine.

  9. Healing Childhood Ear Infections: Prevention, Home Care, and Alternative Treatment. 2nd Edition.

    ERIC Educational Resources Information Center

    Schmidt, Michael A.

    This book describes current controversy in medical journals over existing treatments for chronic childhood earaches. It suggests that the causes of otitis media are a series of events which flourish when poor nutrition occurs, noting that careful attention to diet and nutrition to prevent food allergies, and the use of acupressure, homeopathic…

  10. Alternative approaches for medical countermeasures to biological and chemical terrorism and warfare.

    PubMed

    Hartung, Thomas; Zurlo, Joanne

    2012-01-01

    The desire to develop and evaluate drugs as potential countermeasures for biological and chemical threats requires test systems that can also substitute for the clinical trials normally crucial for drug development. Animal models have limited predictivity for drug efficacy, as is well known from many disappointments in clinical trials. Traditional in vitro and in silico approaches are not really game changers here, but the substantial investment into novel tools now underway might bring about a second generation of alternative approaches. The avenue pursued focuses primarily on the development of a Human on a Chip, i.e., the combination of different three-dimensional (stem) cell-based organ equivalents combined with microfluidics. The prospects of such approaches, their impact on the field of alternative approaches, and necessary complementary activities are discussed. The need to adapt quality assurance measures and experiences from validation is stressed.

  11. Alternative Inventory Control Methods for Use in Managing Medical Supply Inventory

    DTIC Science & Technology

    1988-09-01

    located in a remote area of Japan. It offers limited inpatient and outpatient medical services to a 13 population of approximately 55% active duty, and 45...number of occupied bed days ( OBD ) per month where applicable, for fiscal years 1985 through 1987. Clinics do not admit patients and therefore do not...Force MTFs include OPVs, admissions, OBDs , and average daily patient load. All these measures apply to more than one workcenter, even in small

  12. Complementary and alternative medicine in the treatment of refugees and survivors of torture: a review and proposal for action.

    PubMed

    Longacre, McKenna; Silver-Highfield, Ellen; Lama, Puja; Grodin, Michael

    2012-01-01

    Survivors of torture and refugee trauma often have increased needs for mental and physical healthcare. This is due in part to the complex sequelae of trauma, including chronic pain, major depressive disorder, posttraumatic stress disorder (PTSD) and somatization. This article reviews the scientific medical literature for the efficacy and feasibility of some complementary and alternative medicine (CAM) modalities including meditation, Ayurveda, pranayama/yogic breathing, massage/body-work, dance/movement, spirituality, yoga, music, Traditional Chinese Medicine and acupuncture, qigong, t'ai chi, chiropractic, homeopathy, aromatherapy and Reiki specifically with respect to survivors of torture and refugee trauma. We report that preliminary research suggests that the certain CAM modalities may prove effective as part of an integrated treatment plan for survivors of torture and refugee trauma. Further research is warranted.

  13. Comparative LCA of decentralized wastewater treatment alternatives for non-potable urban reuse.

    PubMed

    Opher, Tamar; Friedler, Eran

    2016-11-01

    Municipal wastewater (WW) effluent represents a reliable and significant source for reclaimed water, very much needed nowadays. Water reclamation and reuse has become an attractive option for conserving and extending available water sources. The decentralized approach to domestic WW treatment benefits from the advantages of source separation, which makes available simple small-scale systems and on-site reuse, which can be constructed on a short time schedule and occasionally upgraded with new technological developments. In this study we perform a Life Cycle Assessment to compare between the environmental impacts of four alternatives for a hypothetical city's water-wastewater service system. The baseline alternative is the most common, centralized approach for WW treatment, in which WW is conveyed to and treated in a large wastewater treatment plant (WWTP) and is then discharged to a stream. The three alternatives represent different scales of distribution of the WW treatment phase, along with urban irrigation and domestic non-potable water reuse (toilet flushing). The first alternative includes centralized treatment at a WWTP, with part of the reclaimed WW (RWW) supplied back to the urban consumers. The second and third alternatives implement de-centralized greywater (GW) treatment with local reuse, one at cluster level (320 households) and one at building level (40 households). Life cycle impact assessment results show a consistent disadvantage of the prevailing centralized approach under local conditions in Israel, where seawater desalination is the marginal source of water supply. The alternative of source separation and GW reuse at cluster level seems to be the most preferable one, though its environmental performance is only slightly better than GW reuse at building level. Centralized WW treatment with urban reuse of WWTP effluents is not advantageous over decentralized treatment of GW because the supply of RWW back to consumers is very costly in materials and

  14. Use and Acceptance of Complementary and Alternative Medicine Among the General Population and Medical Personnel: A Systematic Review

    PubMed Central

    Frass, Michael; Strassl, Robert Paul; Friehs, Helmut; Müllner, Michael; Kundi, Michael; Kaye, Alan D.

    2012-01-01

    Background The interest in complementary and alternative medicine (CAM) has increased during the past decade and the attitude of the general public is mainly positive, but the debate about the clinical effectiveness of these therapies remains controversial among many medical professionals. Methods We conducted a systematic search of the existing literature utilizing different databases, including PubMed/Medline, PSYNDEX, and PsycLit, to research the use and acceptance of CAM among the general population and medical personnel. A special focus on CAM-referring literature was set by limiting the PubMed search to “Complementary Medicine” and adding two other search engines: CAMbase (www.cambase.de) and CAMRESEARCH (www.camresearch.net). These engines were used to reveal publications that at the time of the review were not indexed in PubMed. Results A total of 16 papers met the scope criteria. Prevalence rates of CAM in each of the included studies were between 5% and 74.8%. We found a higher utilization of homeopathy and acupuncture in German-speaking countries. Excluding any form of spiritual prayer, the data demonstrate that chiropractic manipulation, herbal medicine, massage, and homeopathy were the therapies most commonly used by the general population. We identified sex, age, and education as predictors of CAM utilization: More users were women, middle aged, and more educated. The ailments most often associated with CAM utilization included back pain or pathology, depression, insomnia, severe headache or migraine, and stomach or intestinal illnesses. Medical students were the most critical toward CAM. Compared to students of other professions (ie, nursing students: 44.7%, pharmacy students: 18.2%), medical students reported the least consultation with a CAM practitioner (10%). Conclusions The present data demonstrate an increase of CAM usage from 1990 through 2006 in all countries investigated. We found geographical differences, as well as differences between

  15. National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment

    PubMed Central

    Campopiano, Melinda; Baldwin, Grant; McCance-Katz, Elinore

    2015-01-01

    Objectives. We estimated national and state trends in opioid agonist medication-assisted treatment (OA-MAT) need and capacity to identify gaps and inform policy decisions. Methods. We generated national and state rates of past-year opioid abuse or dependence, maximum potential buprenorphine treatment capacity, number of patients receiving methadone from opioid treatment programs (OTPs), and the percentage of OTPs operating at 80% capacity or more using Substance Abuse and Mental Health Services Administration data. Results. Nationally, in 2012, the rate of opioid abuse or dependence was 891.8 per 100 000 people aged 12 years or older compared with national rates of maximum potential buprenorphine treatment capacity and patients receiving methadone in OTPs of, respectively, 420.3 and 119.9. Among states and the District of Columbia, 96% had opioid abuse or dependence rates higher than their buprenorphine treatment capacity rates; 37% had a gap of at least 5 per 1000 people. Thirty-eight states (77.6%) reported at least 75% of their OTPs were operating at 80% capacity or more. Conclusions. Significant gaps between treatment need and capacity exist at the state and national levels. Strategies to increase the number of OA-MAT providers are needed. PMID:26066931

  16. An exploratory study of alternative configurations of governing boards of substance abuse treatment centers

    PubMed Central

    Blum, Terry C.; Roman, Paul M.

    2011-01-01

    Boards of directors are the ultimate governing authorities for most organizations providing substance abuse treatment. A governing board may establish policies, monitor and improve operations, and represent a treatment organization to the public. This paper explores alternative configurations of governing boards in a national sample of 500 substance abuse treatment centers. The study proceeds from the premise that boards may be configured with varying levels of engagement in five aspects of internal management and external connections in treatment center operating environments. Based on interviews with treatment center administrative directors, four clusters emerge, describing boards that are: (1) active and balanced across internal and external domains; (2) active boundary spanners concentrating primarily on external relationships; (3) focused primarily on internal organizational management; and (4) relatively inactive. In post hoc analysis, we found that placement in these clusters is associated with treatment center attributes such as rate of growth and financial results, use of evidence based practices and provision of integrated care. PMID:21489737

  17. A Multidimensional Approach to Medication Selection in the Treatment of Children and Adolescents with ADHD

    PubMed Central

    2007-01-01

    The objective of this paper is to outline clinical patient characteristics to individualize medication selection for children and adolescents with ADHD. The treatment guidelines and clinical parameters outlined in this paper are based on clinical research and evidence- and/or consensus-based guidelines for medication treatment of children and adolescents with ADHD and associated symptoms or comorbid disorders. Recommendations are made for medication selection in different clinical situations. The increased availability of ADHD medications over the past few years has provided a number of treatment options with longer symptom control and improved the remission or “multidimensional normalization” for ADHD patients. Selection of the most appropriate medication(s) for complicated cases may present a serious challenge in some situations. This paper outlines selected complicated cases and treatment options. PMID:20532027

  18. Myiasis: diagnosis, treatment and medical use of maggots.

    PubMed

    Fydryszewski, Nadine A

    2013-01-01

    Two myiasis cases are presented which illustrate aspects of this infestation, and the role of the medical laboratory scientist with regard to the importance of critical thinking, problem-solving, and interprofessional communication skills. The purpose is to heighten awareness of myiasis, and emphasize the role of the medical laboratory scientist as a member of the healthcare team in confirming diagnosis.

  19. Alternative treatments for menopausal symptoms. Systematic review of scientific and lay literature.

    PubMed Central

    Seidl, M. M.; Stewart, D. E.

    1998-01-01

    OBJECTIVE: To review the scientific literature on common alternative remedies for treatment of symptoms attributed to menopause and to contrast this with available lay literature. QUALITY OF EVIDENCE: Scientific articles were identified by searching MEDLINE, CINAHL, and HEALTH databases from 1966 to mid-1997 for English-language articles. More than 200 references were reviewed; 85 were selected for citation based on specific reference to alternative medicine for symptoms commonly attributed to menopause (e.g., hot flashes), to the effects of changing estrogen levels (e.g., irregular menses, vaginal dryness), and to reported side effects of the treatments. MAIN FINDINGS: The scientific literature was categorized under the headings nutritional supplements, herbal remedies, homeopathic remedies, and physical approaches. Some scientific evidence of the safety and efficacy of alternative treatments during menopause was uncovered, with the strongest evidence emerging in favour of phytoestrogens, which occur in high concentrations as isoflavones in soy products. CONCLUSIONS: In available controlled studies, the strongest data support phytoestrogens for their role in diminishing menopausal symptoms related to estrogen deficiency and for possible protective effects on bones and the cardiovascular system. Randomized controlled trials, standardization of dosage, and accurate safety and efficacy labeling are required to ensure proper use of alternative remedies. PMID:9640524

  20. Investigation of bioaerosols released from swine farms using conventional and alternative waste treatment and management technologies

    USGS Publications Warehouse

    Ko, G.; Simmons, O. D.; Likirdopulos, C.A.; Worley-Davis, L.; Williams, M.; Sobsey, M.D.

    2008-01-01

    Microbial air pollution from concentrated animal feeding operations (CAFOs) has raised concerns about potential public health and environmental impacts. We investigated the levels of bioaerosols released from two swine farms using conventional lagoon-sprayfield technology and ten farms using alternative waste treatment and management technologies in the United States. In total, 424 microbial air samples taken at the 12 CAFOs were analyzed for several indicator and pathogenic microorganisms, including culturable bacteria and fungi, fecal coliform, Escherichia coli, Clostridium perfringens, bacteriophage, and Salmonella. At all of the investigated farms, bacterial concentrations at the downwind boundary were higher than those at the upwind boundary, suggesting that the farms are sources of microbial air contamination. In addition, fecal indicator microorganisms were found more frequently near barns and treatment technology sites than upwind or downwind of the farms. Approximately 4.5% (19/424), 1.2% (5/424), 22.2% (94/424), and 12.3% (53/424) of samples were positive for fecal coliform, E. coli, Clostridium, and total coliphage, respectively. Based on statistical comparison of airborne fecal indicator concentrations at alternative treatment technology farms compared to control farms with conventional technology, three alternative waste treatment technologies appear to perform better at reducing the airborne release of fecal indicator microorganisms during on-farm treatment and management processes. These results demonstrate that airborne microbial contaminants are released from swine farms and pose possible exposure risks to farm workers and nearby neighbors. However, the release of airborne microorganisms appears to decrease significantly through the use of certain alternative waste management and treatment technologies. ?? 2008 American Chemical Society.

  1. Klinefelter Syndrome and medical treatment: hypogonadism and beyond.

    PubMed

    Chang, Simon; Skakkebæk, Anne; Gravholt, Claus Højbjerg

    2015-01-01

    Klinefelter syndrome (KS), though described more than 70 years ago, still imposes significant diagnostic challenges. Based on data from epidemiological studies, KS is associated with increased morbidity and mortality. Although the pathophysiology and etiology behind these observations are as yet not well understood, a significant contribution of hypogonadism, central to the syndrome, is traditionally suspected. However, other unknown effects inherent to the syndrome also seem to modify the disease pattern. Herein we show that KS is under-diagnosed since only roughly 25% of patients are diagnosed and the mean age of diagnosis is during adult life. KS is associated with increased morbidity resulting in loss of 2-5 years in lifespan with increased mortality from different diseases and a poor socioeconomic profile. Small testes, hypergonadothrophic hypogonadism and cognitive impairment are usually found. The accompanying hypogonadism can lead to altered body composition and a risk of developing metabolic syndrome, type 2 diabetes and cardiovascular disease. Cancer risk is generally not different from that observed in the background population, although specific cancers like breast cancer and extragonadal germ cell tumors are seen more frequently in KS. The mainstay of medical treatment is testosterone replacement therapy to both attenuate acute and long-term consequences of hypogonadism and possibly prevent the frequent comorbidity. We believe that the diagnostic challenges should be tackled more efficiently, while there is also a pressing need to generate better evidence for timing and the proper dose of testosterone replacement. We advocate for a multidisciplinary setup with the inclusion of pediatricians, speech therapists, general practitioners, psychologists, infertility specialists, urologists and endocrinologists.

  2. 30 CFR 50.20-3 - Criteria-Differences between medical treatment and first aid.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Criteria-Differences between medical treatment... Reporting of Accidents, Injuries, and Illnesses § 50.20-3 Criteria—Differences between medical treatment and... antiseptic constitutes first aid where it is required by work duties that soil the bandage. (ii)...

  3. 30 CFR 50.20-3 - Criteria-Differences between medical treatment and first aid.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Criteria-Differences between medical treatment... Reporting of Accidents, Injuries, and Illnesses § 50.20-3 Criteria—Differences between medical treatment and... antiseptic constitutes first aid where it is required by work duties that soil the bandage. (ii)...

  4. Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults.

    PubMed

    Greenhill, Laurence L; Pliszka, Steven; Dulcan, Mina K; Bernet, William; Arnold, Valerie; Beitchman, Joseph; Benson, R Scott; Bukstein, Oscar; Kinlan, Joan; McClellan, Jon; Rue, David; Shaw, Jon A; Stock, Saundra

    2002-02-01

    This practice parameter describes treatment with stimulant medication. It uses an evidence-based medicine approach derived from a detailed literature review and expert consultation. Stimulant medications in clinical use include methylphenidate, dextroamphetamine, mixed-salts amphetamine, and pemoline. It carries FDA indications for treatment of attention-deficit/hyperactivity disorder and narcolepsy.

  5. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility... medical care or acute psychiatric care; (2) Medical and other information needed for care of the...

  6. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility... medical care or acute psychiatric care; (2) Medical and other information needed for care of the...

  7. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility... medical care or acute psychiatric care; (2) Medical and other information needed for care of the...

  8. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility... medical care or acute psychiatric care; (2) Medical and other information needed for care of the...

  9. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility... medical care or acute psychiatric care; (2) Medical and other information needed for care of the...

  10. Hospital adoption of medical technology: an empirical test of alternative models.

    PubMed Central

    Teplensky, J. D.; Pauly, M. V.; Kimberly, J. R.; Hillman, A. L.; Schwartz, J. S.

    1995-01-01

    OBJECTIVE. This study examines hospital motivations to acquire new medical technology, an issue of considerable policy relevance: in this case, whether, when, and why hospitals acquire a new capital-intensive medical technology, magnetic resonance imaging equipment (MRI). STUDY DESIGN. We review three common explanations for medical technology adoption: profit maximization, technological preeminence, and clinical excellence, and incorporate them into a composite model, controlling for regulatory differences, market structures, and organizational characteristics. All four models are then tested using Cox regressions. DATA SOURCES. The study is based on an initial sample of 637 hospitals in the continental United States that owned or leased an MRI unit as of 31 December 1988, plus nonadopters. Due to missing data the final sample consisted of 507 hospitals. The data, drawn from two telephone surveys, are supplemented by the AHA Survey, census data, and industry and academic sources. PRINCIPAL FINDING. Statistically, the three individual models account for roughly comparable amounts of variance in past adoption behavior. On the basis of explanatory power and parsimony, however, the technology model is "best." Although the composite model is statistically better than any of the individual models, it does not add much more explanatory power adjusting for the number of variables added. CONCLUSIONS. The composite model identified the importance a hospital attached to being a technological leader, its clinical requirements, and the change in revenues it associated with the adoption of MRI as the major determinants of adoption behavior. We conclude that a hospital's adoption behavior is strongly linked to its strategic orientation. PMID:7649751

  11. Legal, workplace, and treatment drug testing with alternate biological matrices on a global scale.

    PubMed

    Cone, E J

    2001-09-15

    Global trends in drug trafficking and drug usage patterns indicate a continuing pattern of escalation throughout the world. Over the last two decades, urinalysis has evolved into a highly accurate means for determining whether individuals have been exposed to illicit drugs of abuse. Advances have also been made in the use of alternate biological matrices such as hair, oral fluids and sweat for drug testing. Often, these new matrices demonstrate some distinct advantages over urinalysis, e.g. less invasive procedures, different time course of drug detection. They may even indicate impairment. National and local laws of each country provide the underpinnings of drug-testing programs, but most countries have not addressed use of these alternate matrices. Currently, only a few countries have statutes that specifically mention use of alternate biological matrices, e.g. United States (Florida state law), Germany, Ireland, Poland and the Czech Republic. Conversely, few countries have prohibited collection of alternate biological specimens or drug test devices that utilize such specimens. In addition, guidelines for implementing drug testing programs have been slow to emerge and most deal primarily with workplace drug testing programs, e.g. United States. Currently, scientific technology utilized in drug testing is advancing rapidly, but there is a clear need for parallel development of guidelines governing the use of alternate matrices for drug testing. This article provides an overview of global drug trafficking patterns and drug use, and results from a survey of legal statutes in 20 countries covering use of alternate matrices for drug testing. In addition, elements needed for the development of guidelines for alternate matrices testing for drugs of abuse are discussed, and specific examples of use of alternate matrices in treatment monitoring are provided.

  12. [To further strengthen the construction of emergency medical treatment system of massive burn].

    PubMed

    Jia, C Y

    2017-03-20

    Although clinical medicine of our country has made great progress in recent years, the rescue of massive burn casualties is still facing enormous challenges. No matter it is the top level design, system configuration, plan preparation, training, education, or the operation process, the medical resource allocation, and the treatment efficiency, are far behind the demand of social development. Therefore, further strengthen the construction of emergency medical treatment system of massive burn is the unshirkable responsibility of burn medical workers in our country.

  13. The ‘Alternative Quality Contract’ in Massachusetts, Based on Global Budgets, Lowered Medical Spending and Improved Quality

    PubMed Central

    Song, Zirui; Safran, Dana Gelb; Landon, Bruce E.; Landrum, Mary Beth; He, Yulei; Mechanic, Robert E.; Day, Matthew P.; Chernew, Michael E.

    2012-01-01

    Seven provider organizations in Massachusetts entered the Blue Cross Blue Shield Alternative Quality Contract in 2009, followed by four more organizations in 2010. This contract, based on a global budget and pay-for-performance for achieving certain quality benchmarks, places providers at risk for excessive spending and rewards them for quality, similar to the new Pioneer Accountable Care Organizations in Medicare. We analyzed changes in spending and quality associated with the Alternative Quality Contract and found that the rate of increase in spending slowed compared to control groups. Overall, participation in the contract over two years led to a savings of 3.3% (1.9% in year-1, 3.3% in year-2) compared to spending in groups not participating in the contract. The savings were even higher for groups whose previous experience had been only in fee-for-service contracting. Such groups’ quarterly savings over two years averaged 8.2% (6.3% in year-1, 9.9% in year-2). Quality of care also improved within organizations participating in the Alternative Quality Contract compared to control organizations in both years. Chronic care management, adult preventive care, and pediatric care improved from year 1 to year 2 within the contracting groups. These results suggest that global budgets coupled with pay-for-performance can begin to slow the underlying growth in medical spending while improving quality. PMID:22786651

  14. Alternative treatments in advanced hepatocellular carcinoma patients with progressive disease after sorafenib treatment: a prospective multicenter cohort study

    PubMed Central

    Nakano, Masahito; Tanaka, Masatoshi; Kuromatsu, Ryoko; Nagamatsu, Hiroaki; Satani, Manabu; Niizeki, Takashi; Okamura, Shusuke; Iwamoto, Hideki; Shimose, Shigeo; Shirono, Tomotake; Noda, Yu; Koga, Hironori; Torimura, Takuji

    2016-01-01

    Sorafenib is an oral multikinase inhibitor that has been approved to treat advanced hepatocellular carcinoma (HCC), though it is unclear how much benefit advanced HCC patients with progressive disease (PD) derive from sorafenib treatment. This study aimed to assess survival risk factors and evaluate therapeutic strategies for advanced HCC patients with PD after sorafenib treatment. We analyzed the clinical data and treatment outcomes for 315 consecutive advanced HCC patients treated with sorafenib. Univariate analyses of overall survival identified therapeutic effect as an independent risk factor in all patients. Among all patients, 141 developed PD. Of those, 58 (41%) were treated with sorafenib monotherapy, 70 (50%) with agents other than sorafenib, and 13 (9%) were not treated at all. The median survival time was 6.1 months for PD patients with sorafenib monotherapy and 12.2 months for those administered alternative treatments (p < 0.0001). Our results indicated that sorafenib treatment may have negative long-term therapeutic effects in advanced HCC patients with PD, and that alternative treatments should be considered for these patients after sorafenib administration. PMID:27462865

  15. Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

    PubMed Central

    Chien, Wai Tong; Yip, Annie LK

    2013-01-01

    During the last three decades, an increasing understanding of the etiology, psychopathology, and clinical manifestations of schizophrenia spectrum disorders, in addition to the introduction of second-generation antipsychotics, has optimized the potential for recovery from the illness. Continued development of various models of psychosocial intervention promotes the goal of schizophrenia treatment from one of symptom control and social adaptation to an optimal restoration of functioning and/or recovery. However, it is still questionable whether these new treatment approaches can address the patients’ needs for treatment and services and contribute to better patient outcomes. This article provides an overview of different treatment approaches currently used in schizophrenia spectrum disorders to address complex health problems and a wide range of abnormalities and impairments resulting from the illness. There are different treatment strategies and targets for patients at different stages of the illness, ranging from prophylactic antipsychotics and cognitive–behavioral therapy in the premorbid stage to various psychosocial interventions in addition to antipsychotics for relapse prevention and rehabilitation in the later stages of the illness. The use of antipsychotics alone as the main treatment modality may be limited not only in being unable to tackle the frequently occurring negative symptoms and cognitive impairments but also in producing a wide variety of adverse effects to the body or organ functioning. Because of varied pharmacokinetics and treatment responsiveness across agents, the medication regimen should be determined on an individual basis to ensure an optimal effect in its long-term use. This review also highlights that the recent practice guidelines and standards have recommended that a combination of treatment modalities be adopted to meet the complex health needs of people with schizophrenia spectrum disorders. In view of the heterogeneity of the

  16. Community treatment orders and Nova Scotia--the least restrictive alternative?

    PubMed

    Trueman, Shelley

    2003-01-01

    CTO/IOC legislation is a bewildering array of presumptions and inconsistencies. It is a reaction to the inherent difficulties of de-institutionalizing treatment into the community and has been based on heated arguments of misconceptions and misunderstandings of various proponents and opponents of CTOs/IOC. Legislators in the United Stated have implemented widely varying legislation over the past twenty-five years yet there is little common basis for states to proceed on or even to analyse when conceptualizing IOC legislation. It isn't surprising that Canada, after looking towards the United States as a leader in mental health legislation, is also encountering inconsistent and illogical legislation from province to province. To compound Canada's own inconsistencies, Canadian courts have not generally followed the lead of the United States of protecting fundamental rights within Canadian mental health legislation. As a result, Canadian provinces still rely on a broad parens patriae justification when infringing the rights of mental health patients and have not truly effected the narrower danger standard that is stated within its legislation. Provincial legislators should be very careful when proposing CTO legislation that will further erode patients' rights. Many provinces and states use the least restrictive alternative to justify the use of CTOs/IOC, either as a catch phrase or as a legitimate factor in considering options. Generally, though, the principle is used in terms of coerced treatment rather than a person's fundamental right to liberty or not to be arbitrarily detained. Legislators have translated the institutional model of medical treatment to the community by intrinsically linking treatment to committal. The most obvious contradictions of community treatment is the backwards slide of preventive commitment based on deterioration rather than purely danger. This includes the arbitrariness of releasing hospitalized patients on a continuing deterioration or

  17. Alternatives for the treatment and disposal of healthcare wastes in developing countries

    SciTech Connect

    Diaz, L.F. . E-mail: ludiaz@calrecovery.com; Savage, G.M.; Eggerth, L.L.

    2005-07-01

    Waste production in healthcare facilities in developing countries has brought about a variety of concerns due to the use of inappropriate methods of managing the wastes. Inappropriate treatment and final disposal of the wastes can lead to adverse impacts to public health, to occupational health and safety, and to the environment. Unfortunately, most economically developing countries suffer a variety of constraints to adequately managing these wastes. Generally in developing countries, few individuals in the staff of the healthcare facility are familiar with the procedures required for a proper waste management program. Furthermore, the management of wastes usually is delegated to poorly educated laborers who perform most activities without proper guidance and insufficient protection. This paper presents some of the most common treatment and disposal methods utilized in the management of infectious healthcare wastes in developing countries. The methods discussed include: autoclave; microwave; chemical disinfection; combustion (low-, medium-, and high-technology); and disposal on the ground (dump site, controlled landfill, pits, and sanitary landfill). Each alternative for treatment and disposal is explained, including a description of the types of wastes that can and cannot be treated. Background information on the technologies also is included in order to provide information to those who may not be familiar with the details of each alternative. In addition, a brief presentation of some of the emissions from each of the treatment and disposal alternatives is presented.

  18. Inflammatory bowel disease Part 1: ulcerative colitis--pathophysiology and conventional and alternative treatment options.

    PubMed

    Head, Kathleen A; Jurenka, Julie S

    2003-08-01

    Ulcerative colitis (UC), a subcategory of inflammatory bowel disease, afflicts 1-2 million people in the United States, and many more worldwide. Although the exact cause of ulcerative colitis remains undetermined, the condition appears to be related to a combination of genetic and environmental factors. While conventional treatments can be effective in maintaining remission and decreasing the length of active disease periods, the treatments are not without side effects, and a significant number of people suffering from UC fail to respond to even the strongest drugs. This article reviews potential unconventional treatments - transdermal nicotine, heparin, melatonin, DHEA, probiotics, fiber, dietary changes, botanicals, essential fatty acids, and other nutrients - that may be considered in conjunction with conventional approaches or as part of a comprehensive alternative treatment protocol. In addition this review addresses risk factors, pathogenesis, nutrient deficiencies, conventional treatment approaches, and extra-intestinal manifestations of the disease.

  19. Alternative Remedies

    MedlinePlus

    ... found to be effective for some patients is medical marijuana. Medical marijuana is approved by the FDA for treatment of ... undergoing chemotherapy, and there is some evidence that medical marijuana can help with pain and stiffness in patients ...

  20. Decision making software for effective selection of treatment train alternative for wastewater using analytical hierarchy process.

    PubMed

    Prasad, A D; Tembhurkar, A R

    2013-10-01

    Proper selection of treatment process and synthesis of treatment train is complex engineering activity requires crucial decision making during planning and designing of any Wastewater Treatment Plant (WWTP). Earlier studies on process selection mainly considered cost as the most important selection criteria and number of studies focused on cost optimization models using dynamic programming, geometric programming and nonlinear programming. However, it has been noticed that traditional cost analysis alone cannot be applied to evaluate Treatment Train (TT) alternatives, as number of important non-tangible factors cannot be easily expressed in monetary units. Recently researches focus on use of multi-criteria technique for selection of treatment process. AHP provides a powerful tool for multi-hierarchy and multi-variable system overcoming limitation of traditional techniques. The AHP model designed to facilitate proper decision making and reduce the margin of errors during optimization due to number of parameters in the hierarchy levels has been used in this study. About 14 important factors and 13 sub factors were identified for the selection of treatment alternatives for wastewater and sludge stream although cost is one of the most important selection criteria. The present paper provides details of developing a soft-tool called "ProSelArt" using an AHP model aiding for proper decision making.

  1. Rhazes, a Genius Physician in the Diagnosis and Treatment of Nocturnal Enuresis in Medical History

    PubMed Central

    Changizi Ashtiyani, Saeed; Shamsi, Mohsen; Cyrus, Ali; Tabatabayei, Seyed Mohammad

    2013-01-01

    Context Nocturnal enuresis has undoubtedly occurred since man's earliest days and the first references are found in the Ebers papyri of 1550 BC. The purpose of this study is to review of Rhazes opinion about diagnosis and treatment of nocturnal enuresis and compare his belief and clinical methods with modern medical practice. Evidence Acquisition In the review study we searched all available and reliable electronic and paper sources using appropriate keywords about the views of Rhazes, and compared them with recent medical evidence about diagnosis and treatment of nocturnal in medication. Results Our findings proved that Rhazes described the symptoms, signs, and the treatment of nocturnal enuresis in accordance with contemporary medicine. Conclusions A review of opinion Rhazes and other ancient Islamic medical textbooks on nocturnal enuresis reveals that medical practice in those days was comparable to modern medicine yet avoiding the side effects that are commonly experienced with the modern medical approach. PMID:24578827

  2. Medications for the Treatment of Sleep Disorders: An Overview

    PubMed Central

    Pagel, J. F.; Parnes, Bennett L.

    2001-01-01

    Sleep disorders can be divided into those producing insomnia, those causing daytime sleepiness, and those disrupting sleep. Transient insomnia is extremely common, afflicting up to 80% of the population. Chronic insomnia affects 15% of the population. Benzodiazepines are frequently used to treat insomnia; however, there may be a withdrawal syndrome with rapid eye movement (REM) rebound. Two newer benzodiazepine-like agents, zolpidem and zaleplon, have fewer side effects, yet good efficacy. Other agents for insomnia include sedating antidepressants and over-the-counter sleep products (sedating antihistamines). Nonpharmacologic behavioral methods may also have therapeutic benefit. An understanding of the electrophysiologic and neurochemical correlates of the stages of sleep is useful in defining and understanding sleep disorders. Excessive daytime sleepiness is often associated with obstructive sleep apnea or depression. Medications, including amphetamines, may be used to induce daytime alertness. Parasomnias include disorders of arousal and of REM sleep. Chronic medical illnesses can become symptomatic during specific sleep stages. Many medications affect sleep stages and can thus cause sleep disorders or exacerbate the effect of chronic illnesses on sleep. Conversely, medications may be used therapeutically for specific sleep disorders. For example, restless legs syndrome and periodic limb movement disorder may be treated with dopamine agonists. An understanding of the disorders of sleep and the effects of medications is required for the appropriate use of medications affecting sleep. PMID:15014609

  3. A Feasibility Study on the Implementation of Teleophthalmology in the Medical Treatment Facilities in the Great Plains Regional Medical Command

    DTIC Science & Technology

    2004-06-01

    and older At time of diagnosis Yearly Prior to pregnancy Prior to conception or early first trimester 3 months Source: American College of...treatment of DR is a cost-effective medical intervention. (ADA) By ensuring a diabetic obtains an annual eye exam, diagnosis and treatment can be provided...at diagnosis , an operational definition of Type 1 diabetes) and 1.6% of older-onset patients (aged ≥ 30 years at diagnosis , an operational

  4. A Comparison of Expedition Medical Condition List Treatment Directives with Integrated Medical Model Simulation Data Presentation and Briefing Report

    NASA Technical Reports Server (NTRS)

    Lewis, Robert

    2013-01-01

    This aerospace medicine clerkship project is under the direction of Dr. Sharmila Watkins and is in cooperation with Dr. Eric Kerstman and Dr. Ronak Shah. The questions of the research project are: 1. What are the main drivers of evacuation and loss of crew life (LOCL) on three Design Reference Missions (DRMs): Near Earth Asteroid (NEA), Lunar Sortie and Lunar Outpost using an inexhaustible International Space Station medical kit 2. What are the treatment designations for these driving medical conditions as listed in Expedition Medical Condition List (EMCL) 3. Do the drivers make sense in the context of the given Design Reference Mission (DRM) 4. Do any EMCL treatment designations need re-assessing.

  5. Texas Children's Medication Algorithm Project: Update from Texas Consensus Conference Panel on Medication Treatment of Childhood Major Depressive Disorder

    ERIC Educational Resources Information Center

    Hughes, Carroll W.; Emslie, Graham J.; Crismon, M. Lynn; Posner, Kelly; Birmaher, Boris; Ryan, Neal; Jensen, Peter; Curry, John; Vitiello, Benedetto; Lopez, Molly; Shon, Steve P.; Pliszka, Steven R.; Trivedi, Madhukar H.

    2007-01-01

    Objective: To revise and update consensus guidelines for medication treatment algorithms for childhood major depressive disorder based on new scientific evidence and expert clinical consensus when evidence is lacking. Method: A consensus conference was held January 13-14, 2005, that included academic clinicians and researchers, practicing…

  6. Applying the least restrictive alternative principle to treatment decisions: A legal and behavioral analysis

    PubMed Central

    Johnston, J. M.; Sherman, Robert A.

    1993-01-01

    The least restrictive alternative concept is widely used in mental health law. This paper addresses how the concept has been applied to treatment decisions. The paper offers both a legal and a behavioral analysis to some problems that have emerged in recent years concerning the selection of behavioral procedures used to change client behavior. The paper also offers ways of improving the application of the concept, which involve developing a more behaviorally functional perspective toward restrictiveness. PMID:22478138

  7. HIV/AIDS: vaccines and alternate strategies for treatment and prevention.

    PubMed

    Voronin, Yegor; Phogat, Sanjay

    2010-09-01

    The symposium "HIV/AIDS: Vaccines and Alternate Strategies for Treatment and Prevention" brought together HIV vaccine researchers to discuss the latest developments in the field. From basic discoveries in virus diversity and mechanisms of neutralization by antibodies to nonhuman primate research and clinical trials of vaccine candidates in volunteers, scientists are making great strides in understanding the mechanisms that may protect against HIV and pathways to achieve this protection through vaccination.

  8. An alternative medical approach for the neuroprotective therapy to slow the progression of Parkinson's disease.

    PubMed

    Muroyama, Akiko

    2013-01-01

    Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the core symptoms such as bradykinesia, resting tremor, rigidity and postural instability. Currently, pharmacotherapy and surgical approaches for the treatments of PD can only improve the neurological symptoms. Therefore, to search neuroprotective therapies using pharmacological and nonpharmacological approaches could be important to delay the progression of pathogenesis in PD. Coenzyme Q10 (CoQ10) is a component of the electron transport chain as well as an important antioxidant in mitochondrial and lipid membranes. The central role of CoQ10 in two areas implicated in the pathogenesis of PD, mitochondrial dysfunction and oxidative damages, suggest that it may be useful for treatment to slow the progression of PD. The neuroprotective effect of CoQ10 has been reported in several in vivo and in vitro models of neurodegenerative disorders. Although CoQ10 attenuated the toxin-induced reduction of dopamine content and tyrosine hydroxylase-immunoreactive neurons in the striatum of the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model, it is still unknown how this nutrition affects the mitochondrial function. We demonstrated that oral administration of CoQ10 significantly attenuated the loss of dopaminergic nerve terminals induced by MPTP treatment. Furthermore, our experimental data indicate that an inhibition of mitochondrial cytochrome c release is one of the primary targets for CoQ10 and may lead to a potent neuroprotection.

  9. Alternative therapies to address the unmet medical needs of patients with phenylketonuria.

    PubMed

    Blau, Nenad; Longo, Nicola

    2015-04-01

    Standard therapy for phenylketonuria (PKU), the most common inherited disorder in amino acid metabolism, is an onerous phenylalanine-restricted diet. Adherence to this stringent diet regimen decreases as patients get older, and this lack of adherence is directly associated with cognitive and executive dysfunction and psychiatric issues. These factors emphasize the need for alternative pharmacological therapies to help treat patients with PKU. Sapropterin dihydrochloride is a synthetic form of tetrahydrobiopterin, the cofactor of phenylalanine hydroxylase that in pharmacological doses can stabilize and increase residual enzyme activity in some patients with PKU. About one-third of all patients with PKU respond to oral sapropterin. Phenylalanine ammonia lyase (PAL) is a prokaryotic enzyme that converts phenylalanine to ammonia and trans-cinnamic acid. Phase I and II trials have shown that injectable recombinant Anabaena variabilis PAL produced in Escherichia coli conjugated with PEG can reduce phenylalanine levels in subjects with PKU. The most frequently reported adverse events were injection-site reactions, dizziness and immune reactions. Additionally, oral administration of PAL and delivery of enzyme substitution therapies by encapsulation in erythrocytes are being investigated. Novel therapies for patients with PKU appear to be options to reduce phenylalanine levels, and may reduce the deleterious effects of this disorder.

  10. Psychotropic Medication Use in HIV-Infected Youth Receiving Treatment at a Single Institution

    PubMed Central

    Wiener, Lori; Battles, Haven; Ryder, Celia; Pao, Maryland

    2008-01-01

    A cross sectional study designed to document the use of psychotropic medication in a population of HIV-infected children and adolescents (N = 64) found 45% of the sample had been prescribed at least one psychotropic medication over a 4-year period. The most common medication category prescribed was antidepressants (30%) followed by stimulant type medications (25%). This study suggests that psychotropic medications are commonly prescribed to HIV-infected children and adolescents. Close partnership with mental health professionals to develop treatment approaches for psychiatric disorders in youth living with HIV is recommended. PMID:17201618

  11. A Review of Complementary and Alternative Treatments for Autism Spectrum Disorders

    PubMed Central

    Lofthouse, Nicholas; Hendren, Robert; Hurt, Elizabeth; Arnold, L. Eugene; Butter, Eric

    2012-01-01

    Given the severe and chronic problems associated with Autism Spectrum Disorders (ASD) and the limitations of available treatments, there exists a large public health need for additional interventions. As more parents are inquiring about complementary and alternative treatments (CATs), both parents and practitioners require up-to-date information about them and whether and how to integrate them into treatment. After presenting data on CAT usage patterns for ASD, we review 13 ingestible (i.e., orally administered) and 6 noningestible (i.e., externally administered) CATs for ASD. For each CAT we briefly describe its definition; rationale for use; current research support, limitations, and future directions; safety issues; and whether we currently recommend, not recommend, or find it acceptable for the treatment of ASD. We conclude this paper with recommendations for future research and ten clinical recommendations for practitioners. PMID:23243505

  12. A Review on Alternative Carbon Sources for Biological Treatment of Nitrate Waste

    NASA Astrophysics Data System (ADS)

    Dhamole, Pradip B.; D'Souza, S. F.; Lele, S. S.

    2015-04-01

    Huge amount of wastewater containing nitrogen is produced by various chemical and biological industries. Nitrogen is present in the form of ammonia, nitrate and nitrite. This review deals with treatment of nitrate based effluent using biological denitrification. Because of its adverse effect on aquatic life and human health, treatment of nitrate bearing effluents has become mandatory before discharge. Treatment of such wastes is a liability for the industries and incurs cost. However, the economics of the process can be controlled by selection of proper method and reduction in the operating cost. This paper reviews the advantages and disadvantages of different methods of nitrate removal with emphasis on biological denitrification. The cost of biological denitrification is controlled by the carbon source. Hence, use of alternative carbon sources such as agricultural wastes, industrial effluent or by products is reviewed in this paper. Policies for reducing the cost of nitrate treatment and enhancing the efficiency have been recommended.

  13. Medication assisted treatment in the treatment of drug abuse and dependence in HIV/AIDS infected drug users.

    PubMed

    Kresina, Thomas F; Bruce, R Douglas; McCance-Katz, Elinore F

    2009-07-01

    Drug use and HIV/AIDS are global public health issues. The World Health Organization (WHO) estimates that up to 30% of HIV infections are related to drug use and associated behaviors. The intersection, of the twin epidemics of HIV and drug/alcohol use, results in difficult medical management issues for the health care providers and researchers who work in the expanding global HIV prevention and treatment fields. Access to care and treatment, medication adherence to multiple therapeutic regimens, and concomitant drug -drug interactions of prescribed treatments are difficult barriers for drug users to overcome without directed interventions. Injection drug users are frequently disenfranchised from medical care and suffer sigma and discrimination creating additional barriers to care and treatment for their drug abuse and dependence as well as HIV infection. In an increasing number of studies, medication assisted treatment of drug abuse and dependence has been shown to be an important HIV prevention intervention. Controlling the global transmission of HIV will require further investment in evidence-based interventions and programs to enhance access to care and treatment of individuals who abuse illicit drugs and alcohol. In this review, we present the cumulative evidence of the importance of medication assisted treatment in the prevention, care, and treatment of HIV infected individuals who also abuse drugs and alcohol.

  14. Patients’ Expectations Regarding Medical Treatment: A Critical Review of Concepts and Their Assessment

    PubMed Central

    Laferton, Johannes A. C.; Kube, Tobias; Salzmann, Stefan; Auer, Charlotte J.; Shedden-Mora, Meike C.

    2017-01-01

    Patients’ expectations in the context of medical treatment represent a growing area of research, with accumulating evidence suggesting their influence on health outcomes across a variety of medical conditions. However, the aggregation of evidence is complicated due to an inconsistent and disintegrated application of expectation constructs and the heterogeneity of assessment strategies. Therefore, based on current expectation concepts, this critical review provides an integrated model of patients’ expectations in medical treatment. Moreover, we review existing assessment tools in the context of the integrative model of expectations and provide recommendations for improving future assessment. The integrative model includes expectations regarding treatment and patients’ treatment-related behavior. Treatment and behavior outcome expectations can relate to aspects regarding benefits and side effects and can refer to internal (e.g., symptoms) and external outcomes (e.g., reactions of others). Furthermore, timeline, structural and process expectations are important aspects with respect to medical treatment. Additionally, generalized expectations such as generalized self-efficacy or optimism have to be considered. Several instruments assessing different aspects of expectations in medical treatment can be found in the literature. However, many were developed without conceptual standardization and psychometric evaluation. Moreover, they merely assess single aspects of expectations, thus impeding the integration of evidence regarding the differential aspects of expectations. As many instruments assess treatment-specific expectations, they are not comparable between different conditions. To generate a more comprehensive understanding of expectation effects in medical treatments, we recommend that future research should apply standardized, psychometrically evaluated measures, assessing multidimensional aspects of patients’ expectations that are applicable across various

  15. Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center

    PubMed Central

    Detweiler, Mark B.; Pagadala, Bhuvaneshwar; Candelario, Joseph; Boyle, Jennifer S.; Detweiler, Jonna G.; Lutgens, Brian W.

    2016-01-01

    The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis.on with treatments suggested in three main review articles. The final sample consisted of 327 patients and 478 separate medication trials involving 21 individual medications plus 13 different medication combinations. The three most frequently utilized medications were prazosin (107 trials), risperidone (81 trials), and quetiapine (72 trials). Five medications had 20 or more trials with successful results (partial to full nightmare cessation) in >50% of trials: risperidone (77%, 1.0–6.0 mg), clonidine (63%, 0.1–2.0 mg), quetiapine (50%, 12.5–800.0 mg), mirtazapine (50%; 7.5–30.0 mg), and terazosin (64%, 50.0–300.0 mg). Notably, olanzapine (2.5–10.0) was successful (full remission) in all five prescription trials in five separate patients. Based on the clinical results, the use of risperidone, clonidine, terazosin, and olanzapine warrants additional investigation in clinically controlled trials as medications prescribed specifically for PTSD nightmares. PMID:27999253

  16. Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center.

    PubMed

    Detweiler, Mark B; Pagadala, Bhuvaneshwar; Candelario, Joseph; Boyle, Jennifer S; Detweiler, Jonna G; Lutgens, Brian W

    2016-12-16

    The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis.on with treatments suggested in three main review articles. The final sample consisted of 327 patients and 478 separate medication trials involving 21 individual medications plus 13 different medication combinations. The three most frequently utilized medications were prazosin (107 trials), risperidone (81 trials), and quetiapine (72 trials). Five medications had 20 or more trials with successful results (partial to full nightmare cessation) in >50% of trials: risperidone (77%, 1.0-6.0 mg), clonidine (63%, 0.1-2.0 mg), quetiapine (50%, 12.5-800.0 mg), mirtazapine (50%; 7.5-30.0 mg), and terazosin (64%, 50.0-300.0 mg). Notably, olanzapine (2.5-10.0) was successful (full remission) in all five prescription trials in five separate patients. Based on the clinical results, the use of risperidone, clonidine, terazosin, and olanzapine warrants additional investigation in clinically controlled trials as medications prescribed specifically for PTSD nightmares.

  17. The adoption of medications in substance abuse treatment: associations with organizational characteristics and technology clusters.

    PubMed

    Knudsen, Hannah K; Ducharme, Lori J; Roman, Paul M

    2007-03-16

    Despite growing interest in closing the "research to practice gap", there are few data on the availability of medications in American substance abuse treatment settings. Recent research suggests that organizational characteristics may be associated with medication availability. It is unclear if the availability of medications can be conceptualized in terms of "technology clusters", where the availability of a medication is positively associated with the likelihood that other medications are also offered. Using data from 403 privately funded and 363 publicly funded specialty substance abuse treatment centers in the US, this research models the availability of agonist medications, naltrexone, disulfiram, and SSRIs. Bivariate logistic regression models indicated considerable variation in adoption across publicly funded non-profit, government-owned, privately funded non-profit, and for-profit treatment centers. Some of these differences were attenuated by organizational characteristics, such as accreditation, the presence of staff physicians, and the availability of detoxification services. There was some evidence that naltrexone, disulfiram, and SSRIs represent a group of less intensely regulated medications that is distinct from more intensely regulated medications. These types of medications were associated with somewhat different correlates. Future research should continue to investigate the similarities and differences in the predictors of medication availability across national contexts.

  18. Medications for addiction treatment: an opportunity for prescribing clinicians to facilitate remission from alcohol and opioid use disorders.

    PubMed

    Park, Tae Woo; Friedmann, Peter D

    2014-10-01

    Substance use disorders are a leading cause of morbidity and mortality in the United States. Medications for the treatment of substance use disorders are effective yet underutilized. This article reviews recent literature examining medications used for the treatment of alcohol and opioid use disorders. The neurobehavioral rationale for medication treatment and the most common ways medications work in the treatment of substance use disorders are discussed. Finally, the medications and the evidence behind their effectiveness are briefly reviewed. Physicians and other prescribing clinicians should take an active role in facilitating remission and recovery from substance use disorders by prescribing these effective medications with brief medical management counseling.

  19. Heart Failure: Pathophysiology, Diagnosis, Medical Treatment Guidelines, and Nursing Management.

    PubMed

    Rogers, Chad; Bush, Nathania

    2015-12-01

    Heart failure (HF) is a debilitating chronic disease and is expected to increase in upcoming years due to demographic changes. Nurses in all settings have an essential role in supporting patients in managing this disease. This article describes the pathophysiology of HF, diagnosis, medical management, and nursing interventions. It is crucial for nurses to understand the pathophysiology of HF and the importance that nursing actions have on enhancing medical management to alleviate symptoms and to deter the advancement of the pathophysiologic state. Such an understanding can ultimately reduce morbidity and mortality and optimize quality of life in patients with HF.

  20. Medication-induced osteoporosis: screening and treatment strategies

    PubMed Central

    Panday, Keshav; Gona, Amitha

    2014-01-01

    Drug-induced osteoporosis is a significant health problem and many physicians are unaware that many commonly prescribed medications contribute to significant bone loss and fractures. In addition to glucocorticoids, proton pump inhibitors, selective serotonin receptor inhibitors, thiazolidinediones, anticonvulsants, medroxyprogesterone acetate, aromatase inhibitors, androgen deprivation therapy, heparin, calcineurin inhibitors, and some chemotherapies have deleterious effects on bone health. Furthermore, many patients are treated with combinations of these medications, possibly compounding the harmful effects of these drugs. Increasing physician awareness of these side effects will allow for monitoring of bone health and therapeutic interventions to prevent or treat drug-induced osteoporosis. PMID:25342997

  1. Aerosol Medications for Treatment of Mucus Clearance Disorders.

    PubMed

    Rubin, Bruce K

    2015-06-01

    Airway mucus hypersecretion and secretion retention can result from inflammation, irritation, stimulation, or mucus-producing tumors. Secretion clearance can be furthered hampered by ciliary dysfunction and by weakness or restrictive lung disease, leading to an ineffective cough. There are a number of different mucoactive medications that have been used to reduce hypersecretion, make secretions easier to transport, or increase the efficiency of cough or mucus clearance. In this paper, I review the pathophysiology of secretory hyper-responsiveness and mucus hypersecretion and discuss the different aerosol medications that can be used to augment secretion clearance.

  2. A comparative analysis of standard and alternative antidepressants in the treatment of human immunodeficiency virus patients.

    PubMed

    Wagner, G J; Rabkin, J G; Rabkin, R

    1996-01-01

    Our research group has conducted clinical trials of standard (imipramine, fluoxetine, and sertraline) and alternative antidepressants (dextroamphetamine and testosterone replacement therapy) in the treatment of clinical depression among patients with human immunodeficiency virus (HIV) illness. This report presents secondary analyses of data pooled from these trials with the purpose of comparing the antidepressant efficacy of these various agents. In all trials, a DSM-III-R depressive disorder was the primary criterion for study entry, and each treatment resulted in significant improvement after both 2 and 6 weeks of treatment according to the Hamilton Depression Rating Scale (HDRS). Response rates for standard antidepressants ranged from 70% to 74%, with similar, high response rates found in trials of dextroamphetamine (93%) and testosterone (81%). The response rate of each active drug treatment was superior to that of placebo (33%). Each treatment was well-tolerated in terms of side effects, and there was essentially no effect of any treatment on CD4 cell count. Differences in trial design, entrance criteria, and measurements require that caution be used in interpreting these results; nonetheless, each of the five treatments studied demonstrated strong efficacy and possessed relatively unique benefits, providing health care providers with valuable treatment options in addressing individual needs of patients.

  3. From Traditional Medicine to Witchcraft: Why Medical Treatments Are Not Always Efficacious

    PubMed Central

    Tanaka, Mark M.; Kendal, Jeremy R.; Laland, Kevin N.

    2009-01-01

    Complementary medicines, traditional remedies and home cures for medical ailments are used extensively world-wide, representing more than US$60 billion sales in the global market. With serious doubts about the efficacy and safety of many treatments, the industry remains steeped in controversy. Little is known about factors affecting the prevalence of efficacious and non-efficacious self-medicative treatments. Here we develop mathematical models which reveal that the most efficacious treatments are not necessarily those most likely to spread. Indeed, purely superstitious remedies, or even maladaptive practices, spread more readily than efficacious treatments under specified circumstances. Low-efficacy practices sometimes spread because their very ineffectiveness results in longer, more salient demonstration and a larger number of converts, which more than compensates for greater rates of abandonment. These models also illuminate a broader range of phenomena, including the spread of innovations, medical treatment of animals, foraging behaviour, and self-medication in non-human primates. PMID:19367333

  4. From traditional medicine to witchcraft: why medical treatments are not always efficacious.

    PubMed

    Tanaka, Mark M; Kendal, Jeremy R; Laland, Kevin N

    2009-01-01

    Complementary medicines, traditional remedies and home cures for medical ailments are used extensively world-wide, representing more than US$60 billion sales in the global market. With serious doubts about the efficacy and safety of many treatments, the industry remains steeped in controversy. Little is known about factors affecting the prevalence of efficacious and non-efficacious self-medicative treatments. Here we develop mathematical models which reveal that the most efficacious treatments are not necessarily those most likely to spread. Indeed, purely superstitious remedies, or even maladaptive practices, spread more readily than efficacious treatments under specified circumstances. Low-efficacy practices sometimes spread because their very ineffectiveness results in longer, more salient demonstration and a larger number of converts, which more than compensates for greater rates of abandonment. These models also illuminate a broader range of phenomena, including the spread of innovations, medical treatment of animals, foraging behaviour, and self-medication in non-human primates.

  5. From the biomedical model to the Islamic alternative: a brief overview of medical practices in the contemporary Arab world.

    PubMed

    Adib, Salim M

    2004-02-01

    Following its climax in the 8th century under the Abbasids of Baghdad, the Arab world entered a prolonged period of division and decadence. "Western" medicine was introduced in the 19th century with the support of the general population. The historical participation of Arabs in the elaboration of that "Western" biomedical model and its apparently consensual re-introduction into the Arab world diffused any sense of cognitive alienation vis-à-vis practices promoted initially by non-Arab doctors. In the late 1960s, Islamist thinkers started proposing "Islamic medicine" as an alternative to the encroachment of the "Western" biomedical model within Arab and Muslim nations. In Islamic medicine, disease is attributed to lack of attention to the spiritual dimension of human beings, yet intermediate causal pathways are not provided. Alongside "orthodox" concepts, Islamic medicine promotes some herbal remedies, in addition to faith-healing through prayer and the recitation of holy verses. While most of those practices may be beneficial, they may cause some harm to patients if they entail delaying or denying timely recourse to "orthodox" medical care. There are currently no Islamic medicine training programs in any Arab country, and Islamic medicine has not emerged as a comprehensive health alternative comparable to other non-Western health models.

  6. Exploration of the frontiers of tradomedical practices: basis for development of alternative medical healthcare services in developing countries.

    PubMed

    Osujih, M

    1993-08-01

    The study is a brief exploration of the functions and roles of the traditional healers in the total health care delivery system as a basis for tapping the salient features of this age old art: for the purpose of refining, and establishing it as an alternative medical health-care service. The investigation is considered relevant particularly in the developing countries where, in addition to the dearth of orthodox medical services, institutions and personnel, it is relatively cheaper, socio-culturally accessible and acceptable. Refining and developing some aspects of the traditional healers' services will serve the interest of the health consumers whose main concern is with service and not the source. Furthermore, it is hoped that the study will stimulate purposeful discussions on the need for an unbiased examination of the materials, methods and techniques of the traditional healers including, eventually, compiling a native pharmacopoeia. A more comprehensive account of the traditional healers contributions to the battle against diseases and maintenance of health and well being is envisaged.

  7. From Punishment to Treatment: The "Clinical Alternative to Punitive Segregation" (CAPS) Program in New York City Jails.

    PubMed

    Glowa-Kollisch, Sarah; Kaba, Fatos; Waters, Anthony; Leung, Y Jude; Ford, Elizabeth; Venters, Homer

    2016-02-02

    The proliferation of jails and prisons as places of institutionalization for persons with serious mental illness (SMI) has resulted in many of these patients receiving jail-based punishments, including solitary confinement. Starting in 2013, the New York City (NYC) jail system developed a new treatment unit for persons with SMI who were judged to have violated jail rules (and previously would have been punished with solitary confinement) called the Clinical Alternative to Punitive Segregation (CAPS) unit. CAPS is designed to offer a full range of therapeutic activities and interventions for these patients, including individual and group therapy, art therapy, medication counseling and community meetings. Each CAPS unit requires approximately $1.5 million more investment per year, largely in additional staff as compared to existing mental health units, and can house approximately 30 patients. Patients with less serious mental illness who received infractions were housed on units that combined solitary confinement with some clinical programming, called Restrictive Housing Units (RHU). Between 1 December 2013 and 31 March 2015, a total of 195 and 1433 patients passed through the CAPS and RHU units, respectively. A small cohort of patients experienced both CAPS and RHU (n = 90). For these patients, their rates of self-harm and injury were significantly lower while on the CAPS unit than when on the RHU units. Improvements in clinical outcomes are possible for incarcerated patients with mental illness with investment in new alternatives to solitary confinement. We have started to adapt the CAPS approach to existing mental health units as a means to promote better clinical outcomes and also help prevent jail-based infractions. The cost of these programs and the dramatic differences in length of stay for patients who earn these jail-based infractions highlight the need for alternatives to incarceration, some of which have recently been announced in NYC.

  8. From Punishment to Treatment: The “Clinical Alternative to Punitive Segregation” (CAPS) Program in New York City Jails

    PubMed Central

    Glowa-Kollisch, Sarah; Kaba, Fatos; Waters, Anthony; Leung, Y. Jude; Ford, Elizabeth; Venters, Homer

    2016-01-01

    The proliferation of jails and prisons as places of institutionalization for persons with serious mental illness (SMI) has resulted in many of these patients receiving jail-based punishments, including solitary confinement. Starting in 2013, the New York City (NYC) jail system developed a new treatment unit for persons with SMI who were judged to have violated jail rules (and previously would have been punished with solitary confinement) called the Clinical Alternative to Punitive Segregation (CAPS) unit. CAPS is designed to offer a full range of therapeutic activities and interventions for these patients, including individual and group therapy, art therapy, medication counseling and community meetings. Each CAPS unit requires approximately $1.5 million more investment per year, largely in additional staff as compared to existing mental health units, and can house approximately 30 patients. Patients with less serious mental illness who received infractions were housed on units that combined solitary confinement with some clinical programming, called Restrictive Housing Units (RHU). Between 1 December 2013 and 31 March 2015, a total of 195 and 1433 patients passed through the CAPS and RHU units, respectively. A small cohort of patients experienced both CAPS and RHU (n = 90). For these patients, their rates of self-harm and injury were significantly lower while on the CAPS unit than when on the RHU units. Improvements in clinical outcomes are possible for incarcerated patients with mental illness with investment in new alternatives to solitary confinement. We have started to adapt the CAPS approach to existing mental health units as a means to promote better clinical outcomes and also help prevent jail-based infractions. The cost of these programs and the dramatic differences in length of stay for patients who earn these jail-based infractions highlight the need for alternatives to incarceration, some of which have recently been announced in NYC. PMID:26848667

  9. Alternating electric tumor treating fields for treatment of glioblastoma: rationale, preclinical, and clinical studies.

    PubMed

    Mittal, Sandeep; Klinger, Neil V; Michelhaugh, Sharon K; Barger, Geoffrey R; Pannullo, Susan C; Juhász, Csaba

    2017-02-24

    OBJECTIVE Treatment for glioblastoma (GBM) remains largely unsuccessful, even with aggressive combined treatment via surgery, radiotherapy, and chemotherapy. Tumor treating fields (TTFs) are low-intensity, intermediate-frequency, alternating electric fields that have antiproliferative properties in vitro and in vivo. The authors provide an up-to-date review of the mechanism of action as well as preclinical and clinical data on TTFs. METHODS A systematic review of the literature was performed using the terms "tumor treating fields," "alternating electric fields," "glioblastoma," "Optune," "NovoTTF-100A," and "Novocure." RESULTS Preclinical and clinical data have demonstrated the potential efficacy of TTFs for treatment of GBM, leading to several pilot studies, clinical trials, and, in 2011, FDA approval for its use as salvage therapy for recurrent GBM and, in 2015, approval for newly diagnosed GBM. CONCLUSIONS Current evidence supports the use of TTFs as an efficacious, antimitotic treatment with minimal toxicity in patients with newly diagnosed and recurrent GBM. Additional studies are needed to further optimize patient selection, determine cost-effectiveness, and assess the full impact on quality of life.

  10. Alternatives to conventional thermal treatments in fruit-juice processing. Part 1: Techniques and applications.

    PubMed

    Jiménez-Sánchez, Cecilia; Lozano-Sánchez, Jesús; Segura-Carretero, Antonio; Fernández-Gutiérrez, Alberto

    2017-02-11

    This paper provides an overview of alternatives to conventional thermal treatments and a review of the literature on fruit-juice processing for three key operations in fruit-juice production such as microbial inactivation, enzyme inactivation, and juice yield enhancement, these being radiation treatments (UV light, high-intensity light pulses, γ-irradiation), electrical treatments (pulsed electric fields, radiofrequency electric fields, ohmic heating), microwave heating, ultrasound, high hydrostatic pressure, inert gas treatments (supercritical carbon dioxide, ozonation), and flash-vacuum expansion. The nonthermal technologies discussed in this review have the potential to meet industry and consumer expectations. However, the lack of standardization in operating conditions hampers comparisons among different studies, and consequently ambiguity arises within the literature. For the juice industry to advance, more detailed studies are needed on the scaling-up, process design, and optimization, as well as on the effect of such technologies on juice quality of juices in order to maximize their potential as alternative nonthermal technologies in fruit-juice processing.

  11. The Prescribed Pediatric Center: A Medical Day Treatment Program for Children with Complex Medical Conditions.

    ERIC Educational Resources Information Center

    Ruppert, Elizabeth S.; Karst, Thomas O.; Brogan, Mark G.

    1998-01-01

    The Prescribed Pediatric Center (Toledo, Ohio) is a community-based, multidisciplinary program for infants and children with chronic, complex medical conditions. This article describes program beginnings; the planning process; and the program's growth, development, and components. Initial program evaluation indicates positive effects on some…

  12. 42 CFR 88.16 - Reimbursement for medically necessary treatment, outpatient prescription pharmaceuticals...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... pharmaceuticals. (1) The costs of providing medically necessary treatment or services for a WTC-related health condition or a health condition medically associated with a WTC-related health condition by a Clinical... Federal Employees Compensation Act (5 U.S.C. 8101 et seq., 20 CFR Part 20). (i) The WTC...

  13. 42 CFR 88.16 - Reimbursement for medically necessary treatment, outpatient prescription pharmaceuticals...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... pharmaceuticals. (1) The costs of providing medically necessary treatment or services for a WTC-related health condition or a health condition medically associated with a WTC-related health condition by a Clinical... Federal Employees Compensation Act (5 U.S.C. 8101 et seq., 20 CFR Part 20). (i) The WTC...

  14. 42 CFR 88.16 - Reimbursement for medically necessary treatment, outpatient prescription pharmaceuticals...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... pharmaceuticals. (1) The costs of providing medically necessary treatment or services for a WTC-related health condition or a health condition medically associated with a WTC-related health condition by a Clinical... Federal Employees Compensation Act (5 U.S.C. 8101 et seq., 20 CFR Part 20). (i) The WTC...

  15. 42 CFR 88.16 - Reimbursement for medically necessary treatment, outpatient prescription pharmaceuticals...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... pharmaceuticals. (1) The costs of providing medically necessary treatment or services for a WTC-related health condition or a health condition medically associated with a WTC-related health condition by a Clinical... Federal Employees Compensation Act (5 U.S.C. 8101 et seq., 20 CFR Part 20). (i) The WTC...

  16. On-site sanitation: a viable alternative to modern wastewater treatment plants.

    PubMed

    Lamichhane, K M

    2007-01-01

    Rapid population growth and urbanization are exerting excessive pressure on soil and water resources. To address these problems this paper proposes a cheap and sustainable alternative sanitation system, which accelerates nutrient recycling ("closing the loop"): ecological sanitation (ecosan) is a potential alternative to conventional sanitation systems that replenishes the organic matter and nutrients of the soil that are taken off as the crop harvest. A comparison is made of the environmental and the operation and maintenance costs between a modern wastewater treatment plant and on-site sanitation. An elevated double box urine diverting toilet ("ecotoilet") is proposed and its advantages and disadvantages over a system with a centrally controlled modern WWTP are discussed. Bagmati Area Sewerage Project in Kathmandu is taken as an example of modern WWTP and ecosan being practiced in a village in Nepal is taken as an example of ecotoilet for the comparison.

  17. Medical and surgical treatment in neurocysticercosis a magnetic resonance study of 161 cases.

    PubMed

    Martinez, H R; Rangel-Guerra, R; Arredondo-Estrada, J H; Marfil, A; Onofre, J

    1995-05-01

    In a prospective non-controlled study we have treated 161 consecutive cases of Active Neurocysticercosis (NCC) diagnosed by Magnetic Resonance (MR). Active NCC was classified in: (1) brain parenchymal cysts (85 cases); (2) ventricular cysts (24 cases); (3) subarachnoid cysts (46 cases); and (4) cysticercus racemose (6 cases). All patients had MR follow up 1 month after treatment. Twenty five patients had MR with gadopentetate dimeglumine (Gd) contrast enhancement. Cine MR was performed in one patient. Medical treatment with albendazole (ABZ) or Praziquantel (PZQ) was applied in 136 cases. Drug efficacy, assessed by disappearance of the lesion on MR, was 92.5% with ABZ and 60% with PZQ. Thirty patients were treated by surgery. Five patients of group I were treated surgically due either to refractory seizures or persistent abnormalities on MR. Ventricular cysts were removed in 20 cases; 4 cases with cysticercus racemose and one with subarachnoid spinal cyst were also treated by surgery. Two patients with 4th ventricle cysts received ABZ and ventricular shunt only. Two cases with intraventricular cysts (lateral ventricles) and two with racemose cysts were successfully treated with ABZ. The Gd infusion showed enhancement in cysts with adjacent inflammatory reaction or edema and in cases with meningeal inflammation. Cine MR was useful in the differential diagnosis with congenital arachnoid cyst. We conclude that (1) MR is sensitive in the diagnosis of active NCC and may be useful in evaluating degenerative changes in the parasite; (2) ABZ is highly effective in the treatment of parenchymal and subarachnoidal NCC; (3) Parenchymal lesions which remain with abnormal appearance on MR (Degenerative cysticerci or gliosis) and refractory seizures should be treated by surgery; (4) Cysticercus racemose without intracranial hypertension may be treated with ABZ; (5) Ventricular cysts are treated by surgical removal, however, ABZ and ventricular peritoneal shunt may also be an

  18. Homeopathic Medications as Clinical Alternatives for Symptomatic Care of Acute Otitis Media and Upper Respiratory Infections in Children

    PubMed Central

    Boyer, Nancy N

    2013-01-01

    The public health and individual risks of inappropriate antibiotic prescribing and conventional over-the-counter symptomatic drugs in pediatric treatment of acute otitis media (AOM) and upper respiratory infections (URIs) are significant. Clinical research suggests that over-the-counter homeopathic medicines offer pragmatic treatment alternatives to conventional drugs for symptom relief in children with uncomplicated AOM or URIs. Homeopathy is a controversial but demonstrably safe and effective 200-year-old whole system of complementary and alternative medicine used worldwide. Numerous clinical studies demonstrate that homeopathy accelerates early symptom relief in acute illnesses at much lower risk than conventional drug approaches. Evidence-based advantages for homeopathy include lower antibiotic fill rates during watchful waiting in otitis media, fewer and less serious side effects, absence of drug-drug interactions, and reduced parental sick leave from work. Emerging evidence from basic and preclinical science research counter the skeptics' claims that homeopathic remedies are biologically inert placebos. Consumers already accept and use homeopathic medicines for self care, as evidenced by annual US consumer expenditures of $2.9 billion on homeopathic remedies. Homeopathy appears equivalent to and safer than conventional standard care in comparative effectiveness trials, but additional well-designed efficacy trials are indicated. Nonetheless, the existing research evidence on safety supports pragmatic use of homeopathy in order to “first do no harm” in the early symptom management of otherwise uncomplicated AOM and URIs in children. PMID:24381823

  19. Homeopathic medications as clinical alternatives for symptomatic care of acute otitis media and upper respiratory infections in children.

    PubMed

    Bell, Iris R; Boyer, Nancy N

    2013-01-01

    The public health and individual risks of inappropriate antibiotic prescribing and conventional over-the-counter symptomatic drugs in pediatric treatment of acute otitis media (AOM) and upper respiratory infections (URIs) are significant. Clinical research suggests that over-the-counter homeopathic medicines offer pragmatic treatment alternatives to conventional drugs for symptom relief in children with uncomplicated AOM or URIs. Homeopathy is a controversial but demonstrably safe and effective 200-year-old whole system of complementary and alternative medicine used worldwide. Numerous clinical studies demonstrate that homeopathy accelerates early symptom relief in acute illnesses at much lower risk than conventional drug approaches. Evidence-based advantages for homeopathy include lower antibiotic fill rates during watchful waiting in otitis media, fewer and less serious side effects, absence of drug-drug interactions, and reduced parental sick leave from work. Emerging evidence from basic and preclinical science research counter the skeptics' claims that homeopathic remedies are biologically inert placebos. Consumers already accept and use homeopathic medicines for self care, as evidenced by annual US consumer expenditures of $2.9 billion on homeopathic remedies. Homeopathy appears equivalent to and safer than conventional standard care in comparative effectiveness trials, but additional well-designed efficacy trials are indicated. Nonetheless, the existing research evidence on safety supports pragmatic use of homeopathy in order to "first do no harm" in the early symptom management of otherwise uncomplicated AOM and URIs in children.

  20. [The meaning of Aristoteles' epikeia for medical treatment].

    PubMed

    Sinha, Anil-Martin; Wiedmann, Franz

    2003-01-01

    Epikeia was originally employed for the interpretation of legal conceptions in the ancient Greek polis. Based on rational-guided clemency, epikeia was extended to human justice in individual cases, and culminated in an independent virtue of natural law beyond mere jurisdiction. Thus, the virtue of epikeia is built on the principles of human rights and dignity of man. As a "principle of equity", the virtue of epikeia allows doctors medical, ethical and individual decisions with respect to the personality and dignity of patients especially in those cases, which have ben proved to be impersonal due to the extremes of medical over- and underdoing so far. Epikeia is adjusted to the individual conscience, which is based on knowledge and certainty, and which expects responsibility and forbearance by the doctor. Epikeia is motivated by the pursuit of well-being of the patient in his inviolable personality and dignity. The sense of epikeia derives from teh affirmation of man as the only purpose of man and from the bliss of medical profession. The virtue of epikeia assembles different numbers of other virtues, and is therefore called on fo the cardinal virtues of medicine. Epikeia is te proof of moral strength and conscience of doctors.

  1. Modern and Traditional Medical Practices of Vietnam. Vietnamese Concepts of Illness and Treatment.

    ERIC Educational Resources Information Center

    Rieu, Le Tai

    This paper discusses superstitious, folk, traditional, and modern medical practices of Vietnam. Concepts of illness, somatization, behavior labeling, diagnostic attempts, and attitudes toward treatment among Vietnamese are also reviewed. (APM)

  2. Medical cost-offset following treatment referral for alcohol and other drug use disorders in a group model HMO.

    PubMed

    Polen, Michael R; Freeborn, Donald K; Lynch, Frances L; Mullooly, John P; Dickinson, Daniel M

    2006-07-01

    The purpose of this study was to determine whether specialty alcohol and other drug (AOD) treatment is associated with reduced subsequent medical care costs. AOD treatment costs and medical costs in a group model health maintenance organization (HMO) were collected for up to 6 years on 1,472 HMO members who were recommended for specialty AOD treatment, and on 738 members without AOD diagnoses or treatment. Addiction Severity Index measures were also obtained from a sample of 293 of those recommended for treatment. Changes in medical costs did not differ between treatment and comparison groups. Nor did individuals with improved treatment outcomes have greater reductions in medical costs. AOD treatment costs were not inversely related to subsequent medical costs, except for a subgroup with recent AOD treatment. In the interviewed sample, better treatment outcomes did not predict lower subsequent medical costs. Multiple treatment episodes may hold promise for producing cost-offsets.

  3. Evidence-based guideline update: Medical treatment of infantile spasms

    PubMed Central

    Go, C.Y.; Mackay, M.T.; Weiss, S.K.; Stephens, D.; Adams-Webber, T.; Ashwal, S.; Snead, O.C.

    2012-01-01

    Objective: To update the 2004 American Academy of Neurology/Child Neurology Society practice parameter on treatment of infantile spasms in children. Methods: MEDLINE and EMBASE were searched from 2002 to 2011 and searches of reference lists of retrieved articles were performed. Sixty-eight articles were selected for detailed review; 26 were included in the analysis. Recommendations were based on a 4-tiered classification scheme combining pre-2002 evidence and more recent evidence. Results: There is insufficient evidence to determine whether other forms of corticosteroids are as effective as adrenocorticotropic hormone (ACTH) for short-term treatment of infantile spasms. However, low-dose ACTH is probably as effective as high-dose ACTH. ACTH is more effective than vigabatrin (VGB) for short-term treatment of children with infantile spasms (excluding those with tuberous sclerosis complex). There is insufficient evidence to show that other agents and combination therapy are effective for short-term treatment of infantile spasms. Short lag time to treatment leads to better long-term developmental outcome. Successful short-term treatment of cryptogenic infantile spasms with ACTH or prednisolone leads to better long-term developmental outcome than treatment with VGB. Recommendations: Low-dose ACTH should be considered for treatment of infantile spasms. ACTH or VGB may be useful for short-term treatment of infantile spasms, with ACTH considered preferentially over VGB. Hormonal therapy (ACTH or prednisolone) may be considered for use in preference to VGB in infants with cryptogenic infantile spasms, to possibly improve developmental outcome. A shorter lag time to treatment of infantile spasms with either hormonal therapy or VGB possibly improves long-term developmental outcomes. PMID:22689735

  4. WSTO9 (TOOKAD) mediated photodynamic therapy as an alternative modality in the treatment of prostate cancer

    NASA Astrophysics Data System (ADS)

    Chen, Qun; Huang, Zheng; Luck, David L.; Beckers, Jill; Brun, Pierre-Herve; Wilson, Brian C.; Scherz, Avigdor; Salomon, Yoram; Hetzel, Fred W.

    2002-06-01

    Photodynamic therapy (PDT) utilizes optical energy to activate a pre-administered photosensitizer drug to achieve a localized tumor control. In the presented study, PDT mediated with a second-generation photosensitizer, WST09 (TOOKAD, Steba Biotech, The Netherlands), is investigated as an alternative therapy in the treatment of prostate cancer. In vivo canine prostate is used as the animal model. PDT was performed by irradiating the surgically exposed prostates both superficially and interstitially with a diode laser (763 nm) to activate the intra-operatively i.v. infused photosensitizer. During light irradiation, tissue optical properties, and temperature were monitored. During the one-week to 3-month period post PDT treatment, the dogs recovered well with little or no complications. The prostates were harvested and subjected to histopathological evaluations. Maximum lesion size of over 3 cm in dimension could be achieved with a single treatment, suggesting the therapy is extremely effective in destroying prostatic tissue. Although we found there was loss of epithelial lining in prostatic urethra, there was no evidence it had caused urinary tract side effects as reported in those studies utilizing transurethral irradiation. In conclusion, we found second generation photosensitizer WST09 mediated PDT may provide an excellent alternative to treat prostate cancer.

  5. Applicability of bacterial cellulose as an alternative to paper points in endodontic treatment.

    PubMed

    Yoshino, Aya; Tabuchi, Mari; Uo, Motohiro; Tatsumi, Hiroto; Hideshima, Katsumi; Kondo, Seiji; Sekine, Joji

    2013-04-01

    Dental root canal treatment is required when dental caries progress to infection of the dental pulp. A major goal of this treatment is to provide complete decontamination of the dental root canal system. However, the morphology of dental root canal systems is complex, and many human dental roots have inaccessible areas. In addition, dental reinfection is fairly common. In conventional treatment, a cotton pellet and paper point made from plant cellulose is used to dry and sterilize the dental root canal. Such sterilization requires a treatment material with high absorbency to remove any residue, the ability to improve the efficacy of intracanal medication and high biocompatibility. Bacterial cellulose (BC) is produced by certain strains of bacteria. In this study, we developed BC in a pointed form and evaluated its applicability as a novel material for dental canal treatment with regard to solution absorption, expansion, tensile strength, drug release and biocompatibility. We found that BC has excellent material and biological characteristics compared with conventional materials, such as paper points (plant cellulose). BC showed noticeably higher absorption and expansion than paper points, and maintained a high tensile strength even when wet. The cumulative release of a model drug was significantly greater from BC than from paper points, and BC showed greater compatibility than paper points. Taken together, BC has great potential for use in dental root canal treatment.

  6. Assessment of Evidence Base from Medical Debriefs Data on Space Motion Sickness Incidence and Treatment

    NASA Technical Reports Server (NTRS)

    Younker, D.R.; Daniels, V.R.; Boyd, J.L.; Putcha, L.

    2008-01-01

    An objective of this data compilation and analysis project is to examine incidence and treatment efficacy of common patho-physiological disturbances during spaceflight. Analysis of medical debriefs data indicated that astronauts used medications to alleviate symptoms of four major ailments for which astronauts received treatment for sleep disturbances, space motion sickness (SMS), pain (headache, back pain) and sinus congestion. In the present data compilation and analysis project on SMS treatment during space missions, subject demographics (gender, age, first-time or repeat flyer), incidence and severity of SMS symptoms and subjective treatment efficacy from 317 crewmember debrief records were examined from STS-1 through STS-89. Preliminary analysis of data revealed that 50% of crew members reported SMS symptoms on at least one flight and 22% never experienced it. In addition, there were 387 medication dosing episodes reported, and promethazine was the most commonly used medication. Results of analysis of symptom check lists, medication use/efficacy and gender and flight record differences in incidence and treatment efficacy will be presented. Evidence gaps for treatment efficacy along with medication use trend analysis will be identified.

  7. Medical complications of anorexia nervosa and their treatments: an update on some critical aspects.

    PubMed

    Brown, Carrie; Mehler, Philip S

    2015-12-01

    Anorexia nervosa has the highest mortality rate of any psychiatric disorder. Many of the deaths are attributable to medical complications which arise as the malnutrition and weight loss worsens. Every body system may be adversely affected by anorexia nervosa. Yet, remarkably, most of the medical complications of anorexia nervosa are treatable and reversible with optimal medical care, as part of a multidisciplinary team who are often involved in the care of these patients. Herein, we will describe the medical complications of anorexia nervosa and their treatments.

  8. [Drugs for young Mozart. Medical treatment of Wolfgang as a child by his father Leopold Mozart].

    PubMed

    Bankl, H C; Reiter, C; Bankl, H

    2001-12-17

    Leopold Mozart (1719-1787), father of Wolfgang Amadé, had profound medical knowledge and was a passionate medical dilettante. As long as the young Mozart lived with his father and travelled on his concert tours with him, Leopold cared for his son in medical matters. Doctors were only consulted occasionally. In the extensive correspondence of Mozart's father drugs and treatments used for Wolfgang Amadé are reported in detail. This represents a reliable description of the pharmacological therapies of the late 18th century. The mentioned drugs are, as far as possible, viewed from todays medical perspective.

  9. Prevention of torture and inhuman or degrading treatment: medical implications of a new European convention.

    PubMed

    Harding, T W

    1989-05-27

    A new European convention creates a mechanism for the prevention of torture and inhuman or degrading treatments of detained people through visits by outside, independent teams with unlimited access to places of detention. The convention has important implications for the medical profession: firstly, visits to psychiatric hospitals will be included and, in particular, to secure facilities, where the risk of human rights abuses is well established; and, secondly, the adequacy and ethics of medical care in prisons will be a key issue in assessing the protection of prisoners' human rights. The convention should be welcomed by the medical profession as a stimulus to the improvement of medical care for detained people.

  10. Development of an Alternative Treatment Scheme for Sr/TRU Removal: Permanganate Treatment of AN-107 Waste

    SciTech Connect

    RT Hallen; SA Bryan; FV Hoopes

    2000-08-04

    A number of Hanford tanks received waste containing organic complexants, which increase the volubility of Sr-90 and transuranic (TRU) elements. Wastes from these tanks require additional pretreatment to remove Sr-90 and TRU for immobilization as low activity waste (Waste Envelope C). The baseline pretreatment process for Sr/TRU removal was isotopic exchange and precipitation with added strontium and iron. However, studies at both Battelle and Savannah River Technology Center (SRTC) have shown that the Sr/Fe precipitates were very difficult to filter. This was a result of the formation of poor filtering iron solids. An alternate treatment technology was needed for Sr/TRU removal. Battelle had demonstrated that permanganate treatment was effective for decontaminating waste samples from Hanford Tank SY-101 and proposed that permanganate be examined as an alternative Sr/TRU removal scheme for complexant-containing tank wastes such as AW107. Battelle conducted preliminary small-scale experiments to determine the effectiveness of permanganate treatment with AN-107 waste samples that had been archived at Battelle from earlier studies. Three series of experiments were performed to evaluate conditions that provided adequate Sr/TRU decontamination using permanganate treatment. The final series included experiments with actual AN-107 diluted feed that had been obtained specifically for BNFL process testing. Conditions that provided adequate Sr/TRU decontamination were identified. A free hydroxide concentration of 0.5M provided adequate decontamination with added Sr of 0.05M and permanganate of 0.03M for archived AN-107. The best results were obtained when reagents were added in the sequence Sr followed by permanganate with the waste at ambient temperature. The reaction conditions for Sr/TRU removal will be further evaluated with a 1-L batch of archived AN-107, which will provide a large enough volume of waste to conduct crossflow filtration studies (Hallen et al. 2000a).

  11. Medicated shampoos for the treatment of seborrheic dermatitis.

    PubMed

    Waldroup, Whitney; Scheinfeld, Noah

    2008-07-01

    Seborrheic dermatitis is a common papulosquamous disorder of the skin, affecting 3% to 5% of the population. Dandruff, a less severe form of seborrheic dermatitis, affects a greater proportion of the population. The exact pathogenesis of seborrheic dermatitis is unknown, however colonization of the lipophilic yeast, Malasezzia furfur, and an inflammatory reaction to this yeast each seem to play a role in disease etiology. Therefore, treatment for seborrheic dermatitis is aimed at yeast elimination and inflammation control. Several treatment modalities are available for seborrheic dermatitis and dandruff including shampoos, which contain both active ingredients related to antimycotic or anti-inflammatory effects and also surfactant ingredients that allow these shampoos to replace regular shampoos in affected patients. The literature regarding the treatment of therapeutic shampoos is reviewed, and treatment strategies for managing seborrheic dermatitis with therapeutic shampoos are provided.

  12. Use of medications in the treatment of acute low back pain.

    PubMed

    Malanga, Gerard A; Dennis, Robin L

    2006-01-01

    The prescription of medications continues to be one of the mainstays of treatment of acute low back pain episodes. The goals of the pharmacologic treatment for acute low back are reduction of pain and return of normal function. Often, nociception is a result of secondary inflammation and muscle spasm after acute injury of a structure of the spine, which may include muscle, tendon, ligament, disc, or bone. An understanding of the appropriate use of medications to address the underlying pain generator and the current evidence for using these medications is essential for any physician who sees and treats patients with acute low back pain.

  13. Screening of alternative technologies to incineration for treatment of chemical-agent-contaminated soil

    SciTech Connect

    Shem, L.M.; Ballou, S.W.; Besmer, M.G.

    1996-12-31

    As part of the Rocky Mountain Arsenal (RMA) Remedial Investigation/Feasibility Study, RMA has contracted Argonne National Laboratory to investigate potential remedial alternatives for the cleanup of agent-contaminated soils. The chemical agents of concern include levinstein mustard, lewisite, sarin, and VX. This investigation has been initially divided into three phases: (1) a literature search to determine what, if any, previous studies have been conducted; (2) a technologies-screening critique of remedial technologies as alternatives to incineration; and (3) an investigation of promising alternatives on RMA soil at the laboratory and bench-scale levels. This paper summarizes the document produced as a result of the technologies screening. The purpose of the document was to determine the applicability of 25 technologies to remediation of agent-contaminated soil for a general site. Technologies were critiqued on the basis of applicability to soil type, applicability to the agents of concern at RMA, applicability to other types of contaminants, cost of the treatment, current status of the technology, and residuals produced.

  14. Parents' Views and Experiences about Complementary and Alternative Medicine Treatments for Their Children with Autistic Spectrum Disorder

    ERIC Educational Resources Information Center

    Senel, Hatice Gunayer

    2010-01-01

    Use of complementary and alternative medicine (CAM) treatments have been increasing for children with autistic spectrum disorder (ASD). In this study, 38 Turkish parents of children with ASD were surveyed related with their use of CAM treatments, experiences, and views for each treatment. They mentioned "Vitamins and minerals",…

  15. Errors of Omission and Commission during Alternative Reinforcement of Compliance: The Effects of Varying Levels of Treatment Integrity

    ERIC Educational Resources Information Center

    Leon, Yanerys; Wilder, David A.; Majdalany, Lina; Myers, Kristin; Saini, Valdeep

    2014-01-01

    We conducted two experiments to evaluate the effects of errors of omission and commission during alternative reinforcement of compliance in young children. In Experiment 1, we evaluated errors of omission by examining two levels of integrity during alternative reinforcement (20 and 60%) for child compliance following no treatment (baseline) versus…

  16. Updated Review of Complementary and Alternative Medicine Treatments for Systemic Lupus Erythematosus

    PubMed Central

    Nakajima, Claire; Manzi, Susan

    2013-01-01

    It is estimated that over 50 % of patients with systemic lupus erythematosus (SLE) have utilized complementary and alternative medicine (CAM) treatments to reduce symptoms and manage their health. However, there are relatively few randomized controlled trials of CAM for SLE. This review describes recent studies of vitamins and supplements, acupuncture, and mind-body interventions in SLE patients. The recent trials of CAM treatments for SLE indicate that supplements such as vitamin D, omega 3 fatty acids, N-acetyl cysteine and turmeric show some promise for reducing SLE disease activity. In addition, mind-body methods such as cognitive-behavioral therapy and other counseling interventions may improve mood and quality of life in SLE. PMID:24078104

  17. The Chinese approach to complementary and alternative medicine treatment for interstitial cystitis/bladder pain syndrome

    PubMed Central

    Ali, Abdullah

    2015-01-01

    Management of interstitial cystitis/bladder pain syndrome (IC/BPS) remains a challenge due to poor understanding on its etiology. Complementary and alternative medicine (CAM), as an optional treatment, has been widely used, because no definitive conventional therapy is available. The different domain of CAM provides miscellaneous treatments for IC/BPS, which mainly include dietary modification, nutraceuticals, bladder training, biofeedback, yoga, massage, physical therapy, Qigong, traditional Chinese medicine and acupuncture. Clinical evidence has shown that each therapy can certainly benefit a portion of IC/BPS patients. However, the target patient group of each therapy has not been well studied and randomized, controlled trials are needed to further confirm the efficacy and reliability of CAM on managing IC/BPS. Despite these limitations, CAM therapeutic characteristics including non-invasive and effectiveness for specific patients allow clinicians and patients to realize multimodal and individualized therapy for IC/BPS. PMID:26816867

  18. Updated review of complementary and alternative medicine treatments for systemic lupus erythematosus.

    PubMed

    Greco, Carol M; Nakajima, Claire; Manzi, Susan

    2013-11-01

    It is estimated that over 50 % of patients with systemic lupus erythematosus (SLE) have utilized complementary and alternative medicine (CAM) treatments to reduce symptoms and manage their health. However, there are relatively few randomized controlled trials of CAM for SLE. This review describes recent studies of vitamins and supplements, acupuncture, and mind-body interventions in SLE patients. The recent trials of CAM treatments for SLE indicate that supplements such as vitamin D, omega 3 fatty acids, N-acetyl cysteine and turmeric show some promise for reducing SLE disease activity. In addition, mind-body methods such as cognitive-behavioral therapy and other counseling interventions may improve mood and quality of life in SLE.

  19. Two Models of Integrating Buprenorphine Treatment and Medical Staff within Formerly "Drug-Free" Outpatient Programs.

    PubMed

    Monico, Laura; Schwartz, Robert P; Gryczynski, Jan; O'Grady, Kevin E; Mitchell, Shannon Gwin

    2016-01-01

    "Drug-free" outpatient programs deliver treatment to the largest number of patients of all treatment modalities in the U.S., providing a significant opportunity to expand access to medication treatments for substance use disorders. This analysis examined staff perceptions of organizational dynamics associated with the delivery of buprenorphine maintenance within three formerly "drug-free" outpatient treatment programs. Semi-structured interviews (N = 15) were conducted with counseling and medical staff, and respondents were predominantly African American (n = 11) and female (n = 12). Themes and concepts related to medical staff integration emerged through an inductive and iterative coding process using Atlas.ti qualitative analysis software. Two treatment clinics incorporated buprenorphine maintenance into their programs using a co-located model of care. Their staff generally reported greater intra-organizational discord regarding the best ways to combine medication and counseling compared to the clinic using an integrated model of care. Co-located program staff reported less communication between medical and clinical staff, which contributed to some uncertainty about proper dosing and concerns about the potential for medication diversion. Clinics that shift from "drug-free" to incorporating buprenorphine maintenance should consider which model of care they wish to adapt and how to train staff and structure staff communication.

  20. Screening paediatric rectal forms of azithromycin as an alternative to oral or injectable treatment.

    PubMed

    Kauss, Tina; Gaudin, Karen; Gaubert, Alexandra; Ba, Boubakar; Tagliaferri, Serena; Fawaz, Fawaz; Fabre, Jean-Louis; Boiron, Jean-Michel; Lafarge, Xavier; White, Nicholas J; Olliaro, Piero L; Millet, Pascal

    2012-10-15

    The aim of this study was to identify a candidate formulation for further development of a home or near-home administrable paediatric rectal form of a broad-spectrum antibiotic - specially intended for (emergency) use in tropical rural settings, in particular for children who cannot take medications orally and far from health facilities where injectable treatments can be given. Azithromycin, a broad-spectrum macrolide used orally or intravenously for the treatment of respiratory tract, skin and soft tissue infections, was selected because of its pharmacokinetic and therapeutic properties. Azithromycin in vitro solubility and stability in physiologically relevant conditions were studied. Various pharmaceutical forms, i.e. rectal suspension, two different rectal gels, polyethylene glycol (PEG) suppository and hard gelatin capsule (HGC) were assessed for in vitro dissolution and in vivo bioavailability in the rabbit. Azithromycin PEG suppository appears to be a promising candidate.

  1. Plant Alkaloids as an Emerging Therapeutic Alternative for the Treatment of Depression

    PubMed Central

    Perviz, Sadia; Khan, Haroon; Pervaiz, Aini

    2016-01-01

    Depression is a heterogeneous mood disorder that has been classified and treated in a variety of ways. Although, a number of synthetic drugs are being used as standard treatment for clinically depressed patients, but they have adverse effects that can compromise the therapeutic treatments and patient's compliance. Unlike, synthetic medications, herbal medicines are widely used across the globe due to their wide applicability and therapeutic efficacy associated with least side effects, which in turn has initiated the scientific research regarding the antidepressant activity. This review is mostly based on the literature of the last decade, aimed at exploring the preclinical profile of plant-based alkaloids (the abundant secondary metabolite) as an emerging therapy for depression. PMID:26913004

  2. Student-Perceived School Climate is Associated with ADHD Medication Treatment among Adolescents in Medicaid

    PubMed Central

    Visser, Susanna N.; Kramer, Dennis; Snyder, Angela B.; Sebian, Joyce; McGiboney, Garry; Handler, Arden

    2015-01-01

    Objective Evaluate the relationship between school climate and ADHD medication treatment among adolescents in Medicaid in Georgia (GA). Methods School climate and Medicaid claims data were aggregated for 159 GA counties. County-level school climate percentile and medicated ADHD prevalence were calculated. T-tests and regression evaluated the relationship between school climate, medicated ADHD, and demographics, weighted by county population. Poorer 2008 school climate (<25th percentile) was regressed on 2011 medicated ADHD prevalence, controlling for potential confounders. Results The prevalence of medicated ADHD was 7.8% among Medicaid-enrolled GA adolescents. The average county-level prevalence of medicated ADHD was 10.0% (SD=2.9%). Poorer school climate was associated with lower rates of medicated ADHD (p<0.0001) and with demographics accounted for 50% of the county variation in medicated ADHD. Conclusions School climate is associated with medicated ADHD among adolescents in Medicaid. Additional research may reveal whether high medicated ADHD may reflect a lack of access to non-pharmacological therapies. PMID:25710947

  3. Is medical treatment for diabetic retinopathy still an unreal dream?

    PubMed

    Giusti, C

    2002-12-01

    Diabetic retinopathy is a highly specific vascular complication of both type 1 and type 2 diabetes, estimated to be the most frequent cause of new cases of blindness in the working population of the Western world. The prevalence of retinopathy is strongly related to the duration of diabetes and glycemic control, even though a multifactorial pathogenesis should be probably considered in genetically susceptible subjects. Intensive diabetes management, with the goal of achieving near-normal glycemia, has been shown to prevent and/or delay the onset of diabetic retinopathy and laser photocoagulation has an established clinical efficacy in preventing visual loss. However, as laser scars always destroy the retinal anatomy permanently, a medical approach to nonproliferative retinopathy should be preferred if its clinical efficacy could be demonstrated. In this paper, recently published reports supporting this hypothesis are reviewed and their conclusions critically discussed.

  4. Complementary and alternative medicine for the treatment and diagnosis of asthma and allergic diseases.

    PubMed

    Passalacqua, G; Compalati, E; Schiappoli, M; Senna, G

    2005-03-01

    The use of Complementary/Alternative Medicines (CAM) is largely diffused and constantly increasing, especially in the field of allergic diseases and asthma. Homeopathy, acupuncture and phytotherapy are the most frequently utilised treatments, whereas complementary diagnostic techniques are mainly used in the field of food allergy-intolerance. Looking at the literature, the majority of clinical trials with CAMS are of low methodological quality, thus difficult to interpret. There are very few studies performed in a rigorously controlled fashion, and those studies provided inconclusive results. In asthma, none of the CAM have thus far been proved more effective than placebo or equally effective as standard treatments. Some herbal products, containing active principles, have displayed some clinical effect, but the herbal remedies are usually not standardised and not quantified, thus carry the risk of toxic effects or interactions. None of the alternative diagnostic techniques (electrodermal testing, kinesiology, leukocytotoxic test, iridology, hair analysis) have been proved able to distinguish between healthy and allergic subjects or to diagnose sensitizations. Therefore these tests must not be used, since they can lead to delayed or incorrect diagnosis and therapy.

  5. Modulation of alternative oxidase to enhance tolerance against cold stress of chickpea by chemical treatments.

    PubMed

    Erdal, Serkan; Genisel, Mucip; Turk, Hulya; Dumlupinar, Rahmi; Demir, Yavuz

    2015-03-01

    The alternative oxidase (AOX) is the enzyme responsible for the alternative respiratory pathway. This experiment was conducted to examine the influence on cold tolerance ability of chickpea (Cicer aurentium cv. Müfitbey) seedlings of AOX activator (pyruvate), AOX inhibitor (salicylhydroxamic acid (SHAM)) and an inhibitor of the cytochrome pathway of respiration (antimycin A) treatments. 5mM pyruvate, 2μM antimycin A and 4mM SHAM solutions were exogenously applied to thirteen-day-old chickpea leaves and then the seedlings were transferred to a different plant growth chamber arranged to 10/5°C (day/night) for 48h. Cold stress markedly increased the activities of antioxidant enzymes compared to controls. Pyruvate and antimycin A significantly increased the cold-induced increase in antioxidant activity but SHAM decreased it. Cold-induced increases in superoxide anion, hydrogen peroxide, and lipid peroxidation levels were significantly reduced by pyruvate and antimycin A, but increased by SHAM treatment. Pyruvate and antimycin A application increased both the activity and protein expression of AOX in comparison to cold stress alone. However, SHAM significantly decreased activity of AOX but did not affect its expression. Total cellular respiration values (TCRV) supported the changes in activity and expression of AOX. While TCRV were increased by cold and pyruvate, they were significantly reduced by SHAM and especially antimycin A. These results indicate that pyruvate and antimycin A applications were effective in reducing oxidative stress by activating the alternative respiratory pathway as well as antioxidant activity. Furthermore, direct activation of AOX, rather than inhibition of the cytochrome pathway, was the most effective way to mitigate cold stress.

  6. Combined Psychotherapy/Medication Treatment: The Valpo Model

    ERIC Educational Resources Information Center

    Cooper, Stewart E.

    2007-01-01

    This article presents how the Valparaiso University Student Counseling and Development Center (SCDC) developed and delivers a combined service treatment model integrating pharmacotherapy with psychotherapy for a subset of the center's clients evidencing significant psychiatric concerns. To explicate the model, several documents that may be of…

  7. Comparative Evaluation of Medical vs. Social Treatment of Alcohol Withdrawal Syndrome.

    ERIC Educational Resources Information Center

    McGovern, Mark P.

    1983-01-01

    Compared medical and social setting detoxification treatments of alcohol withdrawal syndrome regarding the degree to which each involved alcoholics (N=200) in ongoing rehabilitative efforts. Results showed highly significant differences between treatment models, with the social setting model showing significantly greater rates of commitment to…

  8. Medication Assisted Treatment for the 21st Century: Community Education Kit.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.

    The need to support the success of individuals in methadone-assisted recovery, and the recent availability of new pharmacologic treatment options for opioid dependence, calls for an information tool that underscores the evidence-based benefits of medication assisted treatment for opioid dependence. The U.S. Department of Health and Human Services'…

  9. Stress Reactivity Following Brief Treatment for Depression: Differential Effects of Psychotherapy and Medication

    ERIC Educational Resources Information Center

    Hawley, Lance L.; Ho, Moon-Ho Ringo; Zuroff, David C.; Blatt, Sidney J.

    2007-01-01

    Psychotherapy and medication treatments are both effective in reducing depressive symptoms. However, only psychotherapy provides an enduring effect by reducing depressive vulnerability following treatment termination. This differential efficacy may reflect mode-specific effects on the longitudinal relationship between depression and stress. The…

  10. Evaluation of treatment effects in obese children with co-morbid medical or psychiatric conditions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The need for effective treatments for pediatric overweight is well known. We evaluated the applicability of an evidence-based treatment in an applied clinic setting that includes children with severe obesity and comorbid medical or psychiatric conditions. Forty-eight overweight children and their fa...

  11. Use of complementary and alternative medical therapies among racial and ethnic minority adults: results from the 2002 National Health Interview Survey.

    PubMed Central

    Graham, Robert E.; Ahn, Andrew C.; Davis, Roger B.; O'Connor, Bonnie B.; Eisenberg, David M.; Phillips, Russell S.

    2005-01-01

    PURPOSE: Complementary and alternative medicine (CAM) use among ethnic minority populations is poorly understood. We sought to examine CAM use in Hispanics, non-Hispanic blacks and non-Hispanic whites. METHODS: We analyzed data from the Alternative Health Supplement to the 2002 National Health Interview Survey (NHIS), including information on 19 different CAM therapies used in the past 12 months. RESULTS: An estimated 34% of Hispanic, non-Hispanic black and non-Hispanic white adults in the United States used at least one CAM therapy (excluding prayer) during the prior 12 months (2002). CAM use was highest for non-Hispanic whites (36%), followed by Hispanics (27%) and non-Hispanic blacks (26%). Non-Hispanic whites were more likely to use herbal medicine, relaxation techniques and chiropractic more frequently than Hispanics and non-Hispanic blacks. After controlling for other sociodemographic factors, Hispanic and non-Hispanic black races/ethnicities were associated with less CAM use, with adjusted odds ratios (95% confidence intervals) of 0.78 (0.70, 0.87) and 0.71 (0.65, 0.78), respectively. Hispanics cited using CAM because conventional medical treatments were too expensive more frequently than non-Hispanic blacks or whites. Hispanics had the highest provider nondisclosure rates (68.5%), followed by non-Hispanic blacks (65.1%) and non-Hispanic whites (58.1%). CONCLUSIONS: Excluding prayer, Hispanics and non-Hispanic blacks used CAM less frequently than non-Hispanic whites and were less likely to disclose their use to their healthcare provider. Further research is needed to improve our understanding of the disparities in CAM use. PMID:15868773

  12. Development of Chemical Treatment Alternatives for Tetraphenylborate Destruction in Tank 48H

    SciTech Connect

    Lambert, D.P.

    2003-03-11

    This study assessed chemical treatment options for decomposing the tetraphenylborate in High Level Waste (HLW) Tank 48H. Tank 48H, located at the Savannah River Site in Aiken, SC, contains approximately one million liters of HLW. The tetraphenylborate slurry represents legacy material from commissioning of an In Tank Precipitation process to separate radioactive cesium and actinides from the nonradioactive chemicals. During early operations, the process encountered an unplanned chemical reaction that catalytically decomposed the excess tetraphenylborate producing benzene. Subsequent research indicated that personnel could not control the operations within the existing equipment to both meet the desired treatment rate for the waste and maintain the benzene concentration within allowable concentrations. Since then, the Department of Energy selected an alternate treatment process for handling high-level waste at the site. However, the site must destroy the tetraphenylborate before returning the tank to HLW service. The research focuses on identifying treatments to decompose tetraphenylborate to the maximum extent feasible, with a preference for decomposition methods that produce carbon dioxide rather than benzene. A number of experiments examined whether the use of oxidants, catalysts or acids proved effective in decomposing the tetraphenylborate. Additional experiments developed an understanding of the solid, liquid and gas decomposition products.

  13. Health Beliefs, Treatment Preferences and Complementary and Alternative Medicine for Asthma, Smoking and Lung Cancer Self-Management in Diverse Black Communities

    PubMed Central

    George, Maureen

    2012-01-01

    Objectives The purpose of this literature review is to characterize unconventional health beliefs and complementary and alternative medicine (CAM) for asthma, smoking and lung cancer as those that are likely safe and those that likely increase risk in diverse Black communities. These findings should provide the impetus for enhanced patient-provider communication that elicits patients’ beliefs and self-management preferences so that they may be accommodated, or when necessary, reconciled through discussion and partnership. Methods Original research articles relevant to this topic were obtained by conducting a literature search of the PubMed Plus, PsychINFO and SCOPUS databases using combinations of the following search terms: asthma, lung cancer, emphysema, chronic obstructive pulmonary disease (COPD), smoking, beliefs, complementary medicine, alternative medicine, complementary and alternative medicine (CAM), explanatory models, African American, and Black. Results Using predetermined inclusion and exclusion criteria, 51 original research papers were retained. Taken together, they provide evidence that patients hold unconventional beliefs about the origins of asthma and lung cancer and the health risks of smoking, have negative opinions of standard medical and surgical treatments, and have favorable attitudes about using CAM. All but a small number of CAM and health behaviors were considered safe. Conclusions When patients’ unconventional beliefs and preferences are not identified and discussed, there is an increased risk that standard approaches to self-management of lung disease will be sub-optimal, that potentially dangerous CAM practices might be used and that timely medical interventions may be delayed. Practice implications Providers need effective communication skills as the medical dialogue forms the basis of patients’ understanding of disease and self-management options. The preferred endpoint of such discussions should be agreement around an

  14. Role of medical thermography in treatment of Frey's syndrome with botulinum toxin A.

    PubMed

    Green, Richard James; Endersby, Simon; Allen, John; Adams, James

    2014-01-01

    Frey syndrome classically causes gustatory sweating and facial flushing. We describe 2 cases in which medical thermography was used to investigate the symptoms. Images were taken after patients chewed a sialagogue and 2 weeks later they were given injections of botulinum toxin A. Images taken 4 weeks after treatment showed a considerable reduction in sweating and facial flushing, which was supported by the results of quality of life questionnaires completed before and after treatment. Medical thermography is much cleaner than the Minor's starch iodine test. It identifies areas of gustatory sweating, changes in temperature, and vascular changes, which potentially enable treatment to be targeted accurately.

  15. [Current and future medical treatment of Alzheimer's disease].

    PubMed

    Lemper, J C

    2005-09-01

    The current treatment of Alzheimer's disease (MA) is based on a symptomatic pharmacological therapy of the cognitive decline and the behavioural disturbances. Progress towards understanding the cellular and molecular alterations responsible for the disease promise therapeutic strategies based upon the pathological processes. Corrections of dysregulations of the brain's neurotransmitters (cholinergic deficit and glutamatergic overstimulation) bring significant but modest therapeutic improvement. The pivotal role of the proteolytic processing of the amyloid precursor protein (APP) in neuronal death suggests pharmacological inhibition of the secretases; amyloid antiaggregant therapies are possible, vaccination against AB wil need new immunisation protocols, Anti-inflammatory drugs and antioxydant agents as calcium channel blockers could help against the neurotoxic cascade of Abeta, some cholesterol-lowering drugs could enhance its clearance. This article reviews the available data on current pharmacological treatments, and the future possible strategies that could modify the evolution, or prevent Alzheimer's disease.

  16. Does intraperitoneal medical ozone preconditioning and treatment ameliorate the methotrexate induced nephrotoxicity in rats?

    PubMed

    Aslaner, Arif; Çakır, Tuğrul; Çelik, Betül; Doğan, Uğur; Mayir, Burhan; Akyüz, Cebrail; Polat, Cemal; Baştürk, Ahmet; Soyer, Vural; Koç, Süleyman; Şehirli, Ahmet Özer

    2015-01-01

    Methotrexate is a chemotherapeutic agent used for many cancer treatments. It leads to toxicity with its oxidative injury. The purpose of our study is investigating the medical ozone preconditioning and treatment has any effect on the methotrexate-induced kidneys by activating antioxidant enzymes in rats. Eighteen rats were divided into three equal groups; control, Mtx without and with medical ozone. Nephrotoxicity was performed with a single dose of 20 mg/kg Mtx intraperitoneally at the fifteenth day of experiment on groups 2 and 3. Medical ozone preconditioning was performed at a dose of 25 mcg/ml (5 ml) intraperitoneally everyday in the group 3 and treated with medical ozone for five more days while group 2 was received only 5 ml of saline everyday for twenty days. All rats were sacrificed at the end of third week and the blood and kidney tissue samples were obtained to measure the levels of TNF-α, IL-1β, malondialdehyde, glutathione and myeloperoxidase. Kidney injury score was evaluated histolopatologically. Medical ozone preconditioning and treatment ameliorated the biochemical parameters and kidney injury induced by Mtx. There was significant increase in tissue MDA, MPO activity, TNF-α and IL-1β (P<0.05) and significant decrease in tissue GSH and histopathology (P<0.05) after Mtx administration. The preconditioning and treatment with medical ozone ameliorated the nephrotoxicity induced by Mtx in rats by activating antioxidant enzymes and prevented renal tissue.

  17. Does intraperitoneal medical ozone preconditioning and treatment ameliorate the methotrexate induced nephrotoxicity in rats?

    PubMed Central

    Aslaner, Arif; Çakır, Tuğrul; Çelik, Betül; Doğan, Uğur; Mayir, Burhan; Akyüz, Cebrail; Polat, Cemal; Baştürk, Ahmet; Soyer, Vural; Koç, Süleyman; Şehirli, Ahmet Özer

    2015-01-01

    Methotrexate is a chemotherapeutic agent used for many cancer treatments. It leads to toxicity with its oxidative injury. The purpose of our study is investigating the medical ozone preconditioning and treatment has any effect on the methotrexate-induced kidneys by activating antioxidant enzymes in rats. Eighteen rats were divided into three equal groups; control, Mtx without and with medical ozone. Nephrotoxicity was performed with a single dose of 20 mg/kg Mtx intraperitoneally at the fifteenth day of experiment on groups 2 and 3. Medical ozone preconditioning was performed at a dose of 25 mcg/ml (5 ml) intraperitoneally everyday in the group 3 and treated with medical ozone for five more days while group 2 was received only 5 ml of saline everyday for twenty days. All rats were sacrificed at the end of third week and the blood and kidney tissue samples were obtained to measure the levels of TNF-α, IL-1β, malondialdehyde, glutathione and myeloperoxidase. Kidney injury score was evaluated histolopatologically. Medical ozone preconditioning and treatment ameliorated the biochemical parameters and kidney injury induced by Mtx. There was significant increase in tissue MDA, MPO activity, TNF-α and IL-1β (P<0.05) and significant decrease in tissue GSH and histopathology (P<0.05) after Mtx administration. The preconditioning and treatment with medical ozone ameliorated the nephrotoxicity induced by Mtx in rats by activating antioxidant enzymes and prevented renal tissue. PMID:26550330

  18. Medical devices for the treatment of eye diseases.

    PubMed

    Yasukawa, Tsutomu; Ogura, Yuichiro

    2010-01-01

    Development of intraocular drug delivery systems (DDSs) is urgently required for the treatment of eye diseases, especially in the posterior segment of the eye (the vitreous cavity, retina, and choroid), most of which are refractory to conventional pharmacologic approaches; eye drops and systemically administered drugs cannot achieve therapeutic drug concentrations in the posterior segment of the eye. Repeated intravitreal injections of anti-angiogenic agents are effective in the treatment of age-related macular degeneration, but there remain risks of serious side effects such as endophthalmitis associated with repeated injections. Intraocular DDSs may address these problems. Intraocular sustained drug release from implantable or injectable devices has been investigated to treat vitreoretinal diseases. A reservoir-type nonbiodegradable implant was first launched in the market in 1996 for the treatment of cytomegalovirus retinitis secondary to the acquired immunodeficiency syndrome, followed by clinical trials for a variety of potent devices to treat other challenging eye diseases. An injectable rod-shaped insert releasing a steroid is presently being assessed in a phase III trial to treat macular edema secondary to diabetic retinopathy or retinal vein occlusion. Thus various types of intraocular DDSs will be commercially available to treat vision-threatening intraocular diseases in the near future.

  19. 75 FR 48356 - Advancing the Development of Medical Products Used In the Prevention, Diagnosis, and Treatment of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-10

    ... HUMAN SERVICES Food and Drug Administration Advancing the Development of Medical Products Used In the... ``Advancing the Development of Medical Products Used in the Prevention, Diagnosis, and Treatment of Neglected... the development of medical products (drugs, biological products, and medical devices) used in...

  20. Treatment Sequencing for Childhood ADHD: A Multiple-Randomization Study of Adaptive Medication and Behavioral Interventions.

    PubMed

    Pelham, William E; Fabiano, Gregory A; Waxmonsky, James G; Greiner, Andrew R; Gnagy, Elizabeth M; Pelham, William E; Coxe, Stefany; Verley, Jessica; Bhatia, Ira; Hart, Katie; Karch, Kathryn; Konijnendijk, Evelien; Tresco, Katy; Nahum-Shani, Inbal; Murphy, Susan A

    2016-01-01

    Behavioral and pharmacological treatments for children with attention deficit/hyperactivity disorder (ADHD) were evaluated to address whether endpoint outcomes are better depending on which treatment is initiated first and, in case of insufficient response to initial treatment, whether increasing dose of initial treatment or adding the other treatment modality is superior. Children with ADHD (ages 5-12, N = 146, 76% male) were treated for 1 school year. Children were randomized to initiate treatment with low doses of either (a) behavioral parent training (8 group sessions) and brief teacher consultation to establish a Daily Report Card or (b) extended-release methylphenidate (equivalent to .15 mg/kg/dose bid). After 8 weeks or at later monthly intervals as necessary, insufficient responders were rerandomized to secondary interventions that either increased the dose/intensity of the initial treatment or added the other treatment modality, with adaptive adjustments monthly as needed to these secondary treatments. The group beginning with behavioral treatment displayed significantly lower rates of observed classroom rule violations (the primary outcome) at study endpoint and tended to have fewer out-of-class disciplinary events. Further, adding medication secondary to initial behavior modification resulted in better outcomes on the primary outcomes and parent/teacher ratings of oppositional behavior than adding behavior modification to initial medication. Normalization rates on teacher and parent ratings were generally high. Parents who began treatment with behavioral parent training had substantially better attendance than those assigned to receive training following medication. Beginning treatment with behavioral intervention produced better outcomes overall than beginning treatment with medication.

  1. Human Parasites in Medieval Europe: Lifestyle, Sanitation and Medical Treatment.

    PubMed

    Mitchell, Piers D

    2015-01-01

    Parasites have been infecting humans throughout our evolution. However, not all people suffered with the same species or to the same intensity throughout this time. Our changing way of life has altered the suitability of humans to infection by each type of parasite. This analysis focuses upon the evidence for parasites from archaeological excavations at medieval sites across Europe. Comparison between the patterns of infection in the medieval period allows us to see how changes in sanitation, herding animals, growing and fertilizing crops, the fishing industry, food preparation and migration all affected human susceptibility to different parasites. We go on to explore how ectoparasites may have spread infectious bacterial diseases, and also consider what medieval medical practitioners thought of parasites and how they tried to treat them. While modern research has shown the use of a toilet decreases the risk of contracting certain intestinal parasites, the evidence for past societies presented here suggests that the invention of latrines had no observable beneficial effects upon intestinal health. This may be because toilets were not sufficiently ubiquitous until the last century, or that the use of fresh human faeces for manuring crops still ensured those parasite species were easily able to reinfect the population.

  2. Endometriosis in Italy: from cost estimates to new medical treatment.

    PubMed

    Luisi, Stefano; Lazzeri, Lucia; Ciani, Valentina; Petraglia, Felice

    2009-11-01

    Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induced a chronic inflammatory reaction. The data collected from Italy showed that around 3 million women are affected by endoemtriosis and the condition was predominantly found in women of reproductive age (50% of women were in the 29-39 age range), only 25% of women were asymptomatic. The associated symptoms can create an impact in general physical, mental, and social well-being. Endometriosis is associated with severe dysmenorrhea, deep dyspareunia, chronic pelvic pain, ovulation pain, cyclical, or perimenstrual symptoms, with or without abnormal bleeding, infertility, and chronic fatigue. The annual cost for hospital admission can be estimated to be in a total around 54 million euros. The average time for right diagnosis is around 9 years still today and it follows a long and expensive diagnostic search. Therapies can be useful to relieve and sometimes solve the symptoms, encourage fertility, eliminate endometrial lesions, and restore the anatomy of the pelvis. For medical therapy, several different preparations (oral contraceptives, progestogenics, gestrinone, danazol, and GnRHa) and new options (GnRH antagonists, aromatase inhibitors, estrogen receptor beta agoinist, progesterone receptor modulators, angiogenesis inhibitors, and COX-2 selective inhibitors) are available.

  3. Raynaud's phenomenon and digital ischaemia--pharmacologic approach and alternative treatment options.

    PubMed

    Linnemann, Birgit; Erbe, Matthias

    2016-01-01

    The primary goal of therapy is to reduce the frequency and intensity of Raynaud's attacks and to minimize the related morbidity rather than to cure the underlying condition. Treatment strategies depend on whether Raynaud's phenomenon (RP) is primary or secondary. All patients should be instructed about general measures to maintain body warmth and to avoid triggers of RP attacks. Pharmacologic intervention can be useful for patients with severe and frequent RP episodes that impair the patient's quality of life. Calcium channel blockers are currently the most prescribed and studied medications for this purpose. There has been limited evidence for the efficacy of alpha-1-adrenergic receptor antagonists, angiotensin receptor blockers, topical nitrates or fluoxetine to treat RP. The intravenously administered prostacyclin analogue iloprost can reduce the frequency and severity of RP attacks and is considered a second-line therapy in patients with markedly impaired quality of life, critical digital ischaemia and skin ulcers who are at risk for substantial tissue loss and amputation. Phosphodiesterase inhibitors (e.g., sildenafil) can also improve RP symptoms and ulcer healing whereas endothelin-1 receptor antagonists (e.g., bosentan) are mainly considered treatment options in secondary prevention for patients with digital skin ulcers related to systemic sclerosis. However, their use in clinical practice has been limited by their high cost. Antiplatelet therapy with low-dose aspirin is recommended for all patients who suffer from secondary RP due to ischaemia caused by structural vessel damage. Anticoagulant therapy can be considered during the acute phase of digital ischaemia in patients with suspected vascular occlusive disease attributed to the occurrence of new thromboses. In patients with critical digital ischaemia, consideration should be given to hospitalisation, optimisation of medical treatment in accordance with the underlying disease and evaluation for a

  4. 75 FR 9102 - Recovery of Cost of Hospital and Medical Care and Treatment Furnished by the United States...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ..., or dental care. This change responds to the increase in medical costs since 1992, when the current... Part 43 Recovery of Cost of Hospital and Medical Care and Treatment Furnished by the United States... intervening period, the cost of medical care and treatment has increased substantially. That increase...

  5. Medical management of brain tumors and the sequelae of treatment

    PubMed Central

    Schiff, David; Lee, Eudocia Q.; Nayak, Lakshmi; Norden, Andrew D.; Reardon, David A.; Wen, Patrick Y.

    2015-01-01

    Patients with malignant brain tumors are prone to complications that negatively impact their quality of life and sometimes their overall survival as well. Tumors may directly provoke seizures, hypercoagulable states with resultant venous thromboembolism, and mood and cognitive disorders. Antitumor treatments and supportive therapies also produce side effects. In this review, we discuss major aspects of supportive care for patients with malignant brain tumors, with particular attention to management of seizures, venous thromboembolism, corticosteroids and their complications, chemotherapy including bevacizumab, and fatigue, mood, and cognitive dysfunction. PMID:25358508

  6. Association between Medication Adherence and Duration of Outpatient Treatment in Patients with Schizophrenia

    PubMed Central

    Kikuyama, Hiroki; Ohta, Munehiro; Kanazawa, Tetsufumi; Okamura, Takehiko; Yoneda, Hiroshi

    2016-01-01

    Objective Medication adherence is important in the treatment of schizophrenia, and critical periods during treatment may be associated with relapse. However, the relationship between adherence and duration of outpatient treatment (DOT) remains unclear. The authors aimed to clarify the relationship between adherence and DOT at a psychiatric hospital in Japan. Methods For outpatients with schizophrenia who regularly visit Shin-Abuyama hospital, the authors conducted a single questionnaire survey (five questions covering gender, age, DOT, medication shortages, and residual medication) over one month period. Participants were divided into two groups whether DOT were from more than one year to within five years or not. Mantel-Haenszel analysis and logistic regression analysis were performed on the data regarding the medication adherence. Results Effective answers were received for 328 patients. The residual medication rate was significantly higher among those receiving outpatient treatment from more than one year to within five years than five years than those receiving outpatient treatment for more than five years or less than one year (p=0.016). Conclusion This survey suggests that there are critical periods during which patients are most prone to poor adherence. Because poor adherence increases the risk of relapse, specific measures must be taken to improve adherence during these periods. PMID:27482242

  7. New medications for treatment of obesity: metabolic and cardiovascular effects.

    PubMed

    Pucci, Andrea; Finer, Nicholas

    2015-02-01

    The management of obesity remains a major challenge. Dietary therapy often fails, whereas bariatric surgery, although successful, is demanding and applicable to a limited number of patients. Drug therapy has had many setbacks over the past 20 years because of serious adverse effects; however, several new drugs for the treatment of obesity are either licensed in some parts of the world, submitted for registration, or completing phase III trials. These include combinations (at low dose) of existing drugs, e.g., bupropion + naltrexone (Contrave), phentermine + topiramate (Qsymia), higher doses of existing drugs licensed for other indications (liraglutide, 3 mg), and new entities (lorcaserin). We discuss the challenges and opportunities for obesity pharmacotherapy and review in detail the efficacy of the new drugs regarding weight loss and both desirable and potential undesirable cardiovascular (CV) and metabolic risk factors. Substantial barriers remain, even if the drugs are approved, in successfully integrating these agents into weight management practice, largely related to cost, patient acceptability, and clinician willingness to be engaged in obesity treatment. Although hard clinical outcome benefit (at least for CV outcomes) has yet to be established, obesity pharmacotherapy may soon address many of the challenges in the clinical management of obesity, although newer and better drug combinations and more evidence of benefit from appropriately designed outcome trials is needed.

  8. Medical treatment of unresectable hepatocellular carcinoma: Going beyond sorafenib

    PubMed Central

    Porta, Camillo; Paglino, Chiara

    2010-01-01

    Even though Sorafenib has radically changed the natural history of those hepatocellular carcinoma patients who are not amenable for curative treatments, further therapeutic improvements are badly needed. As it was for Sorafenib, our increasingly refined understanding of the complex mechanisms underlying HCC carcinogenesis are the starting point for the future development of such treatments. Presently, a number of molecularly targeted agents are in different stages of development for this once orphan cancer. Indeed, several pathways are presently being explored to identify potentially active drugs, including epidermal growth factor receptor, vascular endothelial growth factor/vascular endothelial growth factor receptors, mammalian target of rapamycin, phosphatidyl-inositol-3-kinase/Akt, insulin growth factor, Aurora kinase, Wnt/β-catenin, retinoic acid receptor and hepatocyte growth factor/C-Met. This review is aimed at addressing the results obtained so far with these newer drugs, also considering the challenges we shall face in the near future, including the issue of response evaluation and identification of predictive/prognostic biomarkers. PMID:21160981

  9. Sciatica from disk herniation: Medical treatment or surgery?

    PubMed

    Legrand, Erick; Bouvard, Béatrice; Audran, Maurice; Fournier, Dominique; Valat, Jean Pierre

    2007-12-01

    Disk-related sciatica is a common disorder that resolves without surgery in 95% of patients within 1 to 12months. Several treatment strategies designed to hasten recovery, enable a return to previous social and occupational activities, and prevent chronicization have been evaluated. Available efficacy data support the use of analgesics, nonsteroidal anti-inflammatory drugs, and epidural steroid injections, which probably relieve the pain and improve the quality of life without radically changing the midterm outcome. After a specialized evaluation of physical, psychological, social, and occupational factors, surgery may be offered to patients with persistent nerve root pain (as opposed to low back pain). The complication rate ranges from 1% to 3%. Surgery is clearly effective, shortening the time to recovery by about 50% compared to nonsurgical treatment. Whether one specific surgical procedure is better than others remains unclear. Methodological weaknesses of studies evaluating the efficacy of percutaneous methods preclude definitive conclusions. Bed rest, systemic glucocorticoid therapy, spinal manipulation, bracing, spinal traction, and physical therapy have no proven effects on the outcome of sciatica.

  10. State of the Evidence Regarding Complimentary and Alternative Medical Treatments for Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Umbarger, Gardner T., III

    2007-01-01

    Both the Elementary and Secondary Education Act of 2001 (No Child Left Behind) and the Individuals with Disabilities Education Improvement Act of 2004 show a public policy preference for the use of interventions that are supported by scientific evidence of their efficacy. At the same time, parents of children with Autism Spectrum Disorders (ASD)…

  11. Medical treatment of the adolescent drug abuser. An opportunity for rehabilitative intervention.

    PubMed

    Schonberg, S K

    1976-03-01

    Illnesses related to both the pharmacologic properties of abused substances and their methods of administration often bring the teenager to medical attention and may provide sufficient motivation for the adolescent to seek help beyond the acute problem. Successful treatment of an overdose reaction, an abstinence syndrome, or any other medical complication of drug abuse may give the physician a unique opportunity to begine further evalution for future care.

  12. Demagnetization Treatment of Remanent Composite Microspheres Studied by Alternating Current Susceptibility Measurements

    PubMed Central

    van Berkum, Susanne; Erné, Ben H.

    2013-01-01

    The magnetic remanence of silica microspheres with a low concentration of embedded cobalt ferrite nanoparticles is studied after demagnetization and remagnetization treatments. When the microspheres are dispersed in a liquid, alternating current (AC) magnetic susceptibility spectra reveal a constant characteristic frequency, corresponding to the rotational diffusion of the microparticles; this depends only on particle size and liquid viscosity, making the particles suitable as a rheological probe and indicating that interactions between the microspheres are weak. On the macroscopic scale, a sample with the dry microparticles is magnetically remanent after treatment in a saturating field, and after a demagnetization treatment, the remanence goes down to zero. The AC susceptibility of a liquid dispersion, however, characterizes the remanence on the scale of the individual microparticles, which does not become zero after demagnetization. The reason is that an individual microparticle contains only a relatively small number of magnetic units, so that even if they can be reoriented magnetically at random, the average vector sum of the nanoparticle dipoles is not negligible on the scale of the microparticle. In contrast, on the macroscopic scale, the demagnetization procedure randomizes the orientations of a macroscopic number of magnetic units, resulting in a remanent magnetization that is negligible compared to the saturation magnetization of the entire sample. PMID:24009021

  13. Complementary and Alternative Medicine for the Treatment of Obesity: A Critical Review

    PubMed Central

    Esteghamati, Alireza; Mazaheri, Tina; Vahidi Rad, Mona; Noshad, Sina

    2015-01-01

    Context: Obesity and its associated morbidities pose a major health hazard to the public. Despite a multiplex of available diet and exercise programs for losing and maintaining weight, over the past years, interest in the use of complementary and alternative medicine (CAM) for obesity treatment has greatly increased. Evidence Acquisition: We searched PubMed, Google scholar and the Cochrane databases for systemic reviews, review articles, meta-analysis and randomized clinical trials up to December 2013. Results: In this review, the efficacy and safety of the more commonly used CAM methods for the treatment of obesity, namely herbal supplements, acupuncture, and non-invasive body-contouring, are briefly discussed. The evidence supporting the effectiveness and safety of these methods is either lacking or point to a negligible clinical benefit, barely surpassing that of the placebo. Furthermore, several limitations are observed in the available scientific literature. These shortcomings include, without being limited to, uncontrolled trial designs, non-random allocation of subjects to treatment arms, small number of patients enrolled, short durations of follow-up, and ambiguous clinical and laboratory endpoints. Conclusions: Further investigations are necessary to accurately determine the efficacy, safety, standard dosage/procedure, and potential side effects of the various CAM methods currently in use. PMID:25892995

  14. Supplements, nutrition, and alternative therapies for the treatment of traumatic brain injury.

    PubMed

    Lucke-Wold, Brandon P; Logsdon, Aric F; Nguyen, Linda; Eltanahay, Ahmed; Turner, Ryan C; Bonasso, Patrick; Knotts, Chelsea; Moeck, Adam; Maroon, Joseph C; Bailes, Julian E; Rosen, Charles L

    2016-10-05

    Studies using traditional treatment strategies for mild traumatic brain injury (TBI) have produced limited clinical success. Interest in treatment for mild TBI is at an all time high due to its association with the development of chronic traumatic encephalopathy and other neurodegenerative diseases, yet therapeutic options remain limited. Traditional pharmaceutical interventions have failed to transition to the clinic for the treatment of mild TBI. As such, many pre-clinical studies are now implementing non-pharmaceutical therapies for TBI. These studies have demonstrated promise, particularly those that modulate secondary injury cascades activated after injury. Because no TBI therapy has been discovered for mild injury, researchers now look to pharmaceutical supplementation in an attempt to foster success in human clinical trials. Non-traditional therapies, such as acupuncture and even music therapy are being considered to combat the neuropsychiatric symptoms of TBI. In this review, we highlight alternative approaches that have been studied in clinical and pre-clinical studies of TBI, and other related forms of neural injury. The purpose of this review is to stimulate further investigation into novel and innovative approaches that can be used to treat the mechanisms and symptoms of mild TBI.

  15. EVALUATION OF ALTERNATE STAINLESS STEEL SURFACE TREATMENTS FOR MASS SPECTROSCOPY AND OTHER TRITIUM SYSTEMS

    SciTech Connect

    Clark, E.; Mauldin, C.; Neikirk, K.

    2012-02-29

    There are specific components in the SRS Tritium Facilities that are required to introduce as few chemical impurities (such as protium and methane) as possible into the process gas. Two such components are the inlet systems for the mass spectroscopy facilities and hydrogen isotope mix standard containers. Two vendors now passivate stainless steel components for these systems, and both are relatively small businesses whose future viability can be questioned, which creates the need for new sources. Stainless steel containers were designed to evaluate alternate surface treatment vendors for tritium storage and handling for these high purity tritium systems. Five vendors applied their own 'best' surface treatments to two containers each - one was a current vendor, another was a chemical vapor deposited silicon coating, and the other three were electropolishing and chemical cleaning vendors. Pure tritium gas was introduced into all ten containers and the composition was monitored over time. The only observed impurities in the gas were some HT, less CT{sub 4}, and very small amounts of T{sub 2}O in all cases. The currently used vendor treated containers contained the least impurities. The chemical vapor deposited silicon treatment resulted in the highest impurity levels. Sampling one set of containers after about one month of tritium exposure revealed the impurity level to be nearly the same as that after more than a year of exposure - this result suggests that cleaning new stainless steel components by tritium gas contact for about a month may be a worthy operation.

  16. Chronic medical conditions among jail detainees in residential psychiatric treatment: a latent class analysis.

    PubMed

    Swartz, James A

    2011-08-01

    Studies of incarcerates with serious mental illnesses have found elevated rates of chronic medical conditions such as asthma and diabetes, and of infectious diseases such as tuberculosis compared with general population rates. This study explored the pattern of chronic medical conditions in a sample of adult detainees in psychiatric treatment in a large urban jail to develop a clinical profile encompassing the full range of medical conditions. A total of 431 male and female detainees were sampled with certainty from admissions to a residential psychiatric treatment program (overall recruitment rate = 67%). Interviews used the World Mental Health version of the Composite International Diagnostic Interview to assess psychiatric and substance use disorders per DSM-IV criteria and chronic medical conditions. Latent class analysis was conducted using 17 medical conditions as class indicators, yielding a 3-class model composed of: a latent class with a high to intermediate probability of multiple medical conditions (HMC; 12.5% of the sample); an intermediate class with a lower probability of having a smaller number of medical conditions (MMC; 43.2%); and a class with a low probability of any medical condition (44.3%). Those in the HMC class were more likely to report respiratory problems, severe headaches, musculoskeletal pain, hypertension, and arthritis, have greater functional impairment, and have a higher number of co-occurring psychiatric disorders. Being older (50+ years) and female were associated with higher odds of being in the HMC or MMC classes. The policy implications for providing medical care to incarcerates with complex mixtures of medical conditions and psychiatric disorders are considered.

  17. Surface treatment of Glassy Polymeric Carbon artifacts for medical applications

    SciTech Connect

    Rodrigues, M. G.; Zimmerman, R. L.; Rezende, M. C.

    1999-06-10

    Glassy Polymeric Carbon (GPC) has been used for mechanical cardiac valves. GCP valves are chemically biocompatible and durable, but less thromboresistant than biological valves. Enhanced thromboresistance of mechanical cardiac components with porous surface has been demonstrated. The endothelialized tissue blood-contacting surface adheres to the porous prosthetic component and decreases the formation of thrombus. Our experience has shown that the porosity of GPC can be increased and controlled by MeV ion bombardment. We report here that the surface roughness of heat-treated GPC bombarded with C, O, Si and Au is also enhanced. The surface roughness of the ion-bombarded samples is on a smaller scale than those roughened by sand blasting (measurements made with Perthomete S and P). The roughness decreases slightly after heat treatment, in linear proportion to the shrinkage of the test piece. Possible beneficial effects of the imbedded ions on tissue adherence and thromboresistance must be determined by in vivo animal experiments.

  18. Study of Managed Care Activities in USAF and other DoD Medical Treatment Facilities

    DTIC Science & Technology

    1990-07-27

    general medical and surgical capability, as well as outpatient surgery: physical therapy; neurology; pediatrics : ENT; primary care: OB-GYN; mental health...Number FTEs: Military 1029 + Civilian 270 zK E. Mission of MTF: Enhance Medical Readiness posture to MZ support the wartime mission; support the...DTIC .. ~F IAC TE JUL 01 1991 AD- A2 3 7 919 0 STUDY OF MANAGED CARE ACTIVITIES IN USAF AND OTHER DOD MEDICAL TREATMENT FACILITIES m 2, 0 a C 0 Mo I

  19. Current medical treatment of estrogen receptor-positive breast cancer

    PubMed Central

    Lumachi, Franco; Santeufemia, Davide A; Basso, Stefano MM

    2015-01-01

    Approximately 80% of breast cancers (BC) are estrogen receptor (ER)-positive and thus endocrine therapy (ET) should be considered complementary to surgery in the majority of patients. The advantages of oophorectomy, adrenalectomy and hypophysectomy in women with advanced BC have been demonstrated many years ago, and currently ET consist of (1) ovarian function suppression (OFS), usually obtained using gonadotropin-releasing hormone agonists (GnRHa); (2) selective estrogen receptor modulators or down-regulators (SERMs or SERDs); and (3) aromatase inhibitors (AIs), or a combination of two or more drugs. For patients aged less than 50 years and ER+ BC, there is no conclusive evidence that the combination of OFS and SERMs (i.e., tamoxifen) or chemotherapy is superior to OFS alone. Tamoxifen users exhibit a reduced risk of BC, both invasive and in situ, especially during the first 5 years of therapy, and extending the treatment to 10 years further reduced the risk of recurrences. SERDs (i.e., fulvestrant) are especially useful in the neoadjuvant treatment of advanced BC, alone or in combination with either cytotoxic agents or AIs. There are two types of AIs: type I are permanent steroidal inhibitors of aromatase, while type II are reversible nonsteroidal inhibitors. Several studies demonstrated the superiority of the third-generation AIs (i.e., anastrozole and letrozole) compared with tamoxifen, and adjuvant therapy with AIs reduces the recurrence risk especially in patients with advanced BC. Unfortunately, some cancers are or became ET-resistant, and thus other drugs have been suggested in combination with SERMs or AIs, including cyclin-dependent kinase 4/6 inhibitors (palbociclib) and mammalian target of rapamycin (mTOR) inhibitors, such as everolimus. Further studies are required to confirm their real usefulness. PMID:26322178

  20. H2S as a possible therapeutic alternative for the treatment of hypertensive kidney injury.

    PubMed

    Dugbartey, George J

    2017-04-01

    Hypertension is the most common cause of cardiovascular morbidities and mortalities, and a major risk factor for renal dysfunction. It is considered one of the causes of chronic kidney disease, which progresses into end-stage renal disease and eventually loss of renal function. Yet, the mechanism underlying the pathogenesis of hypertension and its associated kidney injury is still poorly understood. Moreover, despite existing antihypertensive therapies, achievement of blood pressure control and preservation of renal function still remain a worldwide public health challenge in a subset of hypertensive patients. Therefore, novel modes of intervention are in demand. Hydrogen sulfide (H2S), a gaseous signaling molecule, has been established to possess antihypertensive and renoprotective properties, which may represent an important therapeutic alternative for the treatment of hypertension and kidney injury. This review discusses recent findings about H2S in hypertension and kidney injury from both experimental and clinical studies. It also addresses future direction regarding therapeutic use of H2S.