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

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Medical charged-particle radiation therapy system...-particle radiation therapy system. (a) Identification. A medical charged-particle radiation therapy system...) intended for use in radiation therapy. This generic type of device may include signal analysis and display...

Targeted α-Particle Therapy of Bone Metastases in Prostate Cancer

PubMed Central

Jadvar, Hossein; Quinn, David I.

2013-01-01

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

Particle therapy of moving targets—the strategies for tumour motion monitoring and moving targets irradiation

PubMed Central

2016-01-01

Particle therapy of moving targets is still a great challenge. The motion of organs situated in the thorax and abdomen strongly affects the precision of proton and carbon ion radiotherapy. The motion is responsible for not only the dislocation of the tumour but also the alterations in the internal density along the beam path, which influence the range of particle beams. Furthermore, in case of pencil beam scanning, there is an interference between the target movement and dynamic beam delivery. This review presents the strategies for tumour motion monitoring and moving target irradiation in the context of hadron therapy. Methods enabling the direct determination of tumour position (fluoroscopic imaging of implanted radio-opaque fiducial markers, electromagnetic detection of inserted transponders and ultrasonic tumour localization systems) are presented. Attention is also drawn to the techniques which use external surrogate motion for an indirect estimation of target displacement during irradiation. The role of respiratory-correlated CT [four-dimensional CT (4DCT)] in the determination of motion pattern prior to the particle treatment is also considered. An essential part of the article is the review of the main approaches to moving target irradiation in hadron therapy: gating, rescanning (repainting), gated rescanning and tumour tracking. The advantages, drawbacks and development trends of these methods are discussed. The new accelerators, called “cyclinacs”, are presented, because their application to particle therapy will allow making a breakthrough in the 4D spot scanning treatment of moving organs. PMID:27376637

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

PubMed Central

Kraan, Aafke Christine

2015-01-01

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

Gantry for medical particle therapy facility

DOEpatents

Trbojevic, Dejan

2013-04-23

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

Gantry for medical particle therapy facility

DOEpatents

Trbojevic, Dejan [Wading River, NY

2012-05-08

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

The case for particle therapy.

PubMed

Jones, B

2006-01-01

Among the most important decisions facing the British Government regarding the treatment of cancer in the National Health Service (NHS) is the purchase of charged particle therapy (CPT) centres. CPT is different from conventional radiotherapy: the dose is deposited far more selectively in Bragg Peaks by either protons or "heavy" ions, such as carbon. In this way, it is possible to "dose paint" targets, voxel by voxel, with far less dose to surrounding tissues than with X-ray techniques. At present the UK possesses a 62 MeV cyclotron proton facility at Clatterbridge (Wirral), which provides therapy for intraocular cancers such as melanoma; for deeper situated cancers in the pelvis, chest etc., much higher energies, over 200 MeV are required from a synchrotron facility. There is an impressive expansion in particle beam therapy (PBT) centres worldwide, since they offer good prospects of improved quality of life with enhanced cancer cures in situations where conventional therapy is limited due to radioresistance or by the close proximity of critical normal tissues. There is a threat to UK Oncology, since it is anticipated that several thousand British patients may require referral abroad for therapy; this would severely disrupt their multidisciplinary management and require demanding logistical support.

Review of particle physics

DOE PAGES

Olive, K. A.

2016-10-01

The Review summarizes much of particle physics and cosmology. Using data from previous editions, plus 3,062 new measurements from 721 papers, we list, evaluate, and average measured properties of gauge bosons and the recently discovered Higgs boson, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as supersymmetric particles, heavy bosons, axions, dark photons, etc. All the particle properties and search limits are listed in Summary Tables. We also give numerous tables, figures, formulae, and reviews of topics such as Higgs Boson Physics, Supersymmetry, Grand Unified Theories, Neutrino Mixing, Dark Energy, Dark Matter, Cosmology, Particle Detectors, Colliders,more » Probability and Statistics. As a result, among the 117 reviews are many that are new or heavily revised, including those on Pentaquarks and Inflation.« less

Review of particle physics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Olive, K. A.

The Review summarizes much of particle physics and cosmology. Using data from previous editions, plus 3,062 new measurements from 721 papers, we list, evaluate, and average measured properties of gauge bosons and the recently discovered Higgs boson, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as supersymmetric particles, heavy bosons, axions, dark photons, etc. All the particle properties and search limits are listed in Summary Tables. We also give numerous tables, figures, formulae, and reviews of topics such as Higgs Boson Physics, Supersymmetry, Grand Unified Theories, Neutrino Mixing, Dark Energy, Dark Matter, Cosmology, Particle Detectors, Colliders,more » Probability and Statistics. As a result, among the 117 reviews are many that are new or heavily revised, including those on Pentaquarks and Inflation.« less

[Heavy particle radiation therapy].

PubMed

Lozares, S; Mañeru, F; Pellejero, S

2009-01-01

The characteristics of radiation formed by heavy particles make it a highly useful tool for therapeutic use. Protons, helium nuclei or carbon ions are being successfully employed in radiotherapy installations throughout the world. This article sets out the physical and technological foundations that make these radiation particles suitable for attacking white volume, as well as the different ways of administering treatment. Next, the main clinical applications are described, which show the therapeutic advantages in some of the pathologies most widely employed in proton and hadron therapy centres at present. Under continuous study, the clinical use of heavy particles appears to be an enormously promising path of advance in comparison with classical technologies, both in tumour coverage and in reducing dosages in surrounding tissue.

Review of Particle Physics

NASA Astrophysics Data System (ADS)

Patrignani, C.; Particle Data Group

2016-10-01

The Review summarizes much of particle physics and cosmology. Using data from previous editions, plus 3,062 new measurements from 721 papers, we list, evaluate, and average measured properties of gauge bosons and the recently discovered Higgs boson, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as supersymmetric particles, heavy bosons, axions, dark photons, etc. All the particle properties and search limits are listed in Summary Tables. We also give numerous tables, figures, formulae, and reviews of topics such as Higgs Boson Physics, Supersymmetry, Grand Unified Theories, Neutrino Mixing, Dark Energy, Dark Matter, Cosmology, Particle Detectors, Colliders, Probability and Statistics. Among the 117 reviews are many that are new or heavily revised, including those on Pentaquarks and Inflation. The complete Review is published online in a journal and on the website of the Particle Data Group (http://pdg.lbl.gov). The printed PDG Book contains the Summary Tables and all review articles but no longer includes the detailed tables from the Particle Listings. A Booklet with the Summary Tables and abbreviated versions of some of the review articles is also available. Contents Abstract, Contributors, Highlights and Table of ContentsAcrobat PDF (150 KB) IntroductionAcrobat PDF (456 KB) Particle Physics Summary Tables Gauge and Higgs bosonsAcrobat PDF (155 KB) LeptonsAcrobat PDF (134 KB) QuarksAcrobat PDF (84 KB) MesonsAcrobat PDF (871 KB) BaryonsAcrobat PDF (300 KB) Searches (Supersymmetry, Compositeness, etc.)Acrobat PDF (91 KB) Tests of conservation lawsAcrobat PDF (330 KB) Reviews, Tables, and Plots Detailed contents for this sectionAcrobat PDF (37 KB) Constants, Units, Atomic and Nuclear PropertiesAcrobat PDF (278 KB) Standard Model and Related TopicsAcrobat PDF (7.3 MB) Astrophysics and CosmologyAcrobat PDF (2.7 MB) Experimental Methods and CollidersAcrobat PDF (3.8 MB) Mathematical Tools or Statistics, Monte Carlo, Group

Overview of research and therapy facilities for radiobiological experimental work in particle therapy. Report from the European Particle Therapy Network radiobiology group.

PubMed

Dosanjh, Manjit; Jones, Bleddyn; Pawelke, Jörg; Pruschy, Martin; Sørensen, Brita Singers

2018-04-24

Particle therapy (PT) as cancer treatment, using protons or heavier ions, can provide a more favorable dose distribution compared to X-rays. While the physical characteristics of particle radiation have been the aim of intense research, less focus has been placed on the actual biological responses arising from particle irradiation. One of the biggest challenges for proton radiobiology is the RBE, with an increasing concern that the clinically-applied generic RBE-value of 1.1 is an approximation, as RBE is a complex quantity, depending on both biological and physical parameters, such as dose, LET, cellular and tissue radiobiological characteristics, as well as the endpoints being studied. Most of the available RBE data derive from in vitro experiments, with very limited in vivo data available, especially in late-reacting tissues, which provide the main constraints and influence the quality of life endpoints in radiotherapy. There is a need for systematic, large-scale studies to thoroughly establish the biology of particle radiation in a number of different experimental models in order to refine biophysical mathematical models that can potentially be used to guide PT. The overall objective of the European Particle Therapy Network (EPTN) WP6 is to form a network of research and therapy facilities in order to coordinate and standardize the radiobiological experiments, to obtain more accurate predictive parameters than in the past. Coordinated research is required in order to obtain the most appropriate experimental data. The aim in this paper is to describe the available radiobiology infrastructure of the centers involved in EPTN WP6. Copyright © 2018 Elsevier B.V. All rights reserved.

[Accuracy Check of Monte Carlo Simulation in Particle Therapy Using Gel Dosimeters].

PubMed

Furuta, Takuya

2017-01-01

Gel dosimeters are a three-dimensional imaging tool for dose distribution induced by radiations. They can be used for accuracy check of Monte Carlo simulation in particle therapy. An application was reviewed in this article. An inhomogeneous biological sample placing a gel dosimeter behind it was irradiated by carbon beam. The recorded dose distribution in the gel dosimeter reflected the inhomogeneity of the biological sample. Monte Carlo simulation was conducted by reconstructing the biological sample from its CT image. The accuracy of the particle transport by Monte Carlo simulation was checked by comparing the dose distribution in the gel dosimeter between simulation and experiment.

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

PubMed Central

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

2013-01-01

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

Prediction model of critical weight loss in cancer patients during particle therapy.

PubMed

Zhang, Zhihong; Zhu, Yu; Zhang, Lijuan; Wang, Ziying; Wan, Hongwei

2018-01-01

The objective of this study is to investigate the predictors of critical weight loss in cancer patients receiving particle therapy, and build a prediction model based on its predictive factors. Patients receiving particle therapy were enroled between June 2015 and June 2016. Body weight was measured at the start and end of particle therapy. Association between critical weight loss (defined as >5%) during particle therapy and patients' demographic, clinical characteristic, pre-therapeutic nutrition risk screening (NRS 2002) and BMI were evaluated by logistic regression and decision tree analysis. Finally, 375 cancer patients receiving particle therapy were included. Mean weight loss was 0.55 kg, and 11.5% of patients experienced critical weight loss during particle therapy. The main predictors of critical weight loss during particle therapy were head and neck tumour location, total radiation dose ≥70 Gy on the primary tumour, and without post-surgery, as indicated by both logistic regression and decision tree analysis. Prediction model that includes tumour locations, total radiation dose and post-surgery had a good predictive ability, with the area under receiver operating characteristic curve 0.79 (95% CI: 0.71-0.88) and 0.78 (95% CI: 0.69-0.86) for decision tree and logistic regression model, respectively. Cancer patients with head and neck tumour location, total radiation dose ≥70 Gy and without post-surgery were at higher risk of critical weight loss during particle therapy, and early intensive nutrition counselling or intervention should be target at this population. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A stochastic framework for spot-scanning particle therapy.

PubMed

Robini, Marc; Yuemin Zhu; Wanyu Liu; Magnin, Isabelle

2016-08-01

In spot-scanning particle therapy, inverse treatment planning is usually limited to finding the optimal beam fluences given the beam trajectories and energies. We address the much more challenging problem of jointly optimizing the beam fluences, trajectories and energies. For this purpose, we design a simulated annealing algorithm with an exploration mechanism that balances the conflicting demands of a small mixing time at high temperatures and a reasonable acceptance rate at low temperatures. Numerical experiments substantiate the relevance of our approach and open new horizons to spot-scanning particle therapy.

Deep Inspiration Breath Hold—Based Radiation Therapy: A Clinical Review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boda-Heggemann, Judit, E-mail: judit.boda-heggemann@umm.de; Knopf, Antje-Christin; Simeonova-Chergou, Anna

Several recent developments in linear accelerator–based radiation therapy (RT) such as fast multileaf collimators, accelerated intensity modulation paradigms like volumeric modulated arc therapy and flattening filter-free (FFF) high-dose-rate therapy have dramatically shortened the duration of treatment fractions. Deliverable photon dose distributions have approached physical complexity limits as a consequence of precise dose calculation algorithms and online 3-dimensional image guided patient positioning (image guided RT). Simultaneously, beam quality and treatment speed have continuously been improved in particle beam therapy, especially for scanned particle beams. Applying complex treatment plans with steep dose gradients requires strategies to mitigate and compensate for motion effectsmore » in general, particularly breathing motion. Intrafractional breathing-related motion results in uncertainties in dose delivery and thus in target coverage. As a consequence, generous margins have been used, which, in turn, increases exposure to organs at risk. Particle therapy, particularly with scanned beams, poses additional problems such as interplay effects and range uncertainties. Among advanced strategies to compensate breathing motion such as beam gating and tracking, deep inspiration breath hold (DIBH) gating is particularly advantageous in several respects, not only for hypofractionated, high single-dose stereotactic body RT of lung, liver, and upper abdominal lesions but also for normofractionated treatment of thoracic tumors such as lung cancer, mediastinal lymphomas, and breast cancer. This review provides an in-depth discussion of the rationale and technical implementation of DIBH gating for hypofractionated and normofractionated RT of intrathoracic and upper abdominal tumors in photon and proton RT.« less

TU-G-BRB-02: Clinical Trials in Particle Therapy - Open Questions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Choy, H.

2015-06-15

Proton therapy, in particular, and ion therapy, just beginning, are becoming an increasing focus of attention in clinical radiation oncology and medical physics. Both modalities have been criticized of lacking convincing evidence from randomized trials proving their efficacy, justifying the higher costs involved in these therapies. This session will provide an overview of the current status of clinical trials in proton therapy, including recent developments in ion therapy. As alluded to in the introductory talk by Dr. Schulte, opinions are diverging widely as to the usefulness and need for clinical trials in particle therapy and the challenge of equipoise. Themore » lectures will highlight some of the challenges that surround clinical trials in particle therapy. One, presented by Dr. Choy from UT Southwestern, is that new technology and even different types of particles such as helium and carbon ions are introduced into this environment, increasing the phase space of clinical variables. The other is the issue of medical physics quality assurance with physical phantoms, presented by Mrs. Taylor from IROC Houston, which is more challenging because 3D and 4D image guidance and active delivery techniques are in relatively early stages of development. The role of digital phantoms in developing clinical treatment planning protocols and as a QA tool will also be highlighted by Dr. Lee from NCI. The symposium will be rounded off by a panel discussion among the Symposium speakers, arguing pro or con the need and readiness for clinical trials in proton and ion therapy. Learning Objectives: To get an update on the current status of clinical trials allowing or mandating proton therapy. Learn about the status of planned clinical trials in the U.S. and worldwide involving ion therapy. Discuss the challenges in the design and QA of clinical trials in particle therapy. Learn about existing and future physical and computational anthropomorphic phantoms for charged particle

TU-G-BRB-00: Clinical Trials in Proton and Particle Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

2015-06-15

Proton therapy, in particular, and ion therapy, just beginning, are becoming an increasing focus of attention in clinical radiation oncology and medical physics. Both modalities have been criticized of lacking convincing evidence from randomized trials proving their efficacy, justifying the higher costs involved in these therapies. This session will provide an overview of the current status of clinical trials in proton therapy, including recent developments in ion therapy. As alluded to in the introductory talk by Dr. Schulte, opinions are diverging widely as to the usefulness and need for clinical trials in particle therapy and the challenge of equipoise. Themore » lectures will highlight some of the challenges that surround clinical trials in particle therapy. One, presented by Dr. Choy from UT Southwestern, is that new technology and even different types of particles such as helium and carbon ions are introduced into this environment, increasing the phase space of clinical variables. The other is the issue of medical physics quality assurance with physical phantoms, presented by Mrs. Taylor from IROC Houston, which is more challenging because 3D and 4D image guidance and active delivery techniques are in relatively early stages of development. The role of digital phantoms in developing clinical treatment planning protocols and as a QA tool will also be highlighted by Dr. Lee from NCI. The symposium will be rounded off by a panel discussion among the Symposium speakers, arguing pro or con the need and readiness for clinical trials in proton and ion therapy. Learning Objectives: To get an update on the current status of clinical trials allowing or mandating proton therapy. Learn about the status of planned clinical trials in the U.S. and worldwide involving ion therapy. Discuss the challenges in the design and QA of clinical trials in particle therapy. Learn about existing and future physical and computational anthropomorphic phantoms for charged particle

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

NASA Astrophysics Data System (ADS)

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

2016-05-01

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

TU-G-BRB-04: Digital Phantoms for Developing Protocols in Particle Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, C.

2015-06-15

Proton therapy, in particular, and ion therapy, just beginning, are becoming an increasing focus of attention in clinical radiation oncology and medical physics. Both modalities have been criticized of lacking convincing evidence from randomized trials proving their efficacy, justifying the higher costs involved in these therapies. This session will provide an overview of the current status of clinical trials in proton therapy, including recent developments in ion therapy. As alluded to in the introductory talk by Dr. Schulte, opinions are diverging widely as to the usefulness and need for clinical trials in particle therapy and the challenge of equipoise. Themore » lectures will highlight some of the challenges that surround clinical trials in particle therapy. One, presented by Dr. Choy from UT Southwestern, is that new technology and even different types of particles such as helium and carbon ions are introduced into this environment, increasing the phase space of clinical variables. The other is the issue of medical physics quality assurance with physical phantoms, presented by Mrs. Taylor from IROC Houston, which is more challenging because 3D and 4D image guidance and active delivery techniques are in relatively early stages of development. The role of digital phantoms in developing clinical treatment planning protocols and as a QA tool will also be highlighted by Dr. Lee from NCI. The symposium will be rounded off by a panel discussion among the Symposium speakers, arguing pro or con the need and readiness for clinical trials in proton and ion therapy. Learning Objectives: To get an update on the current status of clinical trials allowing or mandating proton therapy. Learn about the status of planned clinical trials in the U.S. and worldwide involving ion therapy. Discuss the challenges in the design and QA of clinical trials in particle therapy. Learn about existing and future physical and computational anthropomorphic phantoms for charged particle

Alternatives to Testosterone Therapy: A Review.

PubMed

Lo, Eric M; Rodriguez, Katherine M; Pastuszak, Alexander W; Khera, Mohit

2018-01-01

Although testosterone therapy (TTh) is an effective treatment for hypogonadism, recent concerns regarding its safety have been raised. In 2015, the US Food and Drug Administration issued a warning about potential cardiovascular risks resulting from TTh. Fertility preservation is another reason to search for viable alternative therapies to conventional TTh, and in this review we evaluate the literature examining these alternatives. To review the role and limitations of non-testosterone treatments for hypogonadism. A literature search was conducted using PubMed to identify relevant studies examining medical and non-medical alternatives to TTh. Search terms included hypogonadism, testosterone replacement therapy, testosterone therapy, testosterone replacement alternatives, diet and exercise and testosterone, varicocele repair and testosterone, stress reduction and testosterone, and sleep apnea and testosterone. Review of peer-reviewed literature. Medical therapies examined include human chorionic gonadotropins, aromatase inhibitors, and selective estrogen receptor modulators. Non-drug therapies that are reviewed include lifestyle modifications including diet and exercise, improvements in sleep, decreasing stress, and varicocele repair. The high prevalence of obesity and metabolic syndrome in the United States suggests that disease modification could represent a viable treatment approach for affected men with hypogonadism. These alternatives to TTh can increase testosterone levels and should be considered before TTh. Lo EM, Rodriguez KM, Pastuszak AW, Khera M. Alternatives to Testosterone Therapy: A Review. Sex Med Rev 2018;6:106-113. Copyright © 2017. Published by Elsevier Inc.

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

PubMed

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

2016-04-26

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

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

PubMed Central

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

2016-01-01

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

Advanced cell therapies: targeting, tracking and actuation of cells with magnetic particles.

PubMed

Connell, John J; Patrick, P Stephen; Yu, Yichao; Lythgoe, Mark F; Kalber, Tammy L

2015-01-01

Regenerative medicine would greatly benefit from a new platform technology that enabled measurable, controllable and targeting of stem cells to a site of disease or injury in the body. Superparamagnetic iron-oxide nanoparticles offer attractive possibilities in biomedicine and can be incorporated into cells, affording a safe and reliable means of tagging. This review describes three current and emerging methods to enhance regenerative medicine using magnetic particles to guide therapeutic cells to a target organ; track the cells using MRI and assess their spatial localization with high precision and influence the behavior of the cell using magnetic actuation. This approach is complementary to the systemic injection of cell therapies, thus expanding the horizon of stem cell therapeutics.

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

PubMed Central

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

2016-01-01

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

Faster-than-Light Particles: A Review of Tachyon Characteristics.

DTIC Science & Technology

1980-10-01

A-DlAO9(4 529 RAND CORP SANTA MNtICA CA F/6 20/S FASTER-THAN-LIBI4T PARTICLES: A REVIEW OF TACHYON CHARACTERISTIC--ETCWU) OCT B0 E A PUSCHER F49620...77-C-0023 UNCLASSIFIED RAI0IN-1530-AF N. I nmui ininmuuuI LEVEL A RAND NOTE FASTER-THAN-LIGHT PARTICLES: A REVIEW OF ) ( TACHYON CHARACTERISTICS Edward...RECIPIENT’S CATALOG NUMBER 4TIT LE ( d Subtitle) TYPE OF REPORT & PERIOD COVERED ( Faster-than-Light Particles: A Review of /Interim -i Tachyon

Family Therapy and Parent Training: An Integrative Review.

ERIC Educational Resources Information Center

Levinger, Ann Cotton

This paper, written for counselors, psychologists, and educators, presents an integrative review of family therapy and parent training literature. Following the introduction, section 2 reviews family systems theory and family therapy; a definition of family therapy, a historical perspective, and theories of family systems, including the…

Conformal Electromagnetic Particle in Cell: A Review

DOE PAGES

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

2015-10-26

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

WE-FG-BRB-04: RBEs for Human Lung Cancer Cells Exposed to Protons and Heavier Ions: Implications for Clinical Use of Charged Particles in Cancer Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Held, K.

The physical pattern of energy deposition and the enhanced relative biological effectiveness (RBE) of protons and carbon ions compared to photons offer unique and not fully understood or exploited opportunities to improve the efficacy of radiation therapy. Variations in RBE within a pristine or spread out Bragg peak and between particle types may be exploited to enhance cell killing in target regions without a corresponding increase in damage to normal tissue structures. In addition, the decreased sensitivity of hypoxic tumors to photon-based therapies may be partially overcome through the use of more densely ionizing radiations. These and other differences betweenmore » particle and photon beams may be used to generate biologically optimized treatments that reduce normal tissue complications. In this symposium, speakers will examine the impact of the RBE of charged particles on measurable biological endpoints, treatment plan optimization, and the prediction or retrospective assessment of treatment outcomes. In particular, an AAPM task group was formed to critically examine the evidence for a spatially-variant RBE in proton therapy. Current knowledge of proton RBE variation with respect to dose, biological endpoint, and physics parameters will be reviewed. Further, the clinical relevance of these variations will be discussed. Recent work focused on improving simulations of radiation physics and biological response in proton and carbon ion therapy will also be presented. Finally, relevant biology research and areas of research needs will be highlighted, including the dependence of RBE on genetic factors including status of DNA repair pathways, the sensitivity of cancer stem-like cells to charged particles, the role of charged particles in hypoxic tumors, and the importance of fractionation effects. In addition to the physical advantages of protons and more massive ions over photons, the future application of biologically optimized treatment plans and their

REVIEWS OF TOPICAL PROBLEMS: The search for dark matter particles

NASA Astrophysics Data System (ADS)

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

2008-11-01

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

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

PubMed

Zeitlin, Cary; La Tessa, Chiara

2016-01-01

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

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

PubMed Central

Zeitlin, Cary; La Tessa, Chiara

2016-01-01

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

Massage therapy research review

PubMed Central

Field, Tiffany

2017-01-01

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

Massage therapy research review.

PubMed

Field, Tiffany

2016-08-01

In this review, massage therapy has been shown to have beneficial effects on varying conditions including prenatal depression, preterm infants, full-term infants, autism, skin conditions, pain syndromes including arthritis and fibromyalgia, hypertension, autoimmune conditions including asthma and multiple sclerosis, immune conditions including HIV and breast cancer and aging problems including Parkinson's and dementia. Although many of the studies have involved comparisons between massage therapy and standard treatment control groups, several have compared different forms of massage (e.g. Swedish versus Thai massage), and different active therapies such as massage versus exercise. Typically, the massage therapy groups have experienced more positive effects than the control or comparison groups. This may relate to the massage therapy providing more stimulation of pressure receptors, in turn enhancing vagal activity and reducing cortisol levels. Some of the researchers have assessed physical, physiological and biochemical effects, although most have relied exclusively on self-report measures. Despite these methodological problems and the dearth of research from the U.S., the massage therapy profession has grown significantly and massage therapy is increasingly practiced in traditional medical settings, highlighting the need for more rigorous research. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

2009-03-01

As aggressive, 3D-conformal treatment has become the clearly accepted goal of radiation oncology, heavy charged-particle treatment with protons and heavier ions has concurrently and relentlessly ascended to the forefront. Protons and helium nuclei, with relatively low linear-energy-transfer (LET) properties, have consistently been demonstrated to be beneficial for aggressive (high-dose) local treatment of many types of tumors. Protons have been applied to the majority of solid tumors, and have reached a high degree of general acceptance in radiation oncology after three decades and 55,000 patients treated. However, some 15% to 20% of tumor types have proven resistant to even the most aggressive low-LET irradiation. For these radio-resistant tumors, treatment with heavier ions (e.g., carbon) offers great potential benefit. These high-LET particles have increased relative biological effectiveness (RBE) that reaches its maximum in the Bragg peak. Irradiation with these heavier ions offers the unique combination of excellent 3D-dose distribution and increased RBE. We are presently witnessing several, important parallel developments in particle therapy. Protons will likely continue their exponential growth phase, and more compact design systems will make protons available to a larger patient population—thus becoming the "heavy charged particle of choice" for Cancer Centers with limited financial resources. In parallel, major academic efforts will further advance the field of heavier ion therapy, exploring all opportunities for particle treatment and continuing the search for the ideal particle(s) for specific tumors. The future of ion therapy will be best realized by clinical trials that have ready access to top-quality delivery of both protons and heavier ions that can be accurately shaped for treatment of a specific pathology, and which will permit direct randomized-trial comparison of the effectiveness of the various ions for different diseases. Optimal results

3-dimensional beam scanning system for particle radiation therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leemann, C.; Alonso, J.; Grunder, H.

1977-03-01

In radiation therapy treatment volumes up to several liters have to be irradiated. Today's charged particle programs use ridge filters, scattering foils, occluding rings collimators and boluses to shape the dose distribution. An alternative approach, scanning of a small diameter beam, is analyzed and tentative systems specifications are derived. Critical components are scheduled for fabrication and testing at LBL.

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

NASA Astrophysics Data System (ADS)

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

2014-09-01

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

Accelerators for charged particle therapy: PAMELA and related issues

NASA Astrophysics Data System (ADS)

Peach, Ken

2014-05-01

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

Comparison of the Light Charged Particles on Scatter Radiation Dose in Thyroid Hadron Therapy

PubMed Central

Azizi, M; Mowlavi, AA

2014-01-01

Background: Hadron therapy is a novel technique of cancer radiation therapy which employs charged particles beams, 1H and light ions in particular. Due to their physical and radiobiological properties, they allow one to obtain a more conformal treatment, sparing better the healthy tissues located in proximity of the tumor and allowing a higher control of the disease. Objective: As it is well known, these light particles can interact with nuclei in the tissue, and produce the different secondary particles such as neutron and photon. These particles can damage specially the critical organs behind of thyroid gland. Methods: In this research, we simulated neck geometry by MCNPX code and calculated the light particles dose at distance of 2.14 cm in thyroid gland, for different particles beam: 1H, 2H, 3He, and 4He. Thyroid treatment is important because the spine and vertebrae is situated right behind to the thyroid gland on the posterior side. Results: The results show that 2H has the most total flux for photon and neutron, 1.944E-3 and 1.7666E-2, respectively. Whereas 1H and 3He have best conditions, 8.88609E-4 and 1.35431E-3 for photon, 4.90506E-4 and 4.34057E-3 for neutron, respectively. The same calculation has obtained for energy depositions for these particles. Conclusion: In this research, we investigated that which of these light particles can deliver the maximum dose to the normal tissues and the minimum dose to the tumor. By comparing these results for the mentioned light particles, we find out 1H and 3He is the best therapy choices for thyroid glands whereas 2H is the worst. PMID:25505774

Optimization and verification of image reconstruction for a Compton camera towards application as an on-line monitor for particle therapy

NASA Astrophysics Data System (ADS)

Taya, T.; Kataoka, J.; Kishimoto, A.; Tagawa, L.; Mochizuki, S.; Toshito, T.; Kimura, M.; Nagao, Y.; Kurita, K.; Yamaguchi, M.; Kawachi, N.

2017-07-01

Particle therapy is an advanced cancer therapy that uses a feature known as the Bragg peak, in which particle beams suddenly lose their energy near the end of their range. The Bragg peak enables particle beams to damage tumors effectively. To achieve precise therapy, the demand for accurate and quantitative imaging of the beam irradiation region or dosage during therapy has increased. The most common method of particle range verification is imaging of annihilation gamma rays by positron emission tomography. Not only 511-keV gamma rays but also prompt gamma rays are generated during therapy; therefore, the Compton camera is expected to be used as an on-line monitor for particle therapy, as it can image these gamma rays in real time. Proton therapy, one of the most common particle therapies, uses a proton beam of approximately 200 MeV, which has a range of ~ 25 cm in water. As gamma rays are emitted along the path of the proton beam, quantitative evaluation of the reconstructed images of diffuse sources becomes crucial, but it is far from being fully developed for Compton camera imaging at present. In this study, we first quantitatively evaluated reconstructed Compton camera images of uniformly distributed diffuse sources, and then confirmed that our Compton camera obtained 3 %(1 σ) and 5 %(1 σ) uniformity for line and plane sources, respectively. Based on this quantitative study, we demonstrated on-line gamma imaging during proton irradiation. Through these studies, we show that the Compton camera is suitable for future use as an on-line monitor for particle therapy.

Photodynamic therapy in endodontics: a literature review.

PubMed

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

2015-03-01

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

Life Review: Implementation, Theory, Research, and Therapy

ERIC Educational Resources Information Center

Haber, David

2006-01-01

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

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

PubMed Central

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

2011-01-01

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

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

PubMed

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

2015-05-01

Breast cancer is a global health concern. In fact, breast cancer is the primary cause of death among women worldwide and constitutes the most expensive malignancy to treat. As health care resources are finite, decisions regarding the adoption and coverage of breast cancer treatments are increasingly being based on "value for money," i.e., cost-effectiveness. As the evidence about the cost-effectiveness of breast cancer treatments is abundant, therefore difficult to navigate, systematic reviews of published systematic reviews offer the advantage of bringing together the results of separate systematic reviews in a single report. As a consequence, this paper presents an overview of systematic reviews of the cost-effectiveness of hormone therapy, chemotherapy, and targeted therapy for breast cancer to inform policy and reimbursement decision-making. A systematic review was conducted of published systematic reviews documenting cost-effectiveness analyses of breast cancer treatments from 2000 to 2014. Systematic reviews identified through a literature search of health and economic databases were independently assessed against inclusion and exclusion criteria. Systematic reviews of original evaluations were included only if they targeted breast cancer patients and specific breast cancer treatments (hormone therapy, chemotherapy, and targeted therapy only), documented incremental cost-effectiveness ratios, and were reported in the English language. The search strategy used a combination of these key words: "breast cancer," "systematic review/meta-analysis," and "cost-effectiveness/economics." Data were extracted using predefined extraction forms and qualitatively appraised using the assessment of multiple systematic reviews (AMSTAR) tool. The literature search resulted in 511 bibliographic records, of which ten met our inclusion criteria. Five reviews were conducted in the early-stage breast cancer setting and five reviews in the metastatic setting. In early-stage breast

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

PubMed Central

Diaby, Vakaramoko; Xiao, Hong; Montero, Alberto J.

2015-01-01

Breast cancer is a global health concern. In fact, breast cancer is the primary cause of death among women worldwide and constitutes the most expensive malignancy to treat. As health care resources are finite, decisions regarding the adoption and coverage of breast cancer treatments are increasingly being based on “value for money,” i.e., cost-effectiveness. As the evidence about the cost-effectiveness of breast cancer treatments is abundant, therefore difficult to navigate, systematic reviews of published systematic reviews offer the advantage of bringing together the results of separate systematic reviews in a single report. As a consequence, this paper presents an overview of systematic reviews of the cost-effectiveness of hormone therapy, chemotherapy, and targeted therapy for breast cancer to inform policy and reimbursement decision-making. A systematic review was conducted of published systematic reviews documenting cost-effectiveness analyses of breast cancer treatments from 2000 to 2014. Systematic reviews identified through a literature search of health and economic databases were independently assessed against inclusion and exclusion criteria. Systematic reviews of original evaluations were included only if they targeted breast cancer patients and specific breast cancer treatments (hormone therapy, chemotherapy, and targeted therapy only), documented incremental cost-effectiveness ratios, and were reported in the English language. The search strategy used a combination of these key words: “breast cancer,” “systematic review/meta-analysis,” and “cost-effectiveness/economics.” Data were extracted using predefined extraction forms and qualitatively appraised using the assessment of multiple systematic reviews (AMSTAR) tool. The literature search resulted in 511 bibliographic records, of which ten met our inclusion criteria. Five reviews were conducted in the early-stage breast cancer setting and five reviews in the metastatic setting. In

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

PubMed

Sun, Yongda

2014-01-01

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

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

PubMed

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

2011-06-03

Ionizing radiation causes many types of DNA damage, including base damage and single- and double-strand breaks. Photons, including X-rays and γ-rays, are the most widely used type of ionizing radiation in radiobiology experiments, and in radiation cancer therapy. Charged particles, including protons and carbon ions, are seeing increased use as an alternative therapeutic modality. Although the facilities needed to produce high energy charged particle beams are more costly than photon facilities, particle therapy has shown improved cancer survival rates, reflecting more highly focused dose distributions and more severe DNA damage to tumor cells. Despite early successes of charged particle radiotherapy, there is room for further improvement, and much remains to be learned about normal and cancer cell responses to charged particle radiation. 2011 Elsevier B.V. All rights reserved.

Alternative therapies for chronic rhinosinusitis: A review.

PubMed

Griffin, Aaron S; Cabot, Peter; Wallwork, Ben; Panizza, Ben

2018-03-01

The use of alternative medicine in chronic rhinosinusitis (CRS) continues to increase in popularity, for the most part without meeting the burden of being based on sound clinical evidence. New and emerging treatments, both natural and developed, are numerous, and it remains a challenge for otolaryngologists as well as general practitioners to keep up to date with these therapies and their efficacy. In this systematic review, we discuss a number of alternative therapies for CRS, their proposed physiologic mechanisms, and evidence supporting their use. This analysis is based on our review of the English-language literature on alternative therapies for CRS (we did not include any therapies that are already recommended by accepted professional bodies). Data collection was performed using the PubMed database (not restricted to MEDLINE due to the nature of the subject matter), the Cochrane databases, and bibliography searches. We found that while many of the alternative therapies we reviewed might have a firm basis in science, they lack any clinical evidence to support their use specifically for CRS. Some emerging therapies, such as therapeutic ultrasonography and phonophoresis, show some promise, based on a growing body of positive evidence. In addition, the use of baby shampoo, thyme honey, and bromelain additives to saline lavage in CRS are all supported by clinical evidence, as is Sinupret, an oral preparation that contains echinacea. However, higher levels of evidence gleaned from large, well-designed, prospective, randomized, controlled trials are needed before any of these therapies can be recommended.

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

PubMed Central

2012-01-01

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

The cognitive treatment components and therapies of cognitive behavioral therapy for insomnia: A systematic review.

PubMed

Jansson-Fröjmark, Markus; Norell-Clarke, Annika

2018-06-07

Since the beginning of the twenty-first century, there has been an increased focus on developing and testing cognitive components and therapies for insomnia disorder. The aim of the current review was thus to describe and review the efficacy of cognitive components and therapies for insomnia. A systematic review was conducted on 32 studies (N = 1455 subjects) identified through database searches. Criteria for inclusion required that each study constituted a report of outcome from a cognitive component or therapy, that the study had a group protocol, adult participants with diagnosed insomnia or undiagnosed insomnia symptoms or reported poor sleep, and that the study was published until and including 2016 in English. Each study was systematically reviewed with a standard coding sheet. Several cognitive components, a multi-component cognitive program, and cognitive therapy were identified. It is concluded that there is support for paradoxical intention and cognitive therapy. There are also other cognitive interventions that appears promising, such as cognitive refocusing and behavioral experiments. For most interventions, the study quality was rated as low to moderate. We conclude that several cognitive treatment components and therapies can be viewed as efficacious or promising interventions for patients with insomnia disorder. Methodologically stronger studies are, however, warranted. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

PubMed

Schell, S; Wilkens, J J

2012-03-07

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

Spectrum of Art Therapy Practice: Systematic Literature Review of "Art Therapy," 1983-2014

ERIC Educational Resources Information Center

Potash, Jordan S.; Mann, Sarah M.; Martinez, Johanna C.; Roach, Ann B.; Wallace, Nina M.

2016-01-01

The objective of this study was to determine art therapists' fit in the continuum of health delivery services defined by behavioral health. All publications in "Art Therapy: Journal of the American Art" Therapy Association from 1983 (Volume 1) to 2014 (Volume 31) were systematically reviewed to understand how art therapy has been…

Autism and Mind-Body Therapies: A Systematic Review.

PubMed

Hourston, Sarah; Atchley, Rachel

2017-05-01

Mind-body therapies are often used by people with autism spectrum disorders (ASD). However, there has been little examination into which types of mind-body therapies have been investigated for people with ASD and for what purposes. A systematic review was conducted to evaluate the existing evidence for mind-body therapies for people with ASD, particularly to determine the types of mind-body therapies used and the outcomes that are targeted. PubMed, PsychInfo, and Scopus were searched using terms for ASD and mind-body therapies. Sixteen studies were selected for review; these studies tested interventions using mindfulness, meditation, yoga, Nei Yang Gong, and acceptance commitment therapy. Most study outcomes targeted behavior, psychological symptoms, and quality of life for children and adults with ASD as well as their parents. There was little overlap between studies on the types of mind-body therapies used and associated outcomes, and only three of the studies were randomized controlled trials. Most studies were small and uncontrolled. Some studies modified the mind-body therapies to increase accessibility for people with ASD. The evidence for mind-body therapies for people with ASD is limited and would benefit from larger randomized controlled trials.

E-therapy for mental health problems: a systematic review.

PubMed

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

2008-09-01

The widespread availability of the Internet offers opportunities for improving access to therapy for people with mental health problems. There is a seemingly infinite supply of Internet-based interventions available on the World Wide Web. The aim of the present study is to systematically assess the methodological quality of randomized controlled trials (RCTs) concerning e-therapy for mental health problems. Two reviewers independently assessed the methodological quality of the RCTs, based on a list of criteria for the methodological quality assessment as recommended by the Cochrane Back Review Group. The search yielded 14 papers that reported RCTs concerning e-therapy for mental-health problems. The methodological quality of studies included in this review was generally low. It is concluded that e-therapy may turn out to be an appropriate therapeutic entity, but the evidence needs to be more convincing. Recommendations are made concerning the method of reporting RCTs and the need to add some content items to an e-therapy study.

Combination therapy for erectile dysfunction: an update review.

PubMed

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

2011-05-01

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

Modeling Cell and Tumor-Metastasis Dosimetry with the Particle and Heavy Ion Transport Code System (PHITS) Software for Targeted Alpha-Particle Radionuclide Therapy.

PubMed

Lee, Dongyoul; Li, Mengshi; Bednarz, Bryan; Schultz, Michael K

2018-06-26

The use of targeted radionuclide therapy for cancer is on the rise. While beta-particle-emitting radionuclides have been extensively explored for targeted radionuclide therapy, alpha-particle-emitting radionuclides are emerging as effective alternatives. In this context, fundamental understanding of the interactions and dosimetry of these emitted particles with cells in the tumor microenvironment is critical to ascertaining the potential of alpha-particle-emitting radionuclides. One important parameter that can be used to assess these metrics is the S-value. In this study, we characterized several alpha-particle-emitting radionuclides (and their associated radionuclide progeny) regarding S-values in the cellular and tumor-metastasis environments. The Particle and Heavy Ion Transport code System (PHITS) was used to obtain S-values via Monte Carlo simulation for cell and tumor metastasis resulting from interactions with the alpha-particle-emitting radionuclides, lead-212 ( 212 Pb), actinium-225 ( 225 Ac) and bismuth-213 ( 213 Bi); these values were compared to the beta-particle-emitting radionuclides yttrium-90 ( 90 Y) and lutetium-177 ( 177 Lu) and an Auger-electron-emitting radionuclide indium-111 ( 111 In). The effect of cellular internalization on S-value was explored at increasing degree of internalization for each radionuclide. This aspect of S-value determination was further explored in a cell line-specific fashion for six different cancer cell lines based on the cell dimensions obtained by confocal microscopy. S-values from PHITS were in good agreement with MIRDcell S-values (cellular S-values) and the values found by Hindié et al. (tumor S-values). In the cellular model, 212 Pb and 213 Bi decay series produced S-values that were 50- to 120-fold higher than 177 Lu, while 225 Ac decay series analysis suggested S-values that were 240- to 520-fold higher than 177 Lu. S-values arising with 100% cellular internalization were two- to sixfold higher for the nucleus

Music therapy for palliative care: A realist review.

PubMed

McConnell, Tracey; Porter, Sam

2017-08-01

Music therapy has experienced a rising demand as an adjunct therapy for symptom management among palliative care patients. We conducted a realist review of the literature to develop a greater understanding of how music therapy might benefit palliative care patients and the contextual mechanisms that promote or inhibit its successful implementation. We searched electronic databases (CINAHL, Embase, Medline, and PsychINFO) for literature containing information on music therapy for palliative care. In keeping with the realist approach, we examined all relevant literature to develop theories that could explain how music therapy works. A total of 51 articles were included in the review. Music therapy was found to have a therapeutic effect on the physical, psychological, emotional, and spiritual suffering of palliative care patients. We also identified program mechanisms that help explain music therapy's therapeutic effects, along with facilitating contexts for implementation. Music therapy may be an effective nonpharmacological approach to managing distressing symptoms in palliative care patients. The findings also suggest that group music therapy may be a cost-efficient and effective way to support staff caring for palliative care patients. We encourage others to continue developing the evidence base in order to expand our understanding of how music therapy works, with the aim of informing and improving the provision of music therapy for palliative care patients.

Nonstatin therapies for management of dyslipidemia: a review.

PubMed

Sando, Karen R; Knight, Michelle

2015-10-01

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States. Recently published cholesterol treatment guidelines emphasize the use of statins as the preferred treatment strategy for both primary and secondary prevention of CVD. However, the optimal treatment strategy for patients who cannot tolerate statin therapy or those who need additional lipid-lowering therapy is unclear in light of recent evidence that demonstrates a lack of improved cardiovascular outcomes with combination therapy. The purpose of this review is to summarize and interpret evidence that evaluates nonstatin drug classes in reducing cardiovascular outcomes, to provide recommendations for use of nonstatin therapies in clinical practice, and to review emerging nonstatin therapies for management of dyslipidemia. Relevant articles were identified through searches of PubMed, International Pharmaceutical Abstracts, and the Cochrane Database of Systematic Reviews by using the terms niacin, omega-3 fatty acids (FAs), clofibrate, fibrate, fenofibrate, fenofibric acid, gemfibrozil, cholestyramine, colestipol, colesevelam, ezetimibe, proprotein convertase subtilisin/kexin 9 (PCSK9), cholesteryl ester transfer protein (CETP), and cardiovascular outcomes. Only English language, human clinical trials, meta-analyses, and systematic reviews were included. Additional references were identified from citations of published articles. Niacin may reduce cardiovascular events as monotherapy; however, recent trials in combination with statins have failed to show a benefit. Trials with omega-3 FAs have failed to demonstrate significant reductions in cardiovascular outcomes. Fibrates may improve cardiovascular outcomes as monotherapy; however, trials in combination with statins have failed to show a benefit, except in those with elevated triglycerides (>200 mg/dL) or low HDL-C (<40 mg/dL). There is a lack of data that evaluates bile acid sequestrant in combination with statin therapy

Autism and Mind–Body Therapies: A Systematic Review

PubMed Central

2017-01-01

Abstract Background: Mind–body therapies are often used by people with autism spectrum disorders (ASD). However, there has been little examination into which types of mind–body therapies have been investigated for people with ASD and for what purposes. A systematic review was conducted to evaluate the existing evidence for mind–body therapies for people with ASD, particularly to determine the types of mind–body therapies used and the outcomes that are targeted. Methods: PubMed, PsychInfo, and Scopus were searched using terms for ASD and mind–body therapies. Sixteen studies were selected for review; these studies tested interventions using mindfulness, meditation, yoga, Nei Yang Gong, and acceptance commitment therapy. Most study outcomes targeted behavior, psychological symptoms, and quality of life for children and adults with ASD as well as their parents. Results: There was little overlap between studies on the types of mind–body therapies used and associated outcomes, and only three of the studies were randomized controlled trials. Most studies were small and uncontrolled. Some studies modified the mind–body therapies to increase accessibility for people with ASD. Conclusion: The evidence for mind–body therapies for people with ASD is limited and would benefit from larger randomized controlled trials. PMID:28437148

The history of couple therapy: a millennial review.

PubMed

Gurman, Alan S; Fraenkel, Peter

2002-01-01

In this article, we review the major conceptual and clinical influences and trends in the history of couple therapy to date, and also chronicle the history of research on couple therapy. The evolving patterns in theory and practice are reviewed as having progressed through four distinctive phases: Phase I--Atheoretical Marriage Counseling Formation (1930-1963); Phase II--Psychoanalytic Experimentation (1931-1966); Phase III--Family Therapy Incorporation (1963-1985); and Phase IV--Refinement, Extension, Diversification, and Integration (1986-present). The history of research in the field is described as having passed through three phases: Phase I--A Technique in Search of Some Data (1930-1974), Phase II--Irrational(?) Exuberance (1975-1992), and Phase III--Caution and Extension (1993-present). The article concludes with the identification of Four Great Historical Ironies in the History of Couple Therapy.

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

NASA Astrophysics Data System (ADS)

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

2014-02-01

Cyclotrons and first generation synchrotrons are the commonly applied accelerators in medical particle therapy nowadays. Next generation accelerators such as Rapid Cycling Medical Synchrotrons (RCMS), direct drive accelerators, or dielectric wall accelerators have the potential to improve the existing accelerator techniques in this field. Innovative accelerator concepts for medical particle therapy can benefit from ion sources which meet their special requirements. In the present paper we report on measurements with a superconducting Electron Beam Ion Source, the Dresden EBIS-SC, under the aspect of application in combination with RCMS as a well proven technology. The measurements indicate that this ion source can offer significant advantages for medical particle therapy. We show that a superconducting EBIS can deliver ion pulses of medically relevant ions such as protons, C4 + and C6 + ions with intensities and frequencies required for RCMS [S. Peggs and T. Satogata, "A survey of Hadron therapy accelerator technology," in Proceedings of PAC07, BNL-79826- 2008-CP, Albuquerque, New Mexico, USA, 2007; A. Garonna, U. Amaldi et al., "Cyclinac medical accelerators using pulsed C6 +/H+_2 ion sources," in Proceedings of EBIST 2010, Stockholm, Sweden, July 2010]. Ion extraction spectra as well as individual ion pulses have been measured. For example, we report on the generation of proton pulses with up to 3 × 109 protons per pulse and with frequencies of up to 1000 Hz at electron beam currents of 600 mA.

An updated review of the efficacy of cupping therapy.

PubMed

Cao, Huijuan; Li, Xun; Liu, Jianping

2012-01-01

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

An Updated Review of the Efficacy of Cupping Therapy

PubMed Central

Cao, Huijuan; Li, Xun; Liu, Jianping

2012-01-01

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

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

PubMed

Hilliard, Russell E

2006-01-01

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

A State-of-the-Art Review: Personalization of Tinnitus Sound Therapy.

PubMed

Searchfield, Grant D; Durai, Mithila; Linford, Tania

2017-01-01

Background: There are several established, and an increasing number of putative, therapies using sound to treat tinnitus. There appear to be few guidelines for sound therapy selection and application. Aim: To review current approaches to personalizing sound therapy for tinnitus. Methods: A "state-of-the-art" review (Grant and Booth, 2009) was undertaken to answer the question: how do current sound-based therapies for tinnitus adjust for tinnitus heterogeneity? Scopus, Google Scholar, Embase and PubMed were searched for the 10-year period 2006-2016. The search strategy used the following key words: "tinnitus" AND "sound" AND "therapy" AND "guidelines" OR "personalized" OR "customized" OR "individual" OR "questionnaire" OR "selection." The results of the review were cataloged and organized into themes. Results: In total 165 articles were reviewed in full, 83 contained sufficient details to contribute to answering the study question. The key themes identified were hearing compensation, pitched-match therapy, maskability, reaction to sound and psychosocial factors. Although many therapies mentioned customization, few could be classified as being personalized. Several psychoacoustic and questionnaire-based methods for assisting treatment selection were identified. Conclusions: Assessment methods are available to assist clinicians to personalize sound-therapy and empower patients to be active in therapy decision-making. Most current therapies are modified using only one characteristic of the individual and/or their tinnitus.

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

PubMed

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

2009-01-01

This review gives an overview of the current state of research regarding the effectiveness of mirror therapy in upper extremity function. A systematic literature search was performed to identify studies concerning mirror therapy in upper extremity. The included journal articles were reviewed according to a structured diagram and the methodological quality was assessed. Fifteen studies were identified and reviewed. Five different patient categories were studied: two studies focussed on mirror therapy after an amputation of the upper limb, five studies focussed on mirror therapy after stroke, five studies focussed on mirror therapy with complex regional pain syndrome type 1 (CRPS1) patients, one study on mirror therapy with complex regional pain syndrome type 2 (CRPS2) and two studies focussed on mirror therapy after hand surgery other than amputation. Most of the evidence for mirror therapy is from studies with weak methodological quality. The present review showed a trend that mirror therapy is effective in upper limb treatment of stroke patients and patients with CRPS, whereas the effectiveness in other patient groups has yet to be determined.

Optimal pharmacological therapy in ST-elevation myocardial infarction-a review : A review of antithrombotic therapies in STEMI.

PubMed

Hermanides, R S; Kilic, S; van 't Hof, A W J

2018-04-23

Antithrombotic therapy is an essential component in the optimisation of clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. There are currently several intravenous anticoagulant drugs available for primary percutaneous coronary intervention. Dual antiplatelet therapy comprising aspirin and P2Y12 inhibitor represents the cornerstone treatment for STEMI. However, these effective treatment strategies may be associated with bleeding complications. Compared with clopidogrel, prasugrel and ticagrelor are more potent and predictable, which translates into better clinical outcomes. Therefore, these agents are the first-line treatment in primary percutaneous coronary intervention. However, patients can still experience adverse ischaemic events, which might be in part attributed to alternative pathways triggering thrombosis. In this review, we provide a critical and updated review of currently available antithrombotic therapies used in patients with STEMI undergoing primary PCI. Finding a balance that minimises both thrombotic and bleeding risk is difficult, but crucial. Further randomised trials for this optimal balance are needed.

Effects of Charged Particles on Human Tumor Cells

PubMed Central

Held, Kathryn D.; Kawamura, Hidemasa; Kaminuma, Takuya; Paz, Athena Evalour S.; Yoshida, Yukari; Liu, Qi; Willers, Henning; Takahashi, Akihisa

2016-01-01

The use of charged particle therapy in cancer treatment is growing rapidly, in large part because the exquisite dose localization of charged particles allows for higher radiation doses to be given to tumor tissue while normal tissues are exposed to lower doses and decreased volumes of normal tissues are irradiated. In addition, charged particles heavier than protons have substantial potential clinical advantages because of their additional biological effects, including greater cell killing effectiveness, decreased radiation resistance of hypoxic cells in tumors, and reduced cell cycle dependence of radiation response. These biological advantages depend on many factors, such as endpoint, cell or tissue type, dose, dose rate or fractionation, charged particle type and energy, and oxygen concentration. This review summarizes the unique biological advantages of charged particle therapy and highlights recent research and areas of particular research needs, such as quantification of relative biological effectiveness (RBE) for various tumor types and radiation qualities, role of genetic background of tumor cells in determining response to charged particles, sensitivity of cancer stem-like cells to charged particles, role of charged particles in tumors with hypoxic fractions, and importance of fractionation, including use of hypofractionation, with charged particles. PMID:26904502

Electroconvulsive therapy use in adolescents: a systematic review

PubMed Central

2013-01-01

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

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

PubMed Central

2012-01-01

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

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

PubMed

Crowe, Barbara J; Rio, Robin

2004-01-01

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

Online Therapy for Depressive Symptoms: An Evaluation of Counselor-Led and Peer-Supported Life Review Therapy.

PubMed

Westerhof, Gerben J; Lamers, Sanne M A; Postel, Marloes G; Bohlmeijer, Ernst T

2017-09-18

Life review therapy is recognized as an evidence-based treatment for depression in later life. The current article evaluates an online life review therapy in middle-aged and older persons, comparing a counselor-led to a peer-supported mode of delivery. A pilot randomized controlled trial (RCT) was carried out with 3 conditions and 4 measurement points: (a) online life review therapy with online counseling, (b) online life review therapy with online peer support, and (c) a waitlist control condition. A mixed methods study provided insight in the reach, adherence, effectiveness, user experiences, and acceptability. Fifty-eight people were included in the study. The intervention reached a vulnerable group of mainly middle-aged, college-educated women. The pilot RCT on effectiveness showed that participants in all conditions improved significantly in depressive symptoms, engaged living, mastery, and vitality, but not in ego integrity and despair, social support, loneliness, and well-being. The adherence, user experience, and acceptability were better in the counselor condition than in the peer condition. No differences were found between middle-aged and older adults. Despite the nonsignificant effects, possibly due to the small sample size, online life review therapy might be a good method for alleviating depressive symptoms in people in their second half of life. Further research is needed, addressing how online life review is best offered. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nanodosimetry-Based Plan Optimization for Particle Therapy

PubMed Central

Schulte, Reinhard W.

2015-01-01

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

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

PubMed Central

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

2012-01-01

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

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

PubMed

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

2013-01-21

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

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

NASA Astrophysics Data System (ADS)

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

2013-01-01

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

Horticultural therapy in dementia care: a literature review.

PubMed

Blake, Marianne; Mitchell, Gary

2016-01-20

Aim To present a narrative review of the empirical literature on the use of horticultural therapy in dementia care. Method A comprehensive literature search, conducted in December 2014, resulted in the selection of 15 primary research articles for review. Of these, three used qualitative methods, five used quantitative methods and seven used mixed methodology. The articles were critically appraised, and the narrative synthesis used a thematic approach whereby prominent themes from the articles were grouped to form representative themes. Findings Three main themes emerged from the narrative synthesis: the emotional health of people living with dementia, their perceived self-identity and their levels of engagement. Conclusion Horticultural therapy can be beneficial. At a macro-level, it is an inexpensive therapy that does not require specialist training to deliver. At a micro-level, it enhances the wellbeing of people living with dementia. Recommendations are made to promote access to appropriate horticultural therapy for people living with dementia, and for further research in this area.

Airflow and Particle Transport Through Human Airways: A Systematic Review

NASA Astrophysics Data System (ADS)

Kharat, S. B.; Deoghare, A. B.; Pandey, K. M.

2017-08-01

This paper describes review of the relevant literature about two phase analysis of air and particle flow through human airways. An emphasis of the review is placed on elaborating the steps involved in two phase analysis, which are Geometric modelling methods and Mathematical models. The first two parts describes various approaches that are followed for constructing an Airway model upon which analysis are conducted. Broad two categories of geometric modelling viz. Simplified modelling and Accurate modelling using medical scans are discussed briefly. Ease and limitations of simplified models, then examples of CT based models are discussed. In later part of the review different mathematical models implemented by researchers for analysis are briefed. Mathematical models used for Air and Particle phases are elaborated separately.

A State-of-the-Art Review: Personalization of Tinnitus Sound Therapy

PubMed Central

Searchfield, Grant D.; Durai, Mithila; Linford, Tania

2017-01-01

Background: There are several established, and an increasing number of putative, therapies using sound to treat tinnitus. There appear to be few guidelines for sound therapy selection and application. Aim: To review current approaches to personalizing sound therapy for tinnitus. Methods: A “state-of-the-art” review (Grant and Booth, 2009) was undertaken to answer the question: how do current sound-based therapies for tinnitus adjust for tinnitus heterogeneity? Scopus, Google Scholar, Embase and PubMed were searched for the 10-year period 2006–2016. The search strategy used the following key words: “tinnitus” AND “sound” AND “therapy” AND “guidelines” OR “personalized” OR “customized” OR “individual” OR “questionnaire” OR “selection.” The results of the review were cataloged and organized into themes. Results: In total 165 articles were reviewed in full, 83 contained sufficient details to contribute to answering the study question. The key themes identified were hearing compensation, pitched-match therapy, maskability, reaction to sound and psychosocial factors. Although many therapies mentioned customization, few could be classified as being personalized. Several psychoacoustic and questionnaire-based methods for assisting treatment selection were identified. Conclusions: Assessment methods are available to assist clinicians to personalize sound-therapy and empower patients to be active in therapy decision-making. Most current therapies are modified using only one characteristic of the individual and/or their tinnitus. PMID:28970812

A Systematic Review of Bright Light Therapy for Eating Disorders.

PubMed

Beauchamp, Marshall T; Lundgren, Jennifer D

2016-10-27

Bright light therapy is a noninvasive biological intervention for disorders with nonnormative circadian features. Eating disorders, particularly those with binge-eating and night-eating features, have documented nonnormative circadian eating and mood patterns, suggesting that bright light therapy may be an efficacious stand-alone or adjunctive intervention. The purpose of this systematic literature review, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, was (1) to evaluate the state of the empirical treatment outcome literature on bright light therapy for eating disorders and (2) to explore the timing of eating behavior, mood, and sleep-related symptom change so as to understand potential mechanisms of bright light therapy action in the context of eating disorder treatment. A comprehensive literature search using PsycInfo and PubMed/MEDLINE was conducted in April 2016 with no date restrictions to identify studies published using bright light therapy as a treatment for eating disorders. Keywords included combinations of terms describing disordered eating (eating disorder, anorexia nervosa, bulimia nervosa, binge eating, binge, eating behavior, eating, and night eating) and the use of bright light therapy (bright light therapy, light therapy, phototherapy). After excluding duplicates, 34 articles were reviewed for inclusion. 14 published studies of bright light therapy for eating disorders met inclusion criteria (included participants with an eating disorder/disordered-eating behaviors; presented as a case study, case series, open-label clinical trial, or randomized/nonrandomized controlled trial; written in English; and published and available by the time of manuscript review). Results suggest that bright light therapy is potentially effective at improving both disordered-eating behavior and mood acutely, although the timing of symptom response and the duration of treatment effects remain unknown. Future research should

Occupational therapy interventions for shoulder conditions: a systematic review.

PubMed

von der Heyde, Rebecca L

2011-01-01

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

Photodynamic therapy in dentistry: a literature review.

PubMed

Gursoy, Hare; Ozcakir-Tomruk, Ceyda; Tanalp, Jale; Yilmaz, Selçuk

2013-05-01

The purpose of this review was to summarize recent developments regarding photodynamic therapy (PDT) in the field of dentistry. A review of pertinent literature was carried out in PubMED to determine the current position of PDT applications in dentistry. One hundred thirteen relevant articles were retrieved from PubMED by inserting the keywords "photodynamic therapy", "dentistry", "periodontology", "oral surgery", and "endodontics". It is anticipated that this overview will create a specific picture in the practitioner's mind regarding the current status and use of PDT. In spite of different results and suggestions brought about by different researchers, PDT can be considered as a promising and less invasive technique in dentistry. PDT seems to be an effective tool in the treatment of localized and superficial infections. Within the limitations of the present review, it can be concluded that although PDT cannot replace antimicrobial therapy at its current stage, it may be used as an adjunctive tool for facilitating the treatment of oral infections. Oral infections (such as mucosal and endodontic infections, periodontal diseases, caries, and peri-implantitis) are among the specific targets where PDT can be applied. Further long-term clinical studies are necessary in establishing a more specific place of the technique in the field of dentistry.

Music therapy for end-of-life care: An updated systematic review.

PubMed

McConnell, Tracey; Scott, David; Porter, Sam

2016-10-01

Music therapy during palliative and end-of-life care is well established and positive benefits for patients have been reported. Assess the effectiveness of music therapy versus standard care alone or standard care in combination with other therapies for improving psychological, physiological and social outcomes among adult patients in any palliative care setting. In order to update an existing Cochrane systematic review, we searched MEDLINE, CINAHL, EMBASE, PsycINFO, CENTRAL, ClinicalTrials.gov register and Current Controlled Trials register to identify randomised or quasi-randomised controlled trials published between 2009 and April 2015. Nine electronic music therapy journals were searched from 2009 until April 2015, along with reference lists and contact was made with key experts in music therapy. Only studies published in English were eligible for inclusion. Two reviewers independently screened titles, abstracts, assessed relevant studies for eligibility, extracted data and judged risk of bias for included studies. Disagreements were resolved through discussion with a third reviewer. Data were synthesised in Revman using the random effects model. Heterogeneity was assessed using I(2). Three studies were included in the review. Findings suggest that music therapy may be effective for helping to reduce pain in palliative care patients (standard mean deviation = -0.42, 95% confidence interval = -0.68 to -0.17, p = 0.001). Available evidence did not support the use of music therapy to improve overall quality of life in palliative care. While this review suggests that music therapy may be effective for reducing pain, this is based on studies with a high risk of bias. Further high-quality research is required. © The Author(s) 2016.

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

NASA Astrophysics Data System (ADS)

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

2015-10-01

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

A literature review about effectiveness of massage therapy for cancer pain.

PubMed

Somani, Salima; Merchant, Samima; Lalani, Sharifa

2013-11-01

This literature review explores the effectiveness of massage therapy to reduce cancer pain. As part of the review, systematic literature search was carried out on various electronic databases and specialised journals. Included are 19 research-based articles and 8 review articles. The review suggests that cancer has become a common health problem in the world and most of the cancer patients are going through intense and unbearable pain. Studies have reported that most of the cancer patients' pain reduced with therapeutic massage. Seventy-three per cent of cancer patients use massage therapy in the USA. Few studies are available in the context of the developing world related to massage therapy and we could not find any study in the Pakistani context. There is a need to conduct an interventional study about the effectiveness of massage therapy to control cancer pain in developing countries such as Pakistan.

Effectiveness of Manual Therapy Combined With Physical Therapy in Treatment of Patellofemoral Pain Syndrome: Systematic Review.

PubMed

Espí-López, Gemma Victoria; Arnal-Gómez, Anna; Balasch-Bernat, Mercè; Inglés, Marta

2017-06-01

The purpose of this study was to conduct a review of randomized controlled trials (RCTs) to determine the treatment effectiveness of the combination of manual therapy (MT) with other physical therapy techniques. Systematic searches of scientific literature were undertaken on PubMed and the Cochrane Library (2004-2014). The following terms were used: "patellofemoral pain syndrome," "physical therapy," "manual therapy," and "manipulation." RCTs that studied adults diagnosed with patellofemoral pain syndrome (PFPS) treated by MT and physical therapy approaches were included. The quality of the studies was assessed by the Jadad Scale. Five RCTs with an acceptable methodological quality (Jadad ≥ 3) were selected. The studies indicated that MT combined with physical therapy has some effect on reducing pain and improving function in PFPS, especially when applied on the full kinetic chain and when strengthening hip and knee muscles. The different combinations of MT and physical therapy programs analyzed in this review suggest that giving more emphasis to proximal stabilization and full kinetic chain treatments in PFPS will help better alleviation of symptoms.

The systematic review as a research process in music therapy.

PubMed

Hanson-Abromeit, Deanna; Sena Moore, Kimberly

2014-01-01

Music therapists are challenged to present evidence on the efficacy of music therapy treatment and incorporate the best available research evidence to make informed healthcare and treatment decisions. Higher standards of evidence can come from a variety of sources including systematic reviews. To define and describe a range of research review methods using examples from music therapy and related literature, with emphasis on the systematic review. In addition, the authors provide a detailed overview of methodological processes for conducting and reporting systematic reviews in music therapy. The systematic review process is described in five steps. Step 1 identifies the research plan and operationalized research question(s). Step 2 illustrates the identification and organization of the existing literature related to the question(s). Step 3 details coding of data extracted from the literature. Step 4 explains the synthesis of coded findings and analysis to answer the research question(s). Step 5 describes the strength of evidence evaluation and results presentation for practice recommendations. Music therapists are encouraged to develop and conduct systematic reviews. This methodology contributes to review outcome credibility and can determine how information is interpreted and used by clinicians, clients or patients, and policy makers. A systematic review is a methodologically rigorous research method used to organize and evaluate extant literature related to a clinical problem. Systematic reviews can assist music therapists in managing the ever-increasing literature, making well-informed evidence based practice and research decisions, and translating existing music-based and nonmusic based literature to clinical practice and research development. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

ERIC Educational Resources Information Center

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

2010-01-01

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

Secondary radiation measurements for particle therapy applications: nuclear fragmentation produced by 4He ion beams in a PMMA target.

PubMed

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

2017-02-21

Nowadays there is a growing interest in particle therapy treatments exploiting light ion beams against tumors due to their enhanced relative biological effectiveness and high space selectivity. In particular promising results are obtained by the use of 4 He projectiles. Unlike the treatments performed using protons, the beam ions can undergo a fragmentation process when interacting with the atomic nuclei in the patient body. In this paper the results of measurements performed at the Heidelberg Ion-Beam Therapy center are reported. For the first time the absolute fluxes and the energy spectra of the fragments-protons, deuterons, and tritons-produced by 4 He ion beams of 102, 125 and 145 MeV u -1 energies on a poly-methyl methacrylate target were evaluated at different angles. The obtained results are particularly relevant in view of the necessary optimization and review of the treatment planning software being developed for clinical use of 4 He beams in clinical routine and the relative bench-marking of Monte Carlo algorithm predictions.

Secondary radiation measurements for particle therapy applications: nuclear fragmentation produced by 4He ion beams in a PMMA target

NASA Astrophysics Data System (ADS)

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

2017-02-01

Nowadays there is a growing interest in particle therapy treatments exploiting light ion beams against tumors due to their enhanced relative biological effectiveness and high space selectivity. In particular promising results are obtained by the use of 4He projectiles. Unlike the treatments performed using protons, the beam ions can undergo a fragmentation process when interacting with the atomic nuclei in the patient body. In this paper the results of measurements performed at the Heidelberg Ion-Beam Therapy center are reported. For the first time the absolute fluxes and the energy spectra of the fragments—protons, deuterons, and tritons—produced by 4He ion beams of 102, 125 and 145 MeV u-1 energies on a poly-methyl methacrylate target were evaluated at different angles. The obtained results are particularly relevant in view of the necessary optimization and review of the treatment planning software being developed for clinical use of 4He beams in clinical routine and the relative bench-marking of Monte Carlo algorithm predictions.

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

EPA Science Inventory

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

A Review of Particle Swarm Optimization

NASA Astrophysics Data System (ADS)

Jain, N. K.; Nangia, Uma; Jain, Jyoti

2018-03-01

This paper presents an overview of the research progress in Particle Swarm Optimization (PSO) during 1995-2017. Fifty two papers have been reviewed. They have been categorized into nine categories based on various aspects. This technique has attracted many researchers because of its simplicity which led to many improvements and modifications of the basic PSO. Some researchers carried out the hybridization of PSO with other evolutionary techniques. This paper discusses the progress of PSO, its improvements, modifications and applications.

Literature review relevant to particle erosion in complex geometries

NASA Astrophysics Data System (ADS)

Volent, Eirik; Dahlhaug, Ole Gunnar

2018-06-01

Erosion is a challenge in many industries where fluid is transferred through pipe and valve arrangements. Wear can occur in a variety of systems and is often related to the presents of droplets or solid particles in the fluid stream. Solid particles are in many cases present in hydropower systems, and can cause severe damage to system components. Flow conditions, particle size and concentration vary greatly and can thus cause a vast variety of damage, ranging from manageable wear to component failure. The following paper will present a summary of literature relevant to the prediction of erosion in complex geometries. The intention of the review is to investigate the current state of the art, directly relevant to the prediction of wear due to solid particle erosion in complex geometries.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holliday, Emma B.; Frank, Steven J., E-mail: sjfrank@mdanderson.org

2014-06-01

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

Systematic review of evidence underpinning non-pharmacological therapies in dementia.

PubMed

Olley, Richard; Morales, Andrea

2017-05-15

Objective Dementia is one of the most common illnesses worldwide, and is one of the most important causes of disability in older people. Currently, dementia affects over 35million people around the globe. It is expected that this number will increase to 65.7million by 2030. Early detection, diagnosis and treatment to control the principal behaviour symptoms may help reduce these numbers and delay the progression to more advanced and dangerous stages of this disorder with resultant increase quality of life for those affected. The main goal of the present systematic literature review was to examine contemporary evidence relating to non-pharmacological therapy in the treatment of dementia. Methods To achieve the study goal, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used. Results This study identified the five most common behaviours in patients with dementia as aggression, wandering, agitation, apathy and sleep disturbances. Two non-pharmacological therapies were the most studied treatment: music therapy and aromatherapy. Ten other non-pharmacological therapies were also identified, but these lack a sufficient evidence-base. Conclusion Although all the therapies identified could be used as part of the treatment of behavioural symptoms, there is insufficient evidence relating to the indications, appropriate use and effectiveness of these therapies to apply in each behavioural treatment. Thus, the present study has demonstrated a significant research gap. What is known about the topic? Despite the widespread use of many different types of therapies, there is limited evidence regarding the efficacy of non-pharmaceutical therapies deployed in the management of behaviours of concern manifested by some people who suffer with dementia in all its forms. What does this paper add? This systematic review examines contemporary evidence from the literature to determine whether there is an evidence base available that would

Development of a real-time internal and external marker tracking system for particle therapy: a phantom study using patient tumor trajectory data

PubMed Central

Cho, Junsang; Cheon, Wonjoong; Ahn, Sanghee; Jung, Hyunuk; Sheen, Heesoon; Park, Hee Chul

2017-01-01

Abstract Target motion–induced uncertainty in particle therapy is more complicated than that in X-ray therapy, requiring more accurate motion management. Therefore, a hybrid motion-tracking system that can track internal tumor motion and as well as an external surrogate of tumor motion was developed. Recently, many correlation tests between internal and external markers in X-ray therapy have been developed; however, the accuracy of such internal/external marker tracking systems, especially in particle therapy, has not yet been sufficiently tested. In this article, the process of installing an in-house hybrid internal/external motion-tracking system is described and the accuracy level of tracking system was acquired. Our results demonstrated that the developed in-house external/internal combined tracking system has submillimeter accuracy, and can be clinically used as a particle therapy system as well as a simulation system for moving tumor treatment. PMID:28201522

Mind-body Therapies for Menopausal Symptoms: A Systematic Review

PubMed Central

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

2010-01-01

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

Particle platforms for cancer immunotherapy

PubMed Central

Serda, Rita Elena

2013-01-01

Elevated understanding and respect for the relevance of the immune system in cancer development and therapy has led to increased development of immunotherapeutic regimens that target existing cancer cells and provide long-term immune surveillance and protection from cancer recurrence. This review discusses using particles as immune adjuvants to create vaccines and to augment the anticancer effects of conventional chemotherapeutics. Several particle prototypes are presented, including liposomes, polymer nanoparticles, and porous silicon microparticles, the latter existing as either single- or multiparticle platforms. The benefits of using particles include immune-cell targeting, codelivery of antigens and immunomodulatory agents, and sustained release of the therapeutic payload. Nanotherapeutic-based activation of the immune system is dependent on both intrinsic particle characteristics and on the immunomodulatory cargo, which may include danger signals known as pathogen-associated molecular patterns and cytokines for effector-cell activation. PMID:23761969

MONDO: A tracker for the characterization of secondary fast and ultrafast neutrons emitted in particle therapy

NASA Astrophysics Data System (ADS)

Mirabelli, R.; Battistoni, G.; Giacometti, V.; Patera, V.; Pinci, D.; Sarti, A.; Sciubba, A.; Traini, G.; Marafini, M.

2018-01-01

In Particle Therapy (PT) accelerated charged particles and light ions are used for treating tumors. One of the main limitation to the precision of PT is the emission of secondary particles due to the beam interaction with the patient: secondary emitted neutrons can release a significant dose far from the tumor. Therefore, a precise characterization of their flux, production energy and angle distribution is eagerly needed in order to improve the Treatment Planning Systems (TPS) codes. The principal aim of the MONDO (MOnitor for Neutron Dose in hadrOntherapy) project is the development of a tracking device optimized for the detection of fast and ultra-fast secondary neutrons emitted in PT. The detector consists of a matrix of scintillating square fibres coupled with a CMOS-based readout. Here, we present the characterization of the detector tracker prototype and CMOS-based digital SPAD (Single Photon Avalanche Diode) array sensor tested with protons at the Beam Test Facility (Frascati, Italy) and at the Proton Therapy Centre (Trento, Italy), respectively.

Vitamin Therapy and Children with Down's Syndrome: A Review of Research.

ERIC Educational Resources Information Center

Pruess, James B.; And Others

1989-01-01

Following a brief outline of vitamin therapy's effects on schizophrenia and learning disabilities, research is reviewed on vitamin therapy for children with Down's Syndrome, concluding with a discussion of critical responses to research endorsing vitamin therapy. It is concluded that vitamin therapy contributes nothing to the development of…

Dielectrophoretic separation of micron and submicron particles: a review.

PubMed

Dash, Swagatika; Mohanty, Swati

2014-09-01

This paper provides an overview on separation of micron and submicron sized biological (cells, yeast, virus, bacteria, etc.) and nonbiological particles (latex, polystyrene, CNTs, metals, etc.) by dielectrophoresis (DEP), which finds wide applications in the field of medical and environmental science. Mathematical models to predict the electric field, flow profile, and concentration profiles of the particles under the influence of DEP force have also been covered in this review. In addition, advancements made primarily in the last decade, in the area of electrode design (shape and arrangement), new materials for electrode (carbon, silicon, polymers), and geometry of the microdevice, for efficient DEP separation of particles have been highlighted. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Outcomes of physical therapy, speech pathology, and occupational therapy for people with motor neuron disease: a systematic review.

PubMed

Morris, Meg E; Perry, Alison; Bilney, Belinda; Curran, Andrea; Dodd, Karen; Wittwer, Joanne E; Dalton, Gregory W

2006-09-01

This article describes a systematic review and critical evaluation of the international literature on the effects of physical therapy, speech pathology, and occupational therapy for people with motor neuron disease (PwMND). The results were interpreted using the framework of the International Classification of Functioning, Disability and Health. This enabled us to summarize therapy outcomes at the level of body structure and function, activity limitations, participation restrictions, and quality of life. Databases searched included MEDLINE, PUBMED, CINAHL, PSYCInfo, Data base of Abstracts of Reviews of Effectiveness (DARE), The Physiotherapy Evidence data base (PEDro), Evidence Based Medicine Reviews (EMBASE), the Cochrane database of systematic reviews, and the Cochrane Controlled Trials Register. Evidence was graded according to the Harbour and Miller classification. Most of the evidence was found to be at the level of "clinical opinion" rather than of controlled clinical trials. Several nonrandomized small group and "observational studies" provided low-level evidence to support physical therapy for improving muscle strength and pulmonary function. There was also some evidence to support the effectiveness of speech pathology interventions for dysarthria. The search identified a small number of studies on occupational therapy for PwMND, which were small, noncontrolled pre-post-designs or clinical reports.

Development of a real-time internal and external marker tracking system for particle therapy: a phantom study using patient tumor trajectory data.

PubMed

Cho, Junsang; Cheon, Wonjoong; Ahn, Sanghee; Jung, Hyunuk; Sheen, Heesoon; Park, Hee Chul; Han, Youngyih

2017-09-01

Target motion-induced uncertainty in particle therapy is more complicated than that in X-ray therapy, requiring more accurate motion management. Therefore, a hybrid motion-tracking system that can track internal tumor motion and as well as an external surrogate of tumor motion was developed. Recently, many correlation tests between internal and external markers in X-ray therapy have been developed; however, the accuracy of such internal/external marker tracking systems, especially in particle therapy, has not yet been sufficiently tested. In this article, the process of installing an in-house hybrid internal/external motion-tracking system is described and the accuracy level of tracking system was acquired. Our results demonstrated that the developed in-house external/internal combined tracking system has submillimeter accuracy, and can be clinically used as a particle therapy system as well as a simulation system for moving tumor treatment. © The Author 2017. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

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

PubMed

Thoma, Nathan; Pilecki, Brian; McKay, Dean

2015-09-01

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

Review of pharmacological therapy for tinnitus.

PubMed

Patterson, Matthew B; Balough, Ben J

2006-01-01

This article provides a review of studies investigating the pharmacological treatment of tinnitus. Tinnitus continues to be a significant and costly health problem without a uniformly accepted treatment. A wide variety of studies exploring prescription, supplement, and vitamin therapies are assessed for efficacy of treatment and for establishing consistencies in symptom definition, assessment, and outcome measures. This review reveals no compelling evidence suggesting the efficacy of any pharmacological agent in the treatment of tinnitus. Analysis of prior investigations provides insight to appropriate methods for future work, which are outlined.

Helicobacter pylori eradication therapy: A review of current trends.

PubMed

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

2013-01-01

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

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

PubMed Central

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

2013-01-01

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

Immunoglobulin replacement therapy: a twenty-year review and current update.

PubMed

Saeedian, Monika; Randhawa, Inderpal

2014-01-01

The expansion of immunoglobulin replacement to multiple disease entities marks a decade-long advancement in immune therapy. Parallel to its extension, the characteristics and composition of immunoglobulin products have diversified. The aim of this study was to summarize a 20-year comprehensive literature review of currently commercially available immunoglobulin products, particularly examining individual product properties in a comparative format. Data Sources/Study Selections: The literature review was performed using PubMed and Ovid, screening a time span of 2 decades. Both authors reviewed the obtained articles for acceptable quality, and the selection was narrowed down based on criteria for randomized clinical and therapeutic trials. Product-specific characteristics in terms of purification strategy, stabilizers, composition, and viral inactivation were found among the immunoglobulin products investigated. Such differing characteristics manifest in their variable clinical safety and efficacy as assessed by the comparative product analysis. In subgroups of patients, subcutaneous immunoglobulin therapy may be an alternative to intravenous immunoglobulin (IVIG) therapy with an equal efficacy and a lower number of systemic adverse events. Only few comprehensive clinical synopses are available to clearly demonstrate the differences in IVIG products despite the widespread clinical use of the therapy. This review defines significant characteristics of individual immunoglobulin products, noting important differences in product development and application and allowing informed clinical decisions to match a product with patients' risk factors and comorbidity. This balanced approach to gammaglobulin replacement therapy is imperative to produce the highest clinical efficacy and lowest number of adverse events. © 2014 S. Karger AG, Basel.

Republished review: Gene therapy for ocular diseases.

PubMed

Liu, Melissa M; Tuo, Jingsheng; Chan, Chi-Chao

2011-07-01

The eye is an easily accessible, highly compartmentalised and immune-privileged organ that offers unique advantages as a gene therapy target. Significant advancements have been made in understanding the genetic pathogenesis of ocular diseases, and gene replacement and gene silencing have been implicated as potentially efficacious therapies. Recent improvements have been made in the safety and specificity of vector-based ocular gene transfer methods. Proof-of-concept for vector-based gene therapies has also been established in several experimental models of human ocular diseases. After nearly two decades of ocular gene therapy research, preliminary successes are now being reported in phase 1 clinical trials for the treatment of Leber congenital amaurosis. This review describes current developments and future prospects for ocular gene therapy. Novel methods are being developed to enhance the performance and regulation of recombinant adeno-associated virus- and lentivirus-mediated ocular gene transfer. Gene therapy prospects have advanced for a variety of retinal disorders, including retinitis pigmentosa, retinoschisis, Stargardt disease and age-related macular degeneration. Advances have also been made using experimental models for non-retinal diseases, such as uveitis and glaucoma. These methodological advancements are critical for the implementation of additional gene-based therapies for human ocular diseases in the near future.

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

PubMed

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

2009-01-01

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

An integrative review of Reiki touch therapy research.

PubMed

Vitale, Anne

2007-01-01

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

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

PubMed

Schmitt, B; Frölich, L

2007-12-01

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

Intervention quality is not routinely assessed in Cochrane systematic reviews of radiation therapy interventions.

PubMed

Abdul Rahim, Mohamad R; James, Melissa L; Hickey, Brigid E

2017-10-01

The aim of this study was to maximise the benefits from clinical trials involving technological interventions such as radiation therapy. High compliance to the quality assurance protocols is crucial. We assessed whether the quality of radiation therapy intervention was evaluated in Cochrane systematic reviews. We searched 416 published Cochrane systematic reviews and identified 67 Cochrane systematic reviews that investigated radiation therapy or radiotherapy as an intervention. For each systematic review, either quality assurance or quality control for the intervention was identified by a description of such processes in the published systematic reviews. Of the 67 Cochrane systematic reviews studied, only two mentioned quality assurance or quality control. Our findings revealed that 65 of 67 (97%) Cochrane systematic reviews of radiation therapy interventions failed to consider the quality of the intervention. We suggest that advice about the evaluation of intervention quality be added to author support materials. © 2017 The Royal Australian and New Zealand College of Radiologists.

Music Therapy for Posttraumatic Stress in Adults: A Theoretical Review

PubMed Central

Landis-Shack, Nora; Heinz, Adrienne J.; Bonn-Miller, Marcel O.

2017-01-01

Music therapy has been employed as a therapeutic intervention to facilitate healing across a variety of clinical populations. There is theoretical and empirical evidence to suggest that individuals with trauma exposure and Posttraumatic Stress Disorder (PTSD), a condition characterized by enduring symptoms of distressing memory intrusions, avoidance, emotional disturbance, and hyperarousal, may derive benefits from music therapy. The current narrative review describes the practice of music therapy and presents a theoretically-informed assessment and model of music therapy as a tool for addressing symptoms of PTSD. The review also presents key empirical studies that support the theoretical assessment. Social, cognitive, and neurobiological mechanisms (e.g., community building, emotion regulation, increased pleasure, anxiety reduction) that promote music therapy’s efficacy as an adjunctive treatment for individuals with posttraumatic stress are discussed. It is concluded that music therapy may be a useful therapeutic tool to reduce symptoms and improve functioning among individuals with trauma exposure and PTSD, though more rigorous empirical study is required. In addition, music therapy may help foster resilience and engage individuals who struggle with stigma associated with seeking professional help. Practical recommendations for incorporating music therapy into clinical practice are offered along with several suggestions for future research. PMID:29290641

Spinal Manipulative Therapy for Adolescent Idiopathic Scoliosis: A Systematic Review.

PubMed

Théroux, Jean; Stomski, Norman; Losco, Christine Dominique; Khadra, Christelle; Labelle, Hubert; Le May, Sylvie

The purpose of this study was to perform a systematic review of clinical trials of spinal manipulative therapy for adolescent idiopathic scoliosis. Search strategies were developed for PubMed, CINHAL, and CENTRAL databases. Studies were included through June 2016 if they were prospective trials that evaluated spinal manipulative therapy (eg, chiropractic, osteopathic, physical therapy) for adolescent idiopathic scoliosis. Data were extracted and assessed by 2 independent reviewers. Cochrane risk of bias tools were used to assess the quality of the included studies. Data were reported qualitatively because heterogeneity prevented statistical pooling. Four studies satisfied the inclusion criteria and were critically appraised. The findings of the included studies indicated that spinal manipulative therapy might be effective for preventing curve progression or reducing Cobb angle. However, the lack of controls and small sample sizes precluded robust estimation of the interventions' effect sizes. There is currently insufficient evidence to establish whether spinal manipulative therapy may be beneficial for adolescent idiopathic scoliosis. The results of the included studies suggest that spinal manipulative therapy may be a promising treatment, but these studies were all at substantial risk of bias. Further high-quality studies are warranted to conclusively determine if spinal manipulative therapy may be effective in the management of adolescent idiopathic scoliosis. Copyright © 2017. Published by Elsevier Inc.

Reviewing the Past in the Here and Now: Using Gestalt Therapy Techniques with Life Review.

ERIC Educational Resources Information Center

Crose, Royda

1990-01-01

Discusses a Gestalt therapy perspective on the life review process and the use of Gestalt therapy techniques in helping the older client achieve resolution of past conflicts. Notes that, with such resolution, the developmental task of ego integration in the final years of life may be realized. (Author/NB)

Meditation for Depression: A Systematic Review of Mindfulness-Based Cognitive Therapy for Major Depressive Disorder

DTIC Science & Technology

2015-10-01

studies. Physical Therapy Reviews, 13(5), 355-365. Systematic review Piet, J., and Hougaard, E. (2011). The effect of mindfulness-based cognitive...Rutger I. and Probst, M. (2013). A systematic review on physical therapy interventions for patients with binge eating disorder. Disability and...disorder; persistent antisocial behavior; persistent self-injury requiring clinical management/ therapy ; unable to engage with MBCT for physical

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

NASA Technical Reports Server (NTRS)

Byers, D. C.

1978-01-01

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

Systematic reviews of complementary therapies – an annotated bibliography. Part 3: Homeopathy

PubMed Central

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

2001-01-01

Background Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with homeopathy. Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and books. To be included articles had to review prospective clinical trials of homeopathy; had to describe review methods explicitly; had to be published; and had to focus on treatment effects. Information on conditions, interventions, methods, results and conclusions was extracted using a pretested form and summarized descriptively. Results Eighteen out of 22 potentially relevant reviews preselected in the screening process met the inclusion criteria. Six reviews addressed the question whether homeopathy is effective across conditions and interventions. The majority of available trials seem to report positive results but the evidence is not convincing. For isopathic nosodes for allergic conditions, oscillococcinum for influenza-like syndromes and galphimia for pollinosis the evidence is promising while in other areas reviewed the results are equivocal. Interpretation Reviews on homeopathy often address general questions. While the evidence is promising for some topics the findings of the available reviews are unlikely to end the controversy on this therapy. PMID:11527508

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

PubMed Central

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

2013-01-01

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

Review on characterization of nano-particle emissions and PM morphology from internal combustion engines: Part 2 [Review on morphology and nanostructure characterization of nano-particle emission from internal combustion engines

DOE PAGES

Choi, Seungmok; Myung, C. L.; Park, S.

2014-03-05

This study presents a review of the characterization of physical properties, morphology, and nanostructure of particulate emissions from internal combustion engines. Because of their convenience and readiness of measurement, various on-line commercial instruments have been used to measure the mass, number, and size distribution of nano-particles from different engines. However, these on-line commercial instruments have inherent limitations in detailed analysis of chemical and physical properties, morphology, and nanostructure of engine soot agglomerates, information that is necessary to understand the soot formation process in engine combustion, soot particle behavior in after-treatment systems, and health impacts of the nano-particles. For these reasons,more » several measurement techniques used in the carbon research field, i.e., highresolution transmission electron microscopy (HRTEM), X-ray diffraction (XRD), and Raman spectroscopy, were used for analysis of engine particulate matter (PM). This review covers a brief introduction of several measurement techniques and previous results from engine nano-particle characterization studies using those techniques.« less

Occupational therapy practice in acute physical hospital settings: Evidence from a scoping review.

PubMed

Britton, Lauren; Rosenwax, Lorna; McNamara, Beverley

2015-12-01

Increased accountability and growing fiscal limitations in global health care continue to challenge how occupational therapy practices are undertaken. Little is known about how these changes affect current practice in acute hospital settings. This article reviews the relevant literature to further understanding of occupational therapy practice in acute physical hospital settings. A scoping review of five electronic databases was completed using the keywords Occupational therapy, acute hospital settings/acute physical hospital settings, acute care setting/acute care hospital setting, general medicine/general medical wards, occupational therapy service provision/teaching hospitals/tertiary care hospitals. Criteria were applied to determine suitability for inclusion and the articles were analysed to uncover key themes. In total 34 publications were included in the review. Analysis of the publications revealed four themes: (1) Comparisons between the practice of novice and experienced occupational therapists in acute care (2) Occupational therapists and the discharge planning process (3) Role of occupation in the acute care setting and (4) Personal skills needed and organisation factors affecting acute care practice. The current literature has highlighted the challenges occupational therapists face in practicing within an acute setting. Findings from this review enhance understanding of how occupational therapy department managers and educators can best support staff that practise in acute hospital settings. © 2015 Occupational Therapy Australia.

TOPICAL REVIEW: Stem cells engineering for cell-based therapy

NASA Astrophysics Data System (ADS)

Taupin, Philippe

2007-09-01

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

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

PubMed

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

2016-06-01

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

Manual Therapy for Hip Osteoarthritis: A Systematic Review and Meta-analysis.

PubMed

Wang, Qiong; Wang, Teng-teng; Qi, Xiao-feng; Yao, Min; Cui, Xue-jun; Wang, Yong-jun; Liang, Qian-qian

2015-11-01

Hip osteoarthritis (HOA) is one of the major causes of disability in seniors and is costly to society. Manual therapy is one therapeutic approach to treating HOA. To assess the effect of manual therapy compared to the placebo or wait-list/no treatment or a minimal intervention control for HOA at post-treatment and short-, intermediate- and long-term follow-ups. A systematic review and meta-analysis of randomized controlled trials (RCTs). Hospital outpatient clinic in China. We searched PubMed, EMBASE, the Cochrane Library, CINAHL, ISI web of knowledge, and Chinese databases from the inception to October 2014 without language restrictions. References of systematic reviews and other related reviews, files in our department, and conference proceedings as grey literature were also screened by hand. RCTs compared manual therapy to the placebo, wait-list/no treatment or a minimal intervention control with an appropriate and precise description of randomization. Two reviewers independently conducted the search results identification, data extraction, and methodological quality assessment. We calculated the risk difference (RD) for dichotomous data and the mean difference (MD) or standardized mean difference (SMD) for continuous data in a fixed or random effect model. The primary outcomes were self-reported pain in the past week and physical function. The secondary outcomes were the quality of life, global perceived effect, patients' satisfaction, cost, and adverse events. Six studies involving 515 HOA patients were included. Five of the 6 studies ranked as high quality in the methodological assessment. Immediately post-treatment, there was low-quality evidence that manual therapy could not statistically significantly relieve pain (SMD: -0.07 [95%CI -0.38 to 0.24]); for physical function, a moderate quality of evidence showed that manual therapy could not improve the physical function significantly (SMD: 0.14 [95%CI -0.08 to 0.37]). We still found low-quality evidence that

A REVIEW OF LOW-INTENSITY ULTRASOUND FOR CANCER THERAPY

PubMed Central

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

2015-01-01

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

The Therapeutic Relationship in E-Therapy for Mental Health: A Systematic Review

PubMed Central

Schnur, Julie B; Constantino, Michael J; Miller, Sarah J; Brackman, Emily H; Montgomery, Guy H

2012-01-01

Background E-therapy is defined as a licensed mental health care professional providing mental health services via e-mail, video conferencing, virtual reality technology, chat technology, or any combination of these. The use of e-therapy has been rapidly expanding in the last two decades, with growing evidence suggesting that the provision of mental health services over the Internet is both clinically efficacious and cost effective. Yet there are still unanswered concerns about e-therapy, including whether it is possible to develop a successful therapeutic relationship over the Internet in the absence of nonverbal cues. Objective Our objective in this study was to systematically review the therapeutic relationship in e-therapy. Methods We searched PubMed, PsycINFO, and CINAHL through August 2011. Information on study methods and results was abstracted independently by the authors using a standardized form. Results From the 840 reviewed studies, only 11 (1.3%) investigated the therapeutic relationship. The majority of the reviewed studies were focused on the therapeutic alliance—a central element of the therapeutic relationship. Although the results do not allow firm conclusions, they indicate that e-therapy seems to be at least equivalent to face-to-face therapy in terms of therapeutic alliance, and that there is a relationship between the therapeutic alliance and e-therapy outcome. Conclusions Overall, the current literature on the role of therapeutic relationship in e-therapy is scant, and much more research is needed to understand the therapeutic relationship in online environments. PMID:22858538

The therapeutic relationship in e-therapy for mental health: a systematic review.

PubMed

Sucala, Madalina; Schnur, Julie B; Constantino, Michael J; Miller, Sarah J; Brackman, Emily H; Montgomery, Guy H

2012-08-02

E-therapy is defined as a licensed mental health care professional providing mental health services via e-mail, video conferencing, virtual reality technology, chat technology, or any combination of these. The use of e-therapy has been rapidly expanding in the last two decades, with growing evidence suggesting that the provision of mental health services over the Internet is both clinically efficacious and cost effective. Yet there are still unanswered concerns about e-therapy, including whether it is possible to develop a successful therapeutic relationship over the Internet in the absence of nonverbal cues. Our objective in this study was to systematically review the therapeutic relationship in e-therapy. We searched PubMed, PsycINFO, and CINAHL through August 2011. Information on study methods and results was abstracted independently by the authors using a standardized form. From the 840 reviewed studies, only 11 (1.3%) investigated the therapeutic relationship. The majority of the reviewed studies were focused on the therapeutic alliance-a central element of the therapeutic relationship. Although the results do not allow firm conclusions, they indicate that e-therapy seems to be at least equivalent to face-to-face therapy in terms of therapeutic alliance, and that there is a relationship between the therapeutic alliance and e-therapy outcome. Overall, the current literature on the role of therapeutic relationship in e-therapy is scant, and much more research is needed to understand the therapeutic relationship in online environments.

[Why proton therapy? And how?

PubMed

Thariat, Juliette; Habrand, Jean Louis; Lesueur, Paul; Chaikh, Abdulhamid; Kammerer, Emmanuel; Lecomte, Delphine; Batalla, Alain; Balosso, Jacques; Tessonnier, Thomas

2018-03-01

Proton therapy is a radiotherapy, based on the use of protons, charged subatomic particles that stop at a given depth depending on their initial energy (pristine Bragg peak), avoiding any output beam, unlike the photons used in most of the other modalities of radiotherapy. Proton therapy has been used for 60 years, but has only become ubiquitous in the last decade because of recent major advances in particle accelerator technology. This article reviews the history of clinical implementation of protons, the nature of the technological advances that now allows its expansion at a lower cost. It also addresses the technical and physical specificities of proton therapy and the clinical situations for which proton therapy may be relevant but requires evidence. Different proton therapy techniques are possible. These are explained in terms of their clinical potential by explaining the current terminology (such as cyclotrons, synchrotrons or synchrocyclotrons, using superconducting magnets, fixed line or arm rotary with passive diffusion delivery or active by scanning) in basic words. The requirements associated with proton therapy are increased due to the precision of the depth dose deposit. The learning curve of proton therapy requires that clinical indications be prioritized according to their associated uncertainties (such as range uncertainties and movement in lung tumors). Many clinical indications potentially fall under proton therapy ultimately. Clinical strategies are explained in a paralleled manuscript. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Topical therapies in the management of chronic rhinosinusitis: an evidence-based review with recommendations.

PubMed

Rudmik, Luke; Hoy, Monica; Schlosser, Rodney J; Harvey, Richard J; Welch, Kevin C; Lund, Valerie; Smith, Timothy L

2013-04-01

Topical therapies have become an integral component in the management plan for chronic rhinosinusitis (CRS). Several topical therapy strategies have been evaluated, but a formal comprehensive evaluation of the evidence has never been performed. The purpose of this article is to provide an evidence-based approach for the utilization of topical therapies in the management of CRS. A systematic review of the literature was performed and the guidelines for development of an evidence-based review with recommendations were followed. Study inclusion criteria were: adult population >18 years old; chronic rhinosinusitis (CRS) based on published diagnostic criteria; and clearly defined primary clinical end-point. We focused on reporting higher-quality studies (level 2b or higher), but reported on lower-level studies if the topic contained insufficient evidence. We excluded drug-eluting spacer and stent therapy from this review. This review identified and evaluated the literature on 5 topical therapy strategies for CRS: saline irrigation, topical steroid, topical antibiotic, topical antifungal, and topical alternatives (surfactant, manuka honey, and xylitol irrigations). Based on the available evidence, sinonasal saline irrigation and standard topical nasal steroid therapy are recommended in the topical treatment of CRS. Nonstandard (off-label) topical sinonasal steroid therapies can be an option for managing CRS. The evidence recommends against the use of topical antifungal therapy and topical antibiotic therapy delivered using nebulized and spray techniques in routine cases of CRS. There is insufficient clinical research to provide recommendations for alternative therapies or topical antibiotic therapy delivered using other delivery methods (eg, irrigations). © 2013 ARS-AAOA, LLC.

Music therapy in dementia: a narrative synthesis systematic review.

PubMed

McDermott, Orii; Crellin, Nadia; Ridder, Hanne Mette; Orrell, Martin

2013-08-01

Recent reviews on music therapy for people with dementia have been limited to attempting to evaluate whether it is effective, but there is a need for a critical assessment of the literature to provide insight into the possible mechanisms of actions of music therapy. This systematic review uses a narrative synthesis format to determine evidence for effectiveness and provide insight into a model of action. The narrative synthesis framework consists of four elements: (i) theory development; (ii) preliminary synthesis of findings; (iii) exploration of relationships between studies; and (iv) assessment of the robustness of the synthesis. Electronic and hand searches identified 263 potentially relevant studies. Eighteen studies met the full inclusion criteria. Three distinctive strands of investigations emerged: eight studies explored behavioural and psychological aspects, five studies investigated hormonal and physiological changes, and five studies focused on social and relational aspects of music therapy. The musical interventions in the studies were diverse, but singing featured as an important medium for change. Evidence for short-term improvement in mood and reduction in behavioural disturbance was consistent, but there were no high-quality longitudinal studies that demonstrated long-term benefits of music therapy. Future music therapy studies need to define a theoretical model, include better-focused outcome measures, and discuss how the findings may improve the well-being of people with dementia. Copyright © 2012 John Wiley & Sons, Ltd.

Occupational Therapy in the Intensive Care Unit: A Systematic Review.

PubMed

Weinreich, Mark; Herman, Jennifer; Dickason, Stephanie; Mayo, Helen

2017-07-01

This paper is a synthesis of the available literature on occupational therapy interventions performed in the adult intensive care unit (ICU). The databases of Ovid MEDLINE, Embase, the Cochrane Library, ClinicalTrials.gov and CINAHL databases were systematically searched from inception through August 2016 for studies of adults who received occupational therapy interventions in the ICU. Of 1,938 citations reviewed, 10 studies met inclusion criteria. Only one study explicitly discussed occupational therapy interventions performed and only one study specifically tested the efficacy of occupational therapy. Future research is needed to clarify the specific interventions and role of occupational therapy in the ICU and the efficacy of these interventions.

Therapies for bruxism: a systematic review and network meta-analysis (protocol).

PubMed

Mesko, Mauro Elias; Hutton, Brian; Skupien, Jovito Adiel; Sarkis-Onofre, Rafael; Moher, David; Pereira-Cenci, Tatiana

2017-01-13

Bruxism is a sleep disorder characterized by grinding and clenching of the teeth that may be related to irreversible tooth injuries. It is a prevalent condition occurring in up to 31% of adults. However, there is no definitive answer as to which of the many currently available treatments (including drug therapy, intramuscular injections, physiotherapy, biofeedback, kinesiotherapy, use of intraoral devices, or psychological therapy) is the best for the clinical management of the different manifestations of bruxism. The aim of this systematic review and network meta-analysis is to answer the following question: what is the best treatment for adult bruxists? Comprehensive searches of the Cochrane Library, MEDLINE (via PubMed), Scopus, and LILACS will be completed using the following keywords: bruxism and therapies and related entry terms. Studies will be included, according to the eligibility criteria (Controlled Clinical Trials and Randomized Clinical Trials, considering specific outcome measures for bruxism). The reference lists of included studies will be hand searched. Relevant data will be extracted from included studies using a specially designed data extraction sheet. Risk of bias of the included studies will be assessed, and the overall strength of the evidence will be summarized (i.e., GRADE). A random effects model will be used for all pairwise meta-analyses (with a 95% confidence interval). A Bayesian network meta-analysis will explore the relative benefits between the various treatments. The review will be reported using the Preferred Reporting Items for Systematic Reviews incorporating Network Meta-Analyses (PRISMA-NMA) statement. This systematic review aims at identifying and evaluating therapies to treat bruxism. This systematic review may lead to several recommendations, for both patients and researchers, as which is the best therapy for a specific patient case and how future studies need to be designed, considering what is available now and what is

Concise Review: Process Development Considerations for Cell Therapy

PubMed Central

Brieva, Thomas; Raviv, Lior; Rowley, Jon; Niss, Knut; Brandwein, Harvey; Oh, Steve; Karnieli, Ohad

2015-01-01

The development of robust and well-characterized methods of production of cell therapies has become increasingly important as therapies advance through clinical trials toward approval. A successful cell therapy will be a consistent, safe, and effective cell product, regardless of the cell type or application. Process development strategies can be developed to gain efficiency while maintaining or improving safety and quality profiles. This review presents an introduction to the process development challenges of cell therapies and describes some of the tools available to address production issues. This article will provide a summary of what should be considered to efficiently advance a cellular therapy from the research stage through clinical trials and finally toward commercialization. The identification of the basic questions that affect process development is summarized in the target product profile, and considerations for process optimization are discussed. The goal is to identify potential manufacturing concerns early in the process so they may be addressed effectively and thus increase the probability that a therapy will be successful. Significance The present study contributes to the field of cell therapy by providing a resource for those transitioning a potential therapy from the research stage to clinical and commercial applications. It provides the necessary steps that, when followed, can result in successful therapies from both a clinical and commercial perspective. PMID:26315572

Hypogonadism associated with long-term opioid therapy: A systematic review.

PubMed

Birthi, Pravardhan; Nagar, Vittal R; Nickerson, Robert; Sloan, Paul A

2015-01-01

Sexual dysfunction and Opioid-Induced Sexual Hormone Deficiency (OPISHD) have been associated with patients on long-term opioid pain therapy. There have been few comprehensive reviews to establish a relation between hypogonadism with chronic opioid pain management. The OPISHD is often not treated and literature guiding this topic is scarce. To investigate hypogonadism associated with long-term opioid therapy based on qualitative data analysis of the available literature. Systematic review. The review included relevant literature identified through searches of PubMed, Cochrane, Clinical Trials, US National Guideline Clearinghouse, and EMBASE, for the years 1960 to September 2013. The quality assessment and clinical relevance criteria used were the Cochrane Musculoskeletal Review Group Criteria for randomized control trials and the Newcastle-Ottawa Scale Criteria for observational studies. The level of evidence was classified as good, fair, and poor, based on the quality of evidence. The primary outcome measures were clinical symptoms and laboratory markers of hypogonadism. Secondary outcome measure was management of OPISHD. Thirty-one studies were identified, of which 14 studies met inclusion criteria. There were no randomized control trials and eight of 14 studies were of moderate quality. The remaining studies were of poor quality. Four studies report most patients on long-term oral opioid therapy have associated hypogonadism and three studies of patients receiving intrathecal opioid therapy suggest that hypogonadism is common. There is lack of high-quality studies to associate chronic opioid pain management with hypogonadism. At present, there is fair evidence to associate hypogonadism with chronic opioid pain management, and only limited evidence for treatment of OPISHD.

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

PubMed Central

2012-01-01

Background Achilles tendinopathy (AT) is a common condition, causing considerable morbidity in athletes and non-athletes alike. Conservative or physical therapies are accepted as first-line management of AT; however, despite a growing volume of research, there remains a lack of high quality studies evaluating their efficacy. Previous systematic reviews provide preliminary evidence for non-surgical interventions for AT, but lack key quality components as outlined in the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Statement. The aim of this study was to conduct a systematic review and meta-analysis (where possible) of the evidence for physical therapies for AT management. Methods A comprehensive strategy was used to search 11 electronic databases from inception to September 2011. Search terms included Achilles, tendinopathy, pain, physical therapies, electrotherapy and exercise (English language full-text publications, human studies). Reference lists of eligible papers were hand-searched. Randomised controlled trials (RCTs) were included if they evaluated at least one non-pharmacological, non-surgical intervention for AT using at least one outcome of pain and/or function. Two independent reviewers screened 2852 search results, identifying 23 suitable studies, and assessed methodological quality and risk of bias using a modified PEDro scale. Effect size calculation and meta-analyses were based on fixed and random effects models respectively. Results Methodological quality ranged from 2 to 12 (/14). Four studies were excluded due to high risk of bias, leaving 19 studies, the majority of which evaluated midportion AT. Effect sizes from individual RCTs support the use of eccentric exercise. Meta-analyses identified significant effects favouring the addition of laser therapy to eccentric exercise at 12 weeks (pain VAS: standardised mean difference −0.59, 95% confidence interval −1.11 to −0.07), as well as no differences in effect

Review of pharmacological therapies in fibromyalgia syndrome

PubMed Central

2014-01-01

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

Particle Based Technologies for Osteoarthritis Detection and Therapy

PubMed Central

Kavanaugh, Taylor E.; Werfel, Thomas A.; Cho, Hongsik; Hasty, Karen A.; Duvall, Craig L.

2015-01-01

Osteoarthritis (OA) is a disease characterized by degradation of joints with the development of painful osteophytes in the surrounding tissues. Currently, there are a limited number of treatments for this disease and many of these only provide temporary, palliative relief. In this review, we discuss polymer drug delivery systems that can provide targeted and sustained delivery of imaging and therapeutic agents to OA-affected sites. We focus on technologies such as polymeric micelles and nano- / micro-particles, liposomes, and dendrimers for their potential treatment and/or diagnosis of OA. Several promising studies are highlighted, motivating the continued development of delivery technologies to improve treatments for OA. PMID:25990835

Particle Data Group - Downloads

Science.gov Websites

1977 1976 1975 1974 1973 1972 1971 Older Publications Review of Particle Properties 1970 Aug. Review of Particle Properties 1970 Jan. Review of Particle Properties 1969 Review of Particle Properties 1968 Aug

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

ERIC Educational Resources Information Center

Rowe, Cynthia L.

2012-01-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-01-01

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

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

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

2014-05-01

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

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

I J van Rooyen; J H Neethling; J A A Engelbrecht

2012-10-01

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

Complementary therapies for peripheral arterial disease: systematic review.

PubMed

Pittler, Max H; Ernst, Edzard

2005-07-01

While peripheral arterial disease (PAD) affects a considerable proportion of patients in the primary care setting, there is a high level of use of complementary treatment options. The aim was to assess the effectiveness of any type of complementary therapy for peripheral arterial disease. A systematic review was performed. Literature searches were conducted on Medline, Embase, Amed, and the Cochrane Library until December 2004. Hand-searches of medical journals and bibliographies were conducted. There were no restrictions regarding the language of publication. The screening of studies, selection, data extraction, the assessment of methodologic quality and validation were performed independently by the two reviewers. Data from randomized controlled trials, and systematic reviews and meta-analyses, which based their findings on the results of randomized controlled trials were included. Seven systematic reviews and meta-analyses and three additional randomized controlled trials met the inclusion criteria and were reviewed. The evidence relates to acupuncture, biofeedback, chelation therapy, CO(2)-applications and the dietary supplements Allium sativum (garlic), Ginkgo biloba (ginkgo), omega-3 fatty acids, padma 28 and Vitamin E. Most studies included only patients with peripheral arterial disease in Fontaine stage II (intermittent claudication). The reviewed RCTs, systematic reviews and meta-analyses which based their findings on the results of RCTs suggest that G. biloba is effective compared with placebo for patients with intermittent claudication. Evidence also suggests that padma 28 is effective for intermittent claudication, although more data are required to confirm these findings. For all other complementary treatment options there is no evidence beyond reasonable doubt to suggest effectiveness for patients with peripheral arterial disease.

Digital particle image thermometry/velocimetry: a review

NASA Astrophysics Data System (ADS)

Dabiri, Dana

2009-02-01

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

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

NASA Astrophysics Data System (ADS)

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

2012-02-01

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

Complementary Spiritist Therapy: Systematic Review of Scientific Evidence

PubMed Central

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

2011-01-01

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

Art therapy for people with psychosis: a narrative review of the literature.

PubMed

Attard, Angelica; Larkin, Michael

2016-11-01

Art therapy enables individuals to use art to creatively express themselves and communicate differently with themselves, others, and their reality. The National Institute for Health and Clinical Excellence guidelines for psychosis and schizophrenia suggest that arts therapies, which include art therapy, are considered to improve negative symptoms of psychosis. We examined the effectiveness of art therapy for people with psychosis and explored whether art therapy is a meaningful and acceptable intervention in this Review. Seven electronic databases were searched for empirical papers that concerned the use of art therapy for adults with psychosis that were published from 2007 onwards. The search identified 18 papers. High-quality quantitative articles provided inconclusive evidence for the effectiveness of art therapy in adults with psychosis. However, high-quality qualitative articles indicated that therapists and clients considered art therapy to be a beneficial, meaningful, and acceptable intervention, although this conclusion was based on a small number of studies. In this Review, we discuss the theoretical, clinical, and methodological issues in light of the development of more robust research, which is needed to corroborate individuals' experiences and guide evidence-based practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Psychological Treatments for Borderline Personality Disorder: A Review of Cognitive-Behavioral Oriented Therapies].

PubMed

Marques, Sofia; Barrocas, Daniel; Rijo, Daniel

2017-04-28

Borderline personality disorder is the most common personality disorder, with a global prevalence rate between 1.6% and 6%. It is characterized by affective disturbance and impulsivity, which lead to a high number of self-harm behaviors and great amount of health services use. International guidelines recommend psychotherapy as the primary treatment for borderline personality disorder. This paper reviews evidence about the effects and efficacy of cognitive-behavioral oriented psychological treatments for borderline personality disorder. A literature review was conducted in Medline and PubMed databases, using the following keywords: borderline personality disorder, cognitive-behavioral psychotherapy and efficacy. Sixteen randomized clinical trials were evaluate in this review, which analyzed the effects of several cognitive-behavioral oriented psychotherapeutic interventions, namely dialectical behavioral therapy, cognitive behavioral therapy, schema-focused therapy and manual-assisted cognitive therapy. All above stated treatments showed clinical beneficial effects, by reducing borderline personality disorder core pathology and associated general psychopathology, as well as by reducing the severity and frequency of self-harm behaviors, and by improving the overall social, interpersonal and global adjustment. Dialectical behavioral therapy and schema-focused therapy also caused a soaring remission rate of diagnostic borderline personality disorder criteria of 57% and 94%, respectively. Although there were differences between the psychotherapeutic interventions analysed in this review, all showed clinical benefits in the treatment of borderline personality disorder. Dialectical behavioral therapy and schema-focused therapy presented the strongest scientific data documenting their efficacy, but both interventions are integrative cognitive-behavioral therapies which deviate from the traditional cognitive-behavioral model. In summary, the available studies support

Ozone therapy in postgraduate theses in Egypt: systematic review.

PubMed

AlBedah, Abdullah M N; Khalil, Mohamed K M; Elolemy, Ahmed T; Alrasheid, Mohamed H S; Al Mudaiheem, Abdullah; Elolemy, Tawfik M B

2013-08-01

Systematic reviews of the studies published in the major medical data bases have not shown solid support for the use of ozone therapy. Unpublished or grey literature, including postgraduate theses, may solve this controversy. To review the postgraduate theses published in Egypt in order to assess the clinical safety and effectiveness of ozone therapy in specific medical conditions. The databases of the Egyptian Universities' Library Consortium and the databases of each university were searched for postgraduate theses that evaluated ozone therapy as an intervention for any disease or condition in any age group, compared with any or no other intervention and published before September 2010. A total of 28 quasi trials were included. The theses did not report any safety issues in terms of ozone therapy. With respect to its effectiveness, the studies suggested some benefits of ozone in the treatment of dental infection and recovery, musculoskeletal disorders, diabetes mellitus, chronic diseases, and obstetrics and gynaecology. However, the number of studies included was small and they were of limited quality. There is insufficient evidence to recommend the use of ozone in the treatment of dental infections, in facilitating faster dental recovery after extraction or implantation, in diabetes mellitus, musculoskeletal disorders, or obstetrics and gynaecology.

Chronic prostatitis/chronic pelvic pain syndrome: a review of evaluation and therapy.

PubMed

Polackwich, A S; Shoskes, D A

2016-06-01

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), also known as NIH Category III Prostatitis is a highly prevalent syndrome with significant impact on quality of life. As a heterogeneous syndrome, there exists no 'one size fits all' therapy with level 1 evidence to guide therapy. This often leads to a nihilistic approach to patients and clinical outcomes are poor. In this review, we examine the evidence for CP/CPPS therapies and discuss our technique of clinical phenotyping combined with multimodal therapy. Review of Medline articles with terms 'non-bacterial prostatitis', 'abacterial prostatitis' and 'chronic pelvic pain syndrome'. Many individual therapies have been evaluated in the treatment of CP/CPPS; antibiotics, anti-inflammatory medications (including bioflavonoids), neuromodulators, alpha blockers, pelvic floor physical therapy and cognitive behavior therapy. Each of these has been found to have varying success in alleviating symptoms. UPOINT is a system of clinical phenotyping for CP/CPPS patients that has 6 defined domains, which guide multimodal therapy. It has been validated to correlate with symptom burden and therapy guided by UPOINT leads to significant symptom improvement in 75-84% of patients based on three independent studies. CP/CPPS is a heterogeneous condition and, much like with prostate cancer, optimal therapy can only be achieved by classifying patients into clinically meaningful phenotypic groups (much like TNM) and letting the phenotype drive therapy.

WE-FG-BRB-02: Spatial Mapping of the RBE of Scanned Particle Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grosshans, D.

2016-06-15

The physical pattern of energy deposition and the enhanced relative biological effectiveness (RBE) of protons and carbon ions compared to photons offer unique and not fully understood or exploited opportunities to improve the efficacy of radiation therapy. Variations in RBE within a pristine or spread out Bragg peak and between particle types may be exploited to enhance cell killing in target regions without a corresponding increase in damage to normal tissue structures. In addition, the decreased sensitivity of hypoxic tumors to photon-based therapies may be partially overcome through the use of more densely ionizing radiations. These and other differences betweenmore » particle and photon beams may be used to generate biologically optimized treatments that reduce normal tissue complications. In this symposium, speakers will examine the impact of the RBE of charged particles on measurable biological endpoints, treatment plan optimization, and the prediction or retrospective assessment of treatment outcomes. In particular, an AAPM task group was formed to critically examine the evidence for a spatially-variant RBE in proton therapy. Current knowledge of proton RBE variation with respect to dose, biological endpoint, and physics parameters will be reviewed. Further, the clinical relevance of these variations will be discussed. Recent work focused on improving simulations of radiation physics and biological response in proton and carbon ion therapy will also be presented. Finally, relevant biology research and areas of research needs will be highlighted, including the dependence of RBE on genetic factors including status of DNA repair pathways, the sensitivity of cancer stem-like cells to charged particles, the role of charged particles in hypoxic tumors, and the importance of fractionation effects. In addition to the physical advantages of protons and more massive ions over photons, the future application of biologically optimized treatment plans and their

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

PubMed

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

2014-01-01

Alpha-particle radiopharmaceutical therapy (αRPT) is currently enjoying increasing attention as a viable alternative to chemotherapy for targeting of disseminated micrometastatic disease. In theory, αRPT can be personalized through pre-therapeutic imaging and dosimetry. However, in practice, given the particularities of α-particle emissions, a dosimetric methodology that accurately predicts the thresholds for organ toxicity has not been reported. This is in part due to the fact that the biological effects caused by α-particle radiation differ markedly from the effects caused by traditional external beam (photon or electron) radiation or β-particle emitting radiopharmaceuticals. The concept of relative biological effectiveness (RBE) is used to quantify the ratio of absorbed doses required to achieve a given biological response with alpha particles versus a reference radiation (typically a beta emitter or external beam radiation). However, as conventionally defined, the RBE varies as a function of absorbed dose and therefore a single RBE value is limited in its utility because it cannot be used to predict response over a wide range of absorbed doses. Therefore, efforts are underway to standardize bioeffect modeling for different fractionation schemes and dose rates for both nuclear medicine and external beam radiotherapy. Given the preponderant use of external beams of radiation compared to nuclear medicine in cancer therapy, the more clinically relevant quantity, the 2 Gy equieffective dose, EQD2(α/β), has recently been proposed by the ICRU. In concert with EQD2(α/β), we introduce a new, redefined RBE quantity, named RBE2(α/β), as the ratio of the two linear coefficients that characterize the α particle absorbed dose-response curve and the low-LET megavoltage photon 2 Gy fraction equieffective dose-response curve. The theoretical framework for the proposed new formalism is presented along with its application to experimental data obtained from

Redefining Relative Biological Effectiveness in the Context of the EQDX Formalism: Implications for Alpha-Particle Emitter Therapy.

PubMed

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

2013-12-30

Alpha-particle radiopharmaceutical therapy (αRPT) is currently enjoying increasing attention as a viable alternative to chemotherapy for targeting of disseminated micrometastatic disease. In theory, αRPT can be personalized through pre-therapeutic imaging and dosimetry. However, in practice, given the particularities of α-particle emissions, a dosimetric methodology that accurately predicts the thresholds for organ toxicity has not been reported. This is in part due to the fact that the biological effects caused by α-particle radiation differ markedly from the effects caused by traditional external beam (photon or electron) radiation or β-particle emitting radiopharmaceuticals. The concept of relative biological effectiveness (RBE) is used to quantify the ratio of absorbed doses required to achieve a given biological response with alpha particles versus a reference radiation (typically a beta emitter or external beam radiation). However, as conventionally defined, the RBE varies as a function of absorbed dose and therefore a single RBE value is limited in its utility because it cannot be used to predict response over a wide range of absorbed doses. Therefore, efforts are underway to standardize bioeffect modeling for different fractionation schemes and dose rates for both nuclear medicine and external beam radiotherapy. Given the preponderant use of external beams of radiation compared to nuclear medicine in cancer therapy, the more clinically relevant quantity, the 2 Gy equieffective dose, EQD2(α/β), has recently been proposed by the ICRU. In concert with EQD2(α/β), we introduce a new, redefined RBE quantity, named RBE2(α/β), as the ratio of the two linear coefficients that characterize the α particle absorbed dose-response curve and the low-LET megavoltage photon 2 Gy fraction equieffective dose-response curve. The theoretical framework for the proposed new formalism is presented along with its application to experimental data obtained from

Study of the chemical composition of atmospheric aerosol particles in Hungary: a review

NASA Astrophysics Data System (ADS)

Mészáros, E.

The methods used in Hungarian laboratories to study the chemical composition of atmospheric aerosol particles over the last 30 years are reviewed. Individual particles were identified by topochemical techniques and morphological identification with an electron microscope. Bulk analyses were also carried out by applying wet chemical methods, and more recently by the PIXE procedure. The results gained are summarized in connection with the general development of atmospheric aerosol science during the last decades. These studies demonstrated that cloud condensation nuclei are water soluble Aitken sized particles which are composed of sulfates. Neutralized and acidic sulfate particles constitute the main class of fine aerosol particles under continental and oceanic background conditions. Coarse particles contain mostly sodium, silicon and aluminium. The formation and origin of particles in different size ranges are also discussed.

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

PubMed

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

2010-12-01

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

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

PubMed Central

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

2010-01-01

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

Exercise therapy and other types of physical therapy for patients with neuromuscular diseases: a systematic review.

PubMed

Cup, Edith H; Pieterse, Allan J; Ten Broek-Pastoor, Jessica M; Munneke, Marten; van Engelen, Baziel G; Hendricks, Henk T; van der Wilt, Gert J; Oostendorp, Rob A

2007-11-01

To summarize and critically appraise the available evidence on exercise therapy and other types of physical therapies for patients with neuromuscular diseases (NMD). Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, Medline, CINAHL, EMBASE (Rehabilitation and Physical Medicine), and reference lists of reviews and articles. Randomized clinical trials (RCTs), controlled clinical trials (CCTs), and other designs were included. Study participants had to have any of the following types of NMD: motoneuron diseases, disorders of the motor nerve roots or peripheral nerves, neuromuscular transmission disorders, or muscle diseases. All types of exercise therapy and other physical therapy modalities were included. Outcome measures had to be at the level of body functions, activities, or participation according to the definitions of the International Classification of Functioning, Disability and Health (ICF). Two reviewers independently decided on inclusion or exclusion of articles and rated the methodologic quality of the studies included. All RCTs, CCTs, and other designs only if of sufficient methodologic quality were included in a best evidence synthesis. A level of evidence was attributed for each subgroup of NMD and each type of intervention. Initially 58 studies were included: 12 RCTs, 5 CCTs, and 41 other designs. After methodologic assessment, 19 other designs were excluded from further analysis. There is level II evidence ("likely to be effective") for strengthening exercises in combination with aerobic exercises for patients with muscle disorders. Level III evidence ("indications of effectiveness") was found for aerobic exercises in patients with muscle disorders and for the combination of muscle strengthening and aerobic exercises in a heterogeneous group of muscle disorders. Finally, there is level III evidence for breathing exercises for patients with myasthenia gravis and for patients with myotonic muscular dystrophy

In vivo verification of particle therapy: how Compton camera configurations affect 3D image quality

NASA Astrophysics Data System (ADS)

Mackin, D.; Draeger, E.; Peterson, S.; Polf, J.; Beddar, S.

2017-05-01

The steep dose gradients enabled by the Bragg peaks of particle therapy beams are a double edged sword. They enable highly conformal dose distributions, but even small deviations from the planned beam range can cause overdosing of healthy tissue or under-dosing of the tumour. To reduce this risk, particle therapy treatment plans include margins large enough to account for all the sources of range uncertainty, which include patient setup errors, patient anatomy changes, and CT number to stopping power ratios. Any system that could verify the beam range in vivo, would allow reduced margins and more conformal dose distributions. Toward our goal developing such a system based on Compton camera (CC) imaging, we studied how three configurations (single camera, parallel opposed, and orthogonal) affect the quality of the 3D images. We found that single CC and parallel opposed configurations produced superior images in 2D. The increase in parallax produced by an orthogonal CC configuration was shown to be beneficial in producing artefact free 3D images.

Simulated Patients in Physical Therapy Education: Systematic Review and Meta-Analysis.

PubMed

Pritchard, Shane A; Blackstock, Felicity C; Nestel, Debra; Keating, Jenny L

2016-09-01

Traditional models of physical therapy clinical education are experiencing unprecedented pressures. Simulation-based education with simulated (standardized) patients (SPs) is one alternative that has significant potential value, and implementation is increasing globally. However, no review evaluating the effects of SPs on professional (entry-level) physical therapy education is available. The purpose of this study was to synthesize and critically appraise the findings of empirical studies evaluating the contribution of SPs to entry-level physical therapy education, compared with no SP interaction or an alternative education strategy, on any outcome relevant to learning. A systematic search was conducted of Ovid MEDLINE, PubMed, AMED, ERIC, and CINAHL Plus databases and reference lists of included articles, relevant reviews, and gray literature up to May 2015. Articles reporting quantitative or qualitative data evaluating the contribution of SPs to entry-level physical therapy education were included. Two reviewers independently extracted study characteristics, intervention details, and quantitative and qualitative evaluation data from the 14 articles that met the eligibility criteria. Pooled random-effects meta-analysis indicated that replacing up to 25% of authentic patient-based physical therapist practice with SP-based education results in comparable competency (mean difference=1.55/100; 95% confidence interval=-1.08, 4.18; P=.25). Thematic analysis of qualitative data indicated that students value learning with SPs. Assumptions were made to enable pooling of data, and the search strategy was limited to English. Simulated patients appear to have an effect comparable to that of alternative educational strategies on development of physical therapy clinical practice competencies and serve a valuable role in entry-level physical therapy education. However, available research lacks the rigor required for confidence in findings. Given the potential advantages for

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

NASA Astrophysics Data System (ADS)

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

2015-02-01

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

Behavior Therapy for Tourette Syndrome: A Systematic Review and Meta-analysis.

PubMed

Wile, Daryl J; Pringsheim, Tamara M

2013-08-01

When tics caused by Tourette Syndrome cause meaningful impairment for patients, a comprehensive treatment approach includes education of patients, peers, and family, treatment of comorbid behavioral disorders if present, and consideration of behavior therapy and pharmacotherapy for tics themselves. This systematic review and meta-analysis demonstrates that behavior therapies based on Habit Reversal Therapy, including the Comprehensive Behavioral Intervention for Tics are effective in reducing tic severity when compared with supportive psychotherapy. When these behavior therapies are unavailable, Exposure with Response Prevention may also be effective. Both face-to-face and telehealth delivery methods for behavior therapy improve tic severity, and broader distribution of behavior therapy through increased training or telehealth methods is encouraged. High-quality randomized trials comparing behavior therapies for tics with pharmacotherapy are needed.

Abstract ID: 240 A probabilistic-based nuclear reaction model for Monte Carlo ion transport in particle therapy.

PubMed

Maria Jose, Gonzalez Torres; Jürgen, Henniger

2018-01-01

In order to expand the Monte Carlo transport program AMOS to particle therapy applications, the ion module is being developed in the radiation physics group (ASP) at the TU Dresden. This module simulates the three main interactions of ions in matter for the therapy energy range: elastic scattering, inelastic collisions and nuclear reactions. The simulation of the elastic scattering is based on the Binary Collision Approximation and the inelastic collisions on the Bethe-Bloch theory. The nuclear reactions, which are the focus of the module, are implemented according to a probabilistic-based model developed in the group. The developed model uses probability density functions to sample the occurrence of a nuclear reaction given the initial energy of the projectile particle as well as the energy at which this reaction will take place. The particle is transported until the reaction energy is reached and then the nuclear reaction is simulated. This approach allows a fast evaluation of the nuclear reactions. The theory and application of the proposed model will be addressed in this presentation. The results of the simulation of a proton beam colliding with tissue will also be presented. Copyright © 2017.

A systematic review of dental disease in patients undergoing cancer therapy

PubMed Central

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

2010-01-01

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

Systematic review; Nutritional therapy in gestational diabetes mellitus.

PubMed

Thomaz de Lima, Helaine; Lopes Rosado, Eliane; Ribeiro Neves, Paulo Augusto; Corrêa Monteiro Machado, Raphaela; Mello de Oliveira, Larissa; Saunders, Cláudia

2013-11-01

Several methods of dietetic counseling can be used in the nutritional therapy in gestational diabetes mellitus (GDM). The main methods are the traditional method (TM) and the carbohydrate counting (CCM). Presenting a systematic review of the literature on the impact of nutritional therapy in GDM, through TM and CCM, evaluating the results for maternal and child health. We searched databases PubMed, Scopus, Web of Science, Lilacs and CAPES Digital Bank of Thesis. The methodological quality of all the studies included was made using the Jadad score. We have found five studies that evaluated the effects of nutritional therapy, through the TM, on the maternal and child health. None study evaluating the CCM was detected in pregnant women with GDM Nutritional therapy given during antenatal care was effective in reducing pregnancy complications (preeclampsia, excessive gestational weight gain, necessity for cesarean delivery, for insulin therapy and for shoulder dystocia), perinatal complications (macrosomia, neonatal hypoglycemia, and birth weight) and also in better glycemic control. The use of nutritional therapy should be highlighted within the antenatal care for pregnant women with GDM, giving the satisfactory results on metabolic control and on pregnancy outcomes. Studies examining the CCM to GDM patients should be conducted to show its effects on maternal and child health.

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

PubMed

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

2016-03-01

MRSA bacteraemia (MRSAB), including infective endocarditis, carries a high mortality rate, with up to 50% of patients failing initial therapy with vancomycin and requiring salvage therapy. Persistent MRSAB can be difficult to successfully eliminate, especially when source control is not possible due to an irremovable focus or the bacteraemia still persists despite surgical intervention. Although vancomycin and daptomycin are the only two antibiotics approved by the US FDA for the treatment of patients with MRSAB as monotherapy, the employment of novel strategies is required to effectively treat patients with persistent MRSAB and these may frequently involve combination drug therapy. Treatment strategies that are reviewed in this manuscript include vancomycin combined with a β-lactam, daptomycin-based therapy, ceftaroline-based therapy, linezolid-based therapy, quinupristin/dalfopristin, telavancin, trimethoprim/sulfamethoxazole-based therapy and fosfomycin-based therapy. We recommend that combination antibiotic therapy be considered for use in MRSAB salvage treatment. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

COST-ENLIGHT strategic workshop on hadron (particle) therapy, CERN, Geneva, 3-4 May 2007.

PubMed

Taylor, R E

2008-03-01

This meeting was convened by COST (Co-operation in the Field of Scientific and Technical Research) and ENLIGHT (European Network for Research in Light-Ion Hadron Therapy) to review the current status of hadron therapy in Europe. The aims were to increase awareness of hadron therapy within the scientific community, to produce a document outlining the present and future prospects for this treatment modality and to bring together hadron therapy scientists and clinicians. Proton therapy offers the potential for therapeutic gain from dose distribution advantages when compared with photon therapy. Carbon ion therapy, by nature of its higher linear energy transfer (LET) and relative biological effectiveness (RBE), may further improve local control. A further potential benefit of carbon ion therapy is the ability to deliver hypofractionated radiotherapy. A further aim of this meeting was to commence preparation of a programme of work packages with a view to submitting an application for European Union funding within the FP7 programme. This comprises a series of seven work packages, which will be a focus for European collaboration.

Efficacy of aquatic therapy for multiple sclerosis: a systematic review.

PubMed

Corvillo, Iluminada; Varela, Enrique; Armijo, Francisco; Alvarez-Badillo, Antonio; Armijo, Onica; Maraver, Francisco

2017-12-01

Multiple sclerosis (MS) is a chronic, inflammatory, progressive, disabling autoimmune disease affecting the central nervous system. Symptoms and signs of MS vary widely and patients may lose their ability to walk. To date the benefits of aquatic therapy often used for rehabilitation in MS patients have not been reviewed. The aim of this study was to systematically review the current state of aquatic treatment for persons with MS (hydrotherapy, aquatic therapy, aquatic exercises, spa therapy) and to evaluate the scientific evidence supporting the benefits of this therapeutic option. The databases PubMed, Scopus, WoS and PEDro were searched to identify relevant reports published from January 1, 2011 to April 30, 2016. Of 306 articles identified, only 10 fulfilled the inclusion criteria: 5 randomized controlled, 2 simple randomized quasi-experimental, 1 semi-experimental, 1 blind controlled pilot and 1 pilot. Evidence that aquatic treatment improves quality of life in affected patients was very good in two studies, good in four, fair in two and weak in two.

Effectiveness of Occupational Therapy Interventions for Adults With Fibromyalgia: A Systematic Review.

PubMed

Poole, Janet L; Siegel, Patricia

This systematic review addresses the effectiveness of occupational therapy-related interventions for adults with fibromyalgia. We examined the literature published between January 2000 and June 2014. A total of 322 abstracts from five databases were reviewed. Forty-two Level I studies met the inclusion criteria. Studies were evaluated primarily with regard to the following outcomes: daily activities, pain, depressive symptoms, fatigue, and sleep. Strong evidence was found for interventions categorized for this review as cognitive-behavioral interventions; relaxation and stress management; emotional disclosure; physical activity; and multidisciplinary interventions for improving daily living, pain, depressive symptoms, and fatigue. There was limited to no evidence for self-management, and few interventions resulted in better sleep. Although the evidence supports interventions within the scope of occupational therapy practice for people with fibromyalgia, few interventions were occupation based. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Development of a transmission alpha particle dosimetry technique using A549 cells and a Ra-223 source for targeted alpha therapy.

PubMed

Al Darwish, R; Staudacher, A H; Li, Y; Brown, M P; Bezak, E

2016-11-01

In targeted radionuclide therapy, regional tumors are targeted with radionuclides delivering therapeutic radiation doses. Targeted alpha therapy (TAT) is of particular interest due to its ability to deliver alpha particles of high linear energy transfer within the confines of the tumor. However, there is a lack of data related to alpha particle distribution in TAT. These data are required to more accurately estimate the absorbed dose on a cellular level. As a result, there is a need for a dosimeter that can estimate, or better yet determine the absorbed dose deposited by alpha particles in cells. In this study, as an initial step, the authors present a transmission dosimetry design for alpha particles using A549 lung carcinoma cells, an external alpha particle emitting source (radium 223; Ra-223) and a Timepix pixelated semiconductor detector. The dose delivery to the A549 lung carcinoma cell line from a Ra-223 source, considered to be an attractive radionuclide for alpha therapy, was investigated in the current work. A549 cells were either unirradiated (control) or irradiated for 12, 1, 2, or 3 h with alpha particles emitted from a Ra-223 source positioned below a monolayer of A549 cells. The Timepix detector was used to determine the number of transmitted alpha particles passing through the A549 cells and DNA double strand breaks (DSBs) in the form of γ-H2AX foci were examined by fluorescence microscopy. The number of transmitted alpha particles was correlated with the observed DNA DSBs and the delivered radiation dose was estimated. Additionally, the dose deposited was calculated using Monte Carlo code SRIM. Approximately 20% of alpha particles were transmitted and detected by Timepix. The frequency and number of γ-H2AX foci increased significantly following alpha particle irradiation as compared to unirradiated controls. The equivalent dose delivered to A549 cells was estimated to be approximately 0.66, 1.32, 2.53, and 3.96 Gy after 12, 1, 2, and 3 h

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

ERIC Educational Resources Information Center

Simpson, Desley

2015-01-01

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

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

PubMed Central

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

2014-01-01

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

Electroconvulsive therapy for obsessive-compulsive disorder: a systematic review.

PubMed

Fontenelle, Leonardo F; Coutinho, Evandro S F; Lins-Martins, Natália M; Fitzgerald, Paul B; Fujiwara, Hironobo; Yücel, Murat

2015-07-01

Surgical therapies for treatment-refractory obsessive-compulsive disorder (OCD), such as deep brain stimulation or psychosurgery, remain unattainable for many patients. Despite the long-held view that electroconvulsive therapy (ECT) is an ineffective treatment for OCD, there is no systematic review to support or refute this claim, which is the basis of the current review. A systematic search of MEDLINE, Web of Science, Scopus, and LILACS databases was conducted on December 22, 2013, using the terms obsessive-compulsive disorder and electroconvulsive therapy. Reference lists, specific journals, and clinical trial registries were also scrutinized. No date or language limitation was imposed on the search. After irrelevant and redundant records from the 500 identified titles were excluded, the 50 articles reporting the acute treatment effects of ECT in OCD and related constructs (involving a total of 279 patients) were analyzed for this study. The relevant sociodemographic, clinical, and outcome data of individual cases were extracted. Data from individual cases were used to compare the characteristics of responders versus nonresponders to ECT. Most selected records were case reports/series; there were no randomized controlled trials. A positive response was reported in 60.4% of the 265 cases in which individual responses to ECT were available. ECT responders exhibited a significantly later onset of OCD symptoms (P = .003), were more frequently nondepressed (P = .009), more commonly reported being treated with ECT for severe OCD (P = .01), and received a fewer number of ECT sessions (P = .03). ECT responders were also less frequently previously treated with adequate trials of serotonin reuptake inhibitors (P = .05) and cognitive-behavioral therapy (P = .005). Although 60% of the reported cases reviewed exhibited some form of a positive response to ECT, it cannot be stated that this provides evidence that ECT is indeed effective for OCD. © Copyright 2015 Physicians

Scanning systems for particle cancer therapy

DOEpatents

Trbojevic, Dejan

2015-08-04

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

Effectiveness of Occupational Therapy Interventions for Lower-Extremity Musculoskeletal Disorders: A Systematic Review.

PubMed

Dorsey, Julie; Bradshaw, Michelle

Lower-extremity (LE) musculoskeletal disorders (MSDs) can have a major impact on the ability to carry out daily activities. The effectiveness of interventions must be examined to enable occupational therapy practitioners to deliver the most appropriate services. This systematic review examined the literature published between 1995 and July 2014 that investigated the effectiveness of occupational therapy interventions for LE MSDs. Forty-three articles met the criteria and were reviewed. Occupational therapy interventions varied on the basis of population subgroup: hip fracture, LE joint replacement, LE amputation or limb loss, and nonsurgical osteoarthritis and pain. The results indicate an overall strong role for occupational therapy in treating clients with LE MSDs. Activity pacing is an effective intervention for nonsurgical LE MSDs, and multidisciplinary rehabilitation is effective for LE joint replacement and amputation. Further research on specific occupational therapy interventions in this important area is needed. Copyright © 2017 by the American Occupational Therapy Association, Inc.

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

PubMed

Tucquet, Belinda; Leung, Maggie

2014-01-01

This article presents the results of a national clinical practice review conducted in Australia of music therapy services in pediatric oncology hospitals. Literature specifically related to music therapy and symptom management in pediatric oncology is reviewed. The results from a national benchmarking survey distributed to all music therapists working with children with cancer in Australian pediatric hospitals are discussed. Patient and family feedback provided from a quality improvement activity conducted at a major pediatric tertiary hospital is summarized, and considerations for future growth as a profession and further research is proposed. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

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

PubMed Central

Carneiro, Mariana Barquet; Alves, Débora Pinheiro Lédio; Mercadante, Marcelo Tomanik

2013-01-01

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

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

PubMed

Kumar, Saravana; Beaton, Kate; Hughes, Tricia

2013-09-04

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

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

PubMed Central

Kumar, Saravana; Beaton, Kate; Hughes, Tricia

2013-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2016-07-01

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

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

ERIC Educational Resources Information Center

Silverman, Michael J.

2008-01-01

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

Sonodynamic therapy--a review of the synergistic effects of drugs and ultrasound.

PubMed

Rosenthal, Ionel; Sostaric, Joe Z; Riesz, Peter

2004-09-01

Sonodynamic therapy, the ultrasound dependent enhancement of cytotoxic activities of certain compounds (sonosensitizers) in studies with cells in vitro and in tumor bearing animals, is reviewed. The attractive features of this modality for cancer treatment emerges from the ability to focus the ultrasound energy on malignancy sites buried deep in tissues and to locally activate a preloaded sonosensitizer. Possible mechanisms of sonodynamic therapy include generation of sonosensitizer derived radicals which initiate chain peroxidation of membrane lipids via peroxyl and/or alkoxyl radicals, the physical destabilization of the cell membrane by the sonosensitizer thereby rendering the cell more susceptible to shear forces or ultrasound enhanced drug transport across the cell membrane (sonoporation). Evidence against the role of singlet oxygen in sonodynamic therapy is discussed. The mechanism of sonodynamic therapy is probably not governed by a universal mechanism, but may be influenced by multiple factors including the nature of the biological model, the sonosensitizer and the ultrasound parameters. The current review emphasizes the effect of ultrasound induced free radicals in sonodynamic therapy.

Dermaplaning, topical oxygen, and photodynamic therapy: a systematic review of the literature.

PubMed

Pryor, Landon; Gordon, Chad R; Swanson, Edward W; Reish, Richard G; Horton-Beeman, Kelly; Cohen, Steven R

2011-12-01

Noninvasive procedures for facial rejuvenation are becoming an increasingly popular component of a comprehensive skin care regimen. Concurrently, many new treatment methods are now available to both the plastic surgeon and the aesthetician. Because these techniques have become an integral part of many cosmetic practices, this study aimed to assess the existing evidence-based literature as to their clinical efficacy; to provide an objective overview of some of the most popular noninvasive rejuvenation strategies such as dermaplaning, oxygen therapy, and light therapy; to discuss recent pertinent scientific evidence-based literature; and to provide treatment recommendations based on these findings. A systematic review was performed in August 2009 using PubMed and the following keywords: "dermaplaning," "oxygen therapy," and "light therapy." All peer-reviewed articles then were screened independently by three plastic surgeons. The search identified 42 English-written, peer-reviewed manuscripts. The overall amount of scientific data supporting these methods was found to be scarce, anecdotal, and not well documented. Nevertheless, all three noninvasive therapies have become increasingly popular in the cosmetic market because many patients and physicians or surgeons report being pleased with their results. Although the evidence supporting these nonsurgical methods is suboptimal, their uses continue to expand. As with any plastic surgery procedure, providing patients with realistic expectations is essential to achieving optimal outcomes and patient satisfaction. Therefore, critical investigation is warranted. In addition, these methods are most effective when included within a comprehensive skin care regimen consisting of sunscreen, vitamin therapy, and lifestyle modification.

[Physiotherapy, occupational therapy and physical therapy in fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles].

PubMed

Winkelmann, A; Bork, H; Brückle, W; Dexl, C; Heldmann, P; Henningsen, P; Krumbein, L; Pullwitt, V; Schiltenwolf, M; Häuser, W

2017-06-01

The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A literature search for systematic reviews of randomized, controlled trials on physiotherapy, occupational therapy and physical therapy from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences and applicability of available therapies were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. Low to moderate intensity endurance and strength training are strongly recommended. Chiropractic, laser therapy, magnetic field therapy, massage and transcranial magnetic stimulation are not recommended.

The effectiveness of inpatient physical therapy compared to outpatient physical therapy in older adults after total hip replacement in the post-discharge period: a systematic review.

PubMed

Klugarova, Jitka; Klugar, Miloslav; Mareckova, Jana; Gallo, Jiri; Kelnarova, Zuzana

2016-01-01

Total hip replacement is the most effective and safest method for treating severe degenerative, traumatic and other diseases of the hip joint. Total hip replacement can reliably relieve pain and improve function in the majority of patients for a period of 15 to 20 years or more postoperatively. Physical therapy follows each total hip replacement surgery. Physical therapy protocols after total hip replacement in the post-discharge period vary widely in terms of setting (inpatient, outpatient), content (the particular set of exercises used), and frequency (e.g. daily versus twice a week). In current literature, there is no systematic review which has compared the effectiveness of inpatient and outpatient physical therapy in patients after total hip replacement in the post-discharge period. The objective of this systematic review was to compare the effectiveness of inpatient physical therapy with outpatient physical therapy on the quality of life and gait measures in older adults after total hip replacement in the post-discharge period. This review considered studies that include older adults (over 65 years) who have had total hip replacement and are in the post-discharge period. Adults with bilateral or multiple simultaneous surgeries and also patients who have had hemiarthroplasty of the hip joint were excluded.This review considered studies that included any type of physical therapy delivered in inpatient settings provided by professionals with education in physical therapy. Inpatient physical therapy delivered at any frequency and over any duration was included.This review considered studies that included as a comparator any type of physical therapy delivered in outpatient settings provided by professionals with education in physical therapy or no physical therapy.This review considered studies that included the following primary and secondary outcomes. The primary outcome was quality of life, assessed by any validated assessment tool. The secondary outcome was

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

ERIC Educational Resources Information Center

Yeaw, John David Andrew

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

SU-F-T-128: Dose-Volume Constraints for Particle Therapy Treatment Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stewart, R; Smith, W; Hendrickson, K

2016-06-15

Purpose: Determine equivalent Organ at Risk (OAR) tolerance dose (TD) constraints for MV x-rays and particle therapy. Methods: Equivalent TD estimates for MV x-rays are determined from an isoeffect, regression-analysis of published and in-house constraints for various fractionation schedules (n fractions). The analysis yields an estimate of (α/β) for an OAR. To determine equivalent particle therapy constraints, the MV x-ray TD(n) values are divided by the RBE for DSB induction (RBE{sub DSB}) or cell survival (RBE{sub S}). Estimates of (RBE{sub DSB}) are computed using the Monte Carlo Damage Simulation, and estimates of RBES are computed using the Repair-Misrepair-Fixation (RMF) model.more » A research build of the RayStation™ treatment planning system implementing the above model is used to estimate (RBE{sub DSB}) for OARs of interest in 16 proton therapy patient plans (head and neck, thorax, prostate and brain). Results: The analysis gives an (α/β) estimate of about 20 Gy for the trachea and heart and 2–4 Gy for the esophagus, spine, and brachial plexus. Extrapolation of MV x-ray constraints (n = 1) to fast neutrons using RBE{sub DSB} = 2.7 are in excellent agreement with clinical experience (n = 10 to 20). When conventional (n > 30) x-ray treatments are used as the reference radiation, fast neutron RBE increased to a maximum of 6. For comparison to a constant RBE of 1.1, the RayStation™ analysis gave estimates of proton RBE{sub DSB} from 1.03 to 1.33 for OARs of interest. Conclusion: The presented system of models is a convenient formalism to synthesize from multiple sources of information a set of self-consistent plan constraints for MV x-ray and hadron therapy treatments. Estimates of RBE{sub DSB} from the RayStation™ analysis differ substantially from 1.1 and vary among patients and treatment sites. A treatment planning system that incorporates patient and anatomy-specific corrections in proton RBE would create opportunities to increase the

Use of the NASA Space Radiation Laboratory at Brookhaven National Laboratory to Conduct Charged Particle Radiobiology Studies Relevant to Ion Therapy

PubMed Central

Held, Kathryn D.; Blakely, Eleanor A.; Story, Michael D.; Lowenstein, Derek I.

2016-01-01

Although clinical studies with carbon ions have been conducted successfully in Japan and Europe, the limited radiobiological information about charged particles that are heavier than protons remains a significant impediment to exploiting the full potential of particle therapy. There is growing interest in the U.S. to build a cancer treatment facility that utilizes charged particles heavier than protons. Therefore, it is essential that additional radiobiological knowledge be obtained using state-of-the-art technologies and biological models and end points relevant to clinical outcome. Currently, most such ion radiotherapy-related research is being conducted outside the U.S. This article addresses the substantial contributions to that research that are possible at the NASA Space Radiation Laboratory (NSRL) at Brookhaven National Laboratory (BNL), which is the only facility in the U.S. at this time where heavy-ion radiobiology research with the ion species and energies of interest for therapy can be done. Here, we briefly discuss the relevant facilities at NSRL and how selected charged particle biology research gaps could be addressed using those facilities. PMID:27195609

Use of the NASA Space Radiation Laboratory at Brookhaven National Laboratory to Conduct Charged Particle Radiobiology Studies Relevant to Ion Therapy.

PubMed

Held, Kathryn D; Blakely, Eleanor A; Story, Michael D; Lowenstein, Derek I

2016-06-01

Although clinical studies with carbon ions have been conducted successfully in Japan and Europe, the limited radiobiological information about charged particles that are heavier than protons remains a significant impediment to exploiting the full potential of particle therapy. There is growing interest in the U.S. to build a cancer treatment facility that utilizes charged particles heavier than protons. Therefore, it is essential that additional radiobiological knowledge be obtained using state-of-the-art technologies and biological models and end points relevant to clinical outcome. Currently, most such ion radiotherapy-related research is being conducted outside the U.S. This article addresses the substantial contributions to that research that are possible at the NASA Space Radiation Laboratory (NSRL) at Brookhaven National Laboratory (BNL), which is the only facility in the U.S. at this time where heavy-ion radiobiology research with the ion species and energies of interest for therapy can be done. Here, we briefly discuss the relevant facilities at NSRL and how selected charged particle biology research gaps could be addressed using those facilities.

NanOx, a new model to predict cell survival in the context of particle therapy

NASA Astrophysics Data System (ADS)

Cunha, M.; Monini, C.; Testa, E.; Beuve, M.

2017-02-01

Particle therapy is increasingly attractive for the treatment of tumors and the number of facilities offering it is rising worldwide. Due to the well-known enhanced effectiveness of ions, it is of utmost importance to plan treatments with great care to ensure tumor killing and healthy tissues sparing. Hence, the accurate quantification of the relative biological effectiveness (RBE) of ions, used in the calculation of the biological dose, is critical. Nevertheless, the RBE is a complex function of many parameters and its determination requires modeling. The approaches currently used have allowed particle therapy to thrive, but still show some shortcomings. We present herein a short description of a new theoretical framework, NanOx, to calculate cell survival in the context of particle therapy. It gathers principles from existing approaches, while addressing some of their weaknesses. NanOx is a multiscale model that takes the stochastic nature of radiation at nanometric and micrometric scales fully into account, integrating also the chemical aspects of radiation-matter interaction. The latter are included in the model by means of a chemical specific energy, determined from the production of reactive chemical species induced by irradiation. Such a production represents the accumulation of oxidative stress and sublethal damage in the cell, potentially generating non-local lethal events in NanOx. The complementary local lethal events occur in a very localized region and can, alone, lead to cell death. Both these classes of events contribute to cell death. The comparison between experimental data and model predictions for the V79 cell line show a good agreement. In particular, the dependence of the typical shoulders of cell survival curves on linear energy transfer are well described, but also the effectiveness of different ions, including the overkill effect. These results required the adjustment of a number of parameters compatible with the application of the model in

NanOx, a new model to predict cell survival in the context of particle therapy.

PubMed

Cunha, M; Monini, C; Testa, E; Beuve, M

2017-02-21

Particle therapy is increasingly attractive for the treatment of tumors and the number of facilities offering it is rising worldwide. Due to the well-known enhanced effectiveness of ions, it is of utmost importance to plan treatments with great care to ensure tumor killing and healthy tissues sparing. Hence, the accurate quantification of the relative biological effectiveness (RBE) of ions, used in the calculation of the biological dose, is critical. Nevertheless, the RBE is a complex function of many parameters and its determination requires modeling. The approaches currently used have allowed particle therapy to thrive, but still show some shortcomings. We present herein a short description of a new theoretical framework, NanOx, to calculate cell survival in the context of particle therapy. It gathers principles from existing approaches, while addressing some of their weaknesses. NanOx is a multiscale model that takes the stochastic nature of radiation at nanometric and micrometric scales fully into account, integrating also the chemical aspects of radiation-matter interaction. The latter are included in the model by means of a chemical specific energy, determined from the production of reactive chemical species induced by irradiation. Such a production represents the accumulation of oxidative stress and sublethal damage in the cell, potentially generating non-local lethal events in NanOx. The complementary local lethal events occur in a very localized region and can, alone, lead to cell death. Both these classes of events contribute to cell death. The comparison between experimental data and model predictions for the V79 cell line show a good agreement. In particular, the dependence of the typical shoulders of cell survival curves on linear energy transfer are well described, but also the effectiveness of different ions, including the overkill effect. These results required the adjustment of a number of parameters compatible with the application of the model in

Non-Steroidal Anti-inflammatory Drugs As Host-Directed Therapy for Tuberculosis: A Systematic Review

PubMed Central

Kroesen, Vera M.; Gröschel, Matthias I.; Martinson, Neil; Zumla, Alimuddin; Maeurer, Markus; van der Werf, Tjip S.; Vilaplana, Cristina

2017-01-01

Lengthy, antimicrobial therapy targeting the pathogen is the mainstay of conventional tuberculosis treatment, complicated by emerging drug resistances. Host-directed therapies, including non-steroidal anti-inflammatory drugs (NSAIDs), in contrast, target host factors to mitigate disease severity. In the present Systematic Review, we investigate whether NSAIDs display any effects as therapy of TB and discuss possible mechanisms of action of NSAIDs as adjunctive therapy of TB. Ten studies, seven preclinical studies in mice and three clinical trials, were included and systematically reviewed. Our results point toward a beneficial effect of NSAIDs as adjunct to current TB therapy regimens, mediated by decreased lung pathology balancing host-immune reaction. The determination of the best timing for their administration in order to obtain the potential beneficial effects needs further investigation. Even if the preclinical evidence requires clinical evaluation, NSAIDs might represent a potential safe, simple, and cheap improvement in therapy of TB. PMID:28713389

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Redondo, Antonio

2010-01-01

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

Review of lattice results concerning low-energy particle physics

DOE PAGES

Aoki, S.; Aoki, Y.; Bernard, C.; ...

2014-09-01

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

A systematic review on the effectiveness of cognitive behavioral therapy for posttraumatic stress disorder.

PubMed

Mendes, Deise D; Mello, Marcelo Feijó; Ventura, Paula; Passarela, Cristiane De Medeiros; Mari, Jair de Jesus

2008-01-01

Cognitive behavioral therapy (CBT) is the most common psychotherapy approach for the treatment of PTSD. Nevertheless, previous reviews on the efficacy of several types of psychotherapy were unable to detect differences between CBT and other psychotherapies. The purpose of this study was to conduct systematic review on the efficacy ofCBT in comparison with studies that used other psychotherapy techniques. Databases were searched using the following terms: posttraumatic stress disorder/stress disorder, treatment/psychotherapy/behavior cognitive therapy, randomized trials, and adults. Randomized clinical trials published between 1980 and 2005 and that compared CBT with other treatments for PTSD was included. The main outcomes were remission, clinical improvement, dropout rates and changes in symptoms. The 23 clinical trials included in the review comprised 1923 patients: 898 in the treatment group and 1,025 in the control group. CBT had better remission rates than EMDR (RR = 0.35; 95% CI: 0.16; 0.79; p = 0.01) or supportive therapies (RR = 0.43; 95% CI: 0.25; 0.74; p = 0.002, completer analysis). CBT was comparable to Exposure Therapy (ET) (RR = 0.90; 95% CI: 0.58; 1.40; p = 0.64), and cognitive therapy (CT) (RR = 1.01; 95% CI: 0.67; 1.51; p = 0.98) in terms of efficacy and compliance. These findings suggest that specific therapies, such as CBT, exposure therapy and cognitive therapy are equally effective, and more effective than supportive techniques in the treatment of PTSD.

Patient satisfaction with musculoskeletal physical therapy care: a systematic review.

PubMed

Hush, Julia M; Cameron, Kirsten; Mackey, Martin

2011-01-01

Patient satisfaction is an important patient-centered health outcome. To date, no systematic review of the literature on patient satisfaction with musculoskeletal physical therapy care has been conducted. The purpose of this study was to systematically and critically review the literature to determine the degree of patient satisfaction with musculoskeletal physical therapy care and factors associated with satisfaction. The databases CINAHL, MEDLINE, and EBM Reviews were searched from inception to September 2009. Articles were included if the design was a clinical trial, observational study, survey, or qualitative study; patient satisfaction was evaluated; and the study related to the delivery of musculoskeletal physical therapy services conducted in an outpatient setting. The search located 3,790 citations. Fifteen studies met the inclusion criteria. Two authors extracted patient satisfaction data and details of each study. A meta-analysis of patient satisfaction data from 7 studies was conducted. The pooled estimate of patient satisfaction was 4.44 (95% confidence interval=4.41-4.46) on a scale of 1 to 5, where 5 indicates high satisfaction and 1 indicates high dissatisfaction. Additional data were summarized in tables and critically appraised. Nonrespondent bias from individual studies may affect the accuracy and representativeness of these data. Patients are highly satisfied with musculoskeletal physical therapy care delivered across outpatient settings in northern Europe, North America, the United Kingdom, and Ireland. The interpersonal attributes of the therapist and the process of care are key determinants of patient satisfaction. An unexpected finding was that treatment outcome was infrequently and inconsistently associated with patient satisfaction. Physical therapists can enhance the quality of patient-centered care by understanding and optimizing these determinants of patient satisfaction.

WE-FG-BRB-01: Clinical Significance of RBE Variations in Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paganetti, H.

2016-06-15

The physical pattern of energy deposition and the enhanced relative biological effectiveness (RBE) of protons and carbon ions compared to photons offer unique and not fully understood or exploited opportunities to improve the efficacy of radiation therapy. Variations in RBE within a pristine or spread out Bragg peak and between particle types may be exploited to enhance cell killing in target regions without a corresponding increase in damage to normal tissue structures. In addition, the decreased sensitivity of hypoxic tumors to photon-based therapies may be partially overcome through the use of more densely ionizing radiations. These and other differences betweenmore » particle and photon beams may be used to generate biologically optimized treatments that reduce normal tissue complications. In this symposium, speakers will examine the impact of the RBE of charged particles on measurable biological endpoints, treatment plan optimization, and the prediction or retrospective assessment of treatment outcomes. In particular, an AAPM task group was formed to critically examine the evidence for a spatially-variant RBE in proton therapy. Current knowledge of proton RBE variation with respect to dose, biological endpoint, and physics parameters will be reviewed. Further, the clinical relevance of these variations will be discussed. Recent work focused on improving simulations of radiation physics and biological response in proton and carbon ion therapy will also be presented. Finally, relevant biology research and areas of research needs will be highlighted, including the dependence of RBE on genetic factors including status of DNA repair pathways, the sensitivity of cancer stem-like cells to charged particles, the role of charged particles in hypoxic tumors, and the importance of fractionation effects. In addition to the physical advantages of protons and more massive ions over photons, the future application of biologically optimized treatment plans and their

Patients' perception and adherence to vaginal dilator therapy: a systematic review and synthesis employing symbolic interactionism.

PubMed

Lee, Yaelim

2018-01-01

Vaginal dilator (VD) therapy is often recommended for women receiving pelvic radiation therapy or experiencing pain and discomfort during intercourse, as well as for women with a congenital malformation of the vagina. VD use has both physical and psychological benefits; however, it often causes pain, discomfort, and adverse emotions, including embarrassment and loss of modesty, which often result in low adherence to therapy. The aims of this study were to explore the use and adherence of VD therapy in women, identify barriers and facilitators of therapy adherence, and suggest improvement strategies from the theoretical perspective of symbolic interactionism. A systematic review of the literature was conducted using PubMed, CINAHL, and Scopus databases, with no year restrictions. Articles addressing the experience of women using VD therapy, as well as barriers and facilitators of therapy adherence were selected and analyzed. Then, the theoretical perspective of symbolic interactionism was introduced and applied to synthesize the results. A total of 21 articles were selected for the review. Most of the reviewed studies explored VD therapy in women who had undergone pelvic radiation therapy for gynecological cancer. Women's adherence to the therapy ranged between 25% and 89.2%, with great variance in definitions and methods for assessing therapy adherence. Among the five categories of identified barriers to therapy adherence, "unhelpful circumstances" and "negative perceptions toward the VD" were the two most frequently mentioned. The two most frequently reported facilitators of adherence among the six identified categories were "supportive interactions with health care providers" and "risk perception and positive outcome expectancies". On the basis of the perspective of symbolic interactionism, strategies for strengthening interactions with others (eg, health care providers, significant others, and support groups) are discussed in detail. Strategic intervention

Simulation in Occupational Therapy Curricula: A literature review.

PubMed

Bennett, Sally; Rodger, Sylvia; Fitzgerald, Cate; Gibson, Libby

2017-08-01

Simulated learning experiences are increasingly being used in health-care education to enhance student engagement and provide experiences that reflect clinical practice; however, simulation has not been widely investigated in occupational therapy curricula. The aim of this paper was to: (i) describe the existing research about the use and evaluation of simulation over the last three decades in occupational therapy curricula and (ii) consider how simulation has been used to develop competence in students. A literature review was undertaken with searches of MEDLINE, CINAHL and ERIC to locate articles that described or evaluated the use of simulation in occupational therapy curricula. Fifty-seven papers were identified. Occupational therapy educators have used the full scope of simulation modalities, including written case studies (22), standardised patients (13), video case studies (15), computer-based and virtual reality cases (7), role-play (8) and mannequins and part-task trainers (4). Ten studies used combinations of these modalities and two papers compared modalities. Most papers described the use of simulation for foundational courses, as for preparation for fieldwork, and to address competencies necessary for newly graduating therapists. The majority of studies were descriptive, used pre-post design, or were student's perceptions of the value of simulation. Simulation-based education has been used for a wide range of purposes in occupational therapy curricula and appears to be well received. Randomised controlled trials are needed to more accurately understand the effects of simulation not just for occupational therapy students but for longer term outcomes in clinical practice. © 2017 Occupational Therapy Australia.

Evidence-based Peer Review for Radiation Therapy - Updated Review of the Literature with a Focus on Tumour Subsite and Treatment Modality.

PubMed

Huo, M; Gorayski, P; Poulsen, M; Thompson, K; Pinkham, M B

2017-10-01

Technological advances in radiation therapy permit steep dose gradients from the target to spare normal tissue, but increase the risk of geographic miss. Suboptimal target delineation adversely affects clinical outcomes. Prospective peer review is a method for quality assurance of oncologists' radiotherapy plans. Published surveys suggest it is widely implemented. However, it may not be feasible to review every case before commencement of radiation therapy in all departments. The rate of plan changes following peer review of cases without a specific subsite or modality is typically around 10%. Stereotactic body radiation therapy, head and neck, gynaecological, gastrointestinal, haematological and lung cases are associated with higher rates of change of around 25%. These cases could thus be prioritised for peer review. Other factors may limit peer review efficacy including organisational culture, time constraints and the physical environment in which sessions are held. Recommendations for peer review endorsed by the American Society for Radiation Oncology were made available in 2013, but a number of relevant studies have been published since. Here we review and update the literature, and provide an updated suggestion for the implementation of peer review to serve as an adjunct to published guidelines. This may help practitioners evaluate their current processes and maximise the utility and effectiveness of peer review sessions. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

An Exploration of Teacher Perceptions toward Occupational Therapy and Occupational Therapy Practices: A Scoping Review

ERIC Educational Resources Information Center

Truong, Vi; Hodgetts, Sandra

2017-01-01

Many occupational therapists work in school-based practice, where collaborative consultation between teachers and therapists is critical for intervention effectiveness. This scoping review explores teacher perceptions toward occupational therapy (OT). Three themes emerged: (1) teachers' confusion over the OT role and scope of practice; (2)…

Effectiveness of Occupational Therapy Interventions for Musculoskeletal Shoulder Conditions: A Systematic Review.

PubMed

Marik, Tambra L; Roll, Shawn C

People with musculoskeletal disorders of the shoulder commonly experience pain, decreased strength, and restricted range of motion (ROM) that limit participation in meaningful occupational activities. The purpose of this systematic review was to evaluate the current evidence for interventions within the occupational therapy scope of practice that address pain reduction and increase participation in functional activities. Seventy-six studies were reviewed for this study-67 of Level I evidence, 7 of Level II evidence, and 2 of Level III evidence. Strong evidence was found that ROM, strengthening exercises, and joint mobilizations can improve function and decrease pain. The evidence to support physical modalities is moderate to mixed, depending on the shoulder disorder. Occupational therapy practitioners can use this evidence to guide daily clinical decision making. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Effects of Aquatic Therapy and Land-Based Therapy versus Land-Based Therapy Alone on Range of Motion, Edema, and Function after Hip or Knee Replacement: A Systematic Review and Meta-analysis.

PubMed

Gibson, Alison J; Shields, Nora

2015-01-01

To determine whether aquatic therapy in combination with land-based therapy improves patient outcomes after hip or knee arthroplasty compared with land-based therapy alone. For this systematic review, six online databases (MEDLINE, CINAHL, AMED, EMBASE, Cochrane, and PEDro) were searched from the earliest date available until September 2013. Controlled trials published in English in a peer-reviewed journal that compared aquatic therapy in combination with land-based therapy with land-based therapy alone were included; trial quality was assessed using the PEDro scale. Data were presented as standardized mean differences (SMDs), their associated 95% CIs, and meta-analyses. Three small trials of moderate quality were included in the qualitative analysis. Meta-analysis of two of these studies found moderate-quality evidence that aquatic therapy in combination with land-based therapy improves functional outcomes (SMD=0.53; 95% CI, 0.03-1.03), knee range of motion (measured in knee or hip arthroplasty; SMD=0.78; 95% CI, 0.27-1.29), and edema (SMD=-0.66; 95% CI, -1.16 to -0.15) compared with land-based therapy alone. The results for improved functional outcomes were not considered clinically significant. It is not possible to draw confident conclusions from this review because of the small number of studies of limited quality and the modest differences found. Further studies of sound methodological quality are required to confirm the results. Economic analysis alongside randomized controlled trials is needed to examine the cost-effectiveness of these clinical outcomes.

A systematic review of postoperative hand therapy management of basal joint arthritis.

PubMed

Wolfe, Terri; Chu, Jennifer Y; Woods, Tammy; Lubahn, John D

2014-04-01

There are a variety of postoperative immobilization and therapy options for patients with basal joint arthritis. Although prior systematic reviews have compared surgical procedures used to treat basal joint arthritis, none to our knowledge compares therapy protocols for this condition, which are considered an important part of the treatment. (1) We sought to determine whether differences in the length and type of postoperative immobilization affect clinical results after basal joint arthritis surgery. (2) We also compared specific therapy protocols that were prescribed. (3) Finally, we evaluated published protocols to determine when patients were released to full activity to see whether these appeared to affect clinical results. A systematic review of English-language studies in the PubMed and Cochrane databases was performed. Studies were then reviewed to determine what postoperative immobilization and therapy protocols the authors used and when patients were released to full activities. A total of 19 studies were identified using the search criteria. All but one of the studies included a postoperative period of immobilization in either a cast or splint. Immobilization time varied depending on whether Kirschner wires were used for the surgery and whether an implant was placed. Postoperative therapy protocols also varied but followed three general patterns. Some therapy protocols involved teaching patients a home exercise program only, whereas some authors described routine referral to a therapist. The third group consisted of studies in which patients were only referred for therapy if the physicians determined it was necessary during followup. Many studies did not give a specific time for full return to activity and instead described a gradual transition to full activity after immobilization was discontinued. Because of the variability and small numbers, no conclusive recommendations could be made on any of the three study questions. Comparative, multicenter

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

PubMed

Baijens, Laura W J; Speyer, Renée

2009-03-01

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

A critical methodological review of discourse and conversation analysis studies of family therapy.

PubMed

Tseliou, Eleftheria

2013-12-01

Discourse (DA) and conversation (CA) analysis, two qualitative research methods, have been recently suggested as potentially promising for the study of family therapy due to common epistemological adherences and their potential for an in situ study of therapeutic dialog. However, to date, there is no systematic methodological review of the few existing DA and CA studies of family therapy. This study aims at addressing this lack by critically reviewing published DA and CA studies of family therapy on methodological grounds. Twenty-eight articles in total are reviewed in relation to certain methodological axes identified in the relevant literature. These include choice of method, framing of research question(s), data/sampling, type of analysis, epistemological perspective, content/type of knowledge claims, and attendance to criteria for good quality practice. It is argued that the reviewed studies show "glimpses" of the methods' potential for family therapy research despite the identification of certain "shortcomings" regarding their methodological rigor. These include unclearly framed research questions and the predominance of case study designs. They also include inconsistencies between choice of method, stated or unstated epistemological orientations and knowledge claims, and limited attendance to criteria for good quality practice. In conclusion, it is argued that DA and CA can add to the existing quantitative and qualitative methods for family therapy research. They can both offer unique ways for a detailed study of the actual therapeutic dialog, provided that future attempts strive for a methodologically rigorous practice and against their uncritical deployment. © FPI, Inc.

The experience and expectations of terminally ill patients receiving music therapy in the palliative setting: a systematic review.

PubMed

Qi He Mabel, Leow; Drury, Vicki Blair; Hong, Poon Wing

Music therapy is a popular form of complementary therapy used in the hospice in Western countries, as people who are terminally ill have several needs arising directly from the disease process. In the area of palliative care, no systematic review has been conducted on the experience of patients using music therapy from the qualitative perspective. Hence, a synthesized summary of the experience of music therapy is presented. The aim of this review was to critically analyse and synthesize existing evidence related to terminally ill patients' experiences of using music therapy in the palliative setting. This review considered quantitative descriptive studies, and qualitative research with adult participants who were terminally ill receiving palliative care in a hospital, an in-patient hospice, a nursing home, or their own homes, regardless of their diagnosis who had undergone at least one music therapy session with a trained music therapist and were not cognitively impaired. Healthcare workers who have witnessed patients participating in music therapy were also included in the review. Only published primary research studies were included in the review. This review was limited to papers in English. A three-step search strategy was undertaken. First, an initial limited search of CINAHL and MEDLINE was done. Second, an extensive search using all identified keywords and index terms across all included databases was done. Finally, a hand search of the reference lists and bibliographies of included articles was conducted METHODOLOGICAL QUALITY: Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardised critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (QARI) for qualitative papers, and Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) for quantitative descriptive papers

Systematic Review of the Effectiveness of Physical Therapy Modalities in Women With Provoked Vestibulodynia.

PubMed

Morin, Mélanie; Carroll, Marie-Soleil; Bergeron, Sophie

2017-07-01

Pelvic floor muscle physical therapy is recommended in clinical guidelines for women with provoked vestibulodynia (PVD). Including isolated or combined treatment modalities, physical therapy is viewed as an effective first-line intervention, yet no systematic review concerning the effectiveness of physical therapy has been conducted. To systematically appraise the current literature on the effectiveness of physical therapy modalities for decreasing pain during intercourse and improving sexual function in women with PVD. A systematic literature search using PubMed, Scopus, CINHAL, and PEDro was conducted until October 2016. Moreover, a manual search from reference lists of included articles was performed. Ongoing trials also were reviewed using clinicaltrial.gov and ISRCTNregistry. Randomized controlled trials, prospective and retrospective cohorts, and case reports evaluating the effect of isolated or combined physical therapy modalities in women with PVD were included in the review. Main outcome measures were pain during intercourse, sexual function, and patient's perceived improvement. The literature search resulted in 43 eligible studies including 7 randomized controlled trials, 20 prospective studies, 5 retrospective studies, 6 case reports, and 6 study protocols. Most studies had a high risk of bias mainly associated with the lack of a comparison group. Another common bias was related to insufficient sample size, non-validated outcomes, non-standardized intervention, and use of other ongoing treatment. The vast majority of studies showed that physical therapy modalities such as biofeedback, dilators, electrical stimulation, education, multimodal physical therapy, and multidisciplinary approaches were effective for decreasing pain during intercourse and improving sexual function. The positive findings for the effectiveness of physical therapy modalities in women with PVD should be investigated further in robust and well-designed randomized controlled trials

Spiritually Modified Cognitive Therapy: A Review of the Literature

ERIC Educational Resources Information Center

Hodge, David R.

2006-01-01

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

Manual therapy in adults with tension-type headache: A systematic review.

PubMed

Cumplido-Trasmonte, C; Fernández-González, P; Alguacil-Diego, I M; Molina-Rueda, F

2018-03-07

Tension-type headache is the most common primary headache, with a high prevalence and a considerable socioeconomic impact. Manual physical therapy techniques are widely used in the clinical field to treat the symptoms associated with tension-type headache. This systematic review aims to determine the effectiveness of manual and non-invasive therapies in the treatment of patients with tension-type headache. We conducted a systematic review of randomised controlled trials in the following databases: Brain, PubMed, Web of Science, PEDro, Scopus, CINAHL, and Science Direct. Ten randomised controlled trials were included for analysis. According to these studies, manual therapy improves symptoms, increasing patients' well-being and improving the outcome measures analysed. Manual therapy has positive effects on pain intensity, pain frequency, disability, overall impact, quality of life, and craniocervical range of motion in adults with tension-type headache. None of the techniques was found to be superior to the others; combining different techniques seems to be the most effective approach. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

MONDO: a neutron tracker for particle therapy secondary emission characterisation

NASA Astrophysics Data System (ADS)

Marafini, M.; Gasparini, L.; Mirabelli, R.; Pinci, D.; Patera, V.; Sciubba, A.; Spiriti, E.; Stoppa, D.; Traini, G.; Sarti, A.

2017-04-01

Tumour control is performed in particle therapy using particles and ions, whose high irradiation precision enhances the effectiveness of the treatment, while sparing the healthy tissue surrounding the target volume. Dose range monitoring devices using photons and charged particles produced by the beam interacting with the patient’s body have already been proposed, but no attempt has been made yet to exploit the detection of the abundant neutron component. Since neutrons can release a significant dose far away from the tumour region, precise measurements of their flux, production energy and angle distributions are eagerly sought in order to improve the treatment planning system (TPS) software. It will thus be possible to predict not only the normal tissue toxicity in the target region, but also the risk of late complications in the whole body. The aforementioned issues underline the importance of an experimental effort devoted to the precise characterisation of neutron production, aimed at the measurement of their abundance, emission point and production energy. The technical challenges posed by a neutron detector aimed at high detection efficiency and good backtracking precision are addressed within the MONDO (monitor for neutron dose in hadrontherapy) project, whose main goal is to develop a tracking detector that can target fast and ultrafast neutrons. A full reconstruction of two consecutive elastic scattering interactions undergone by the neutrons inside the detector material will be used to measure their energy and direction. The preliminary results of an MC simulation performed using the FLUKA software are presented here, together with the DSiPM (digital SiPM) readout implementation. New detector readout implementations specifically tailored to the MONDO tracker are also discussed, and the neutron detection efficiency attainable with the proposed neutron tracking strategy are reported.

MONDO: a neutron tracker for particle therapy secondary emission characterisation.

PubMed

Marafini, M; Gasparini, L; Mirabelli, R; Pinci, D; Patera, V; Sciubba, A; Spiriti, E; Stoppa, D; Traini, G; Sarti, A

2017-04-21

Tumour control is performed in particle therapy using particles and ions, whose high irradiation precision enhances the effectiveness of the treatment, while sparing the healthy tissue surrounding the target volume. Dose range monitoring devices using photons and charged particles produced by the beam interacting with the patient's body have already been proposed, but no attempt has been made yet to exploit the detection of the abundant neutron component. Since neutrons can release a significant dose far away from the tumour region, precise measurements of their flux, production energy and angle distributions are eagerly sought in order to improve the treatment planning system (TPS) software. It will thus be possible to predict not only the normal tissue toxicity in the target region, but also the risk of late complications in the whole body. The aforementioned issues underline the importance of an experimental effort devoted to the precise characterisation of neutron production, aimed at the measurement of their abundance, emission point and production energy. The technical challenges posed by a neutron detector aimed at high detection efficiency and good backtracking precision are addressed within the MONDO (monitor for neutron dose in hadrontherapy) project, whose main goal is to develop a tracking detector that can target fast and ultrafast neutrons. A full reconstruction of two consecutive elastic scattering interactions undergone by the neutrons inside the detector material will be used to measure their energy and direction. The preliminary results of an MC simulation performed using the FLUKA software are presented here, together with the DSiPM (digital SiPM) readout implementation. New detector readout implementations specifically tailored to the MONDO tracker are also discussed, and the neutron detection efficiency attainable with the proposed neutron tracking strategy are reported.

Massage Therapy for Pain and Function in Patients With Arthritis: A Systematic Review of Randomized Controlled Trials.

PubMed

Nelson, Nicole L; Churilla, James R

2017-09-01

Massage therapy is gaining interest as a therapeutic approach to managing osteoarthritis and rheumatoid arthritis symptoms. To date, there have been no systematic reviews investigating the effects of massage therapy on these conditions. Systematic review was used. The primary aim of this review was to critically appraise and synthesize the current evidence regarding the effects of massage therapy as a stand-alone treatment on pain and functional outcomes among those with osteoarthritis or rheumatoid arthritis. Relevant randomized controlled trials were searched using the electronic databases Google Scholar, MEDLINE, and PEDro. The PEDro scale was used to assess risk of bias, and the quality of evidence was assessed with the GRADE approach. This review found seven randomized controlled trials representing 352 participants who satisfied the inclusion criteria. Risk of bias ranged from four to seven. Our results found low- to moderate-quality evidence that massage therapy is superior to nonactive therapies in reducing pain and improving certain functional outcomes. It is unclear whether massage therapy is more effective than other forms of treatment. There is a need for large, methodologically rigorous randomized controlled trials investigating the effectiveness of massage therapy as an intervention for individuals with arthritis.

A systematic review of the evidence regarding cognitive therapy skills that assist cognitive behavioural therapy in adults who have an intellectual disability.

PubMed

Cooney, Patricia; Tunney, Conall; O'Reilly, Gary

2018-01-01

Cognitive behavioural therapy (CBT) is being increasingly adapted for use with people who have an intellectual disability. However, it remains unclear whether inherent cognitive deficits that are present in adults who have an intellectual disability preclude the use of cognitive-based therapies. This review aims to systematically examine "cognitive therapy skills" in adults who have an intellectual disability that assist engagement in CBT. Two authors independently reviewed titles and abstracts of articles located through electronic database searching. Outcomes of the 18 studies selected for full-text review are mixed and limited by a moderately high risk of bias. The authors suggest eleven findings from research areas of emotion recognition, cognitive mediation, discriminating between thoughts, feelings and behaviours, linking events and emotions that have implications for the design of CBT programmes and future research for this population. © 2017 John Wiley & Sons Ltd.

Play Therapy with Abused Children: A Review of the Literature.

ERIC Educational Resources Information Center

White, JoAnna; Allers, Christopher T.

1994-01-01

Presents review and critique of play therapy literature related to abused and neglected children. Discusses seven characteristic play behaviors and two common play themes of maltreated children. Offers recommendations for future research. Includes 50 citations. (Author/CRR)

[Physical therapy in pediatric primary care: a review of experiences].

PubMed

de Sá, Miriam Ribeiro Calheiros; Thomazinho, Paula de Almeida; Santos, Fabiano Luiz; Cavalcanti, Nicolette Celani; Ribeiro, Carla Trevisan Martins; Negreiros, Maria Fernanda Vieira; Vinhaes, Marcia Regina

2014-11-01

To review pediatric physical therapy experiences described in the literature and to analyze the production of knowledge on physical therapy in the context of pediatric primary health care (PPHC). A systematic review was conducted according to the PRISMA criteria. The following databases were searched: MEDLINE, LILACS, SciELO, PubMed, Scopus and Cochrane; Brazilian Ministry of Health's CAPES doctoral dissertations database; and System for Information on Grey Literature in Europe (SIGLE). The following search terms were used: ["primary health care" and ("physical therapy" or "physiotherapy") and ("child" or "infant")] and equivalent terms in Portuguese and Spanish, with no restriction on publication year. Thirteen articles from six countries were analyzed and grouped into three main themes: professional dilemmas (three articles), specific competencies and skills required in a PPHC setting (seven articles), and practice reports (four articles). Professional dilemmas involved expanding the role of physical therapists to encompass community environments and sharing the decision-making process with the family, as well as collaborative work with other health services to identify the needs of children. The competencies and skills mentioned in the literature related to the identification of clinical and sociocultural symptoms that go beyond musculoskeletal conditions, the establishment of early physical therapy diagnoses, prevention of overmedication, and the ability to work as team players. Practice reports addressed stimulation in children with neurological diseases, respiratory treatment, and establishing groups with mothers of children with these conditions. The small number of studies identified in this review suggests that there is little knowledge regarding the roles of physical therapists in PPHC and possibly regarding the professional abilities required in this setting. Therefore, further studies are required to provide data on the field, along with a continuing

A low proportion of systematic reviews in physical therapy are registered: a survey of 150 published systematic reviews.

PubMed

Oliveira, Crystian B; Elkins, Mark R; Lemes, Ítalo Ribeiro; de Oliveira Silva, Danilo; Briani, Ronaldo V; Monteiro, Henrique Luiz; Azevedo, Fábio Mícolis de; Pinto, Rafael Zambelli

Systematic reviews provide the best evidence about the effectiveness of healthcare interventions. Although systematic reviews are conducted with explicit and transparent methods, discrepancies might occur between the protocol and the publication. To estimate the proportion of systematic reviews of physical therapy interventions that are registered, the methodological quality of (un)registered systematic reviews and the prevalence of outcome reporting bias in registered systematic reviews. A random sample of 150 systematic reviews published in 2015 indexed on the PEDro database. We included systematic reviews written in English, Italian, Portuguese and Spanish. A checklist for assessing the methodological quality of systematic reviews tool was used. Relative risk was calculated to explore the association between meta-analysis results and the changes in the outcomes. Twenty-nine (19%) systematic reviews were registered. Funding and publication in a journal with an impact factor higher than 5.0 were associated with registration. Registered systematic reviews demonstrated significantly higher methodological quality (median=8) than unregistered systematic reviews (median=5). Nine (31%) registered systematic reviews demonstrated discrepancies between protocol and publication with no evidence that such discrepancies were applied to favor the statistical significance of the intervention (RR=1.16; 95% CI: 0.63-2.12). A low proportion of systematic reviews in the physical therapy field are registered. The registered systematic reviews showed high methodological quality without evidence of outcome reporting bias. Further strategies should be implemented to encourage registration. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Review Article: Celiac Disease, New Approaches to Therapy

PubMed Central

Rashtak, Shahrooz; Murray, Joseph A

2014-01-01

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

Particle Therapy Using Protons or Carbon Ions for Unresectable or Incompletely Resected Bone and Soft Tissue Sarcomas of the Pelvis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Demizu, Yusuke, E-mail: y_demizu@nifty.com; Jin, Dongcun; Sulaiman, Nor Shazrina

Purpose: To retrospectively analyze the treatment outcomes of particle therapy using protons or carbon ions for unresectable or incompletely resected bone and soft tissue sarcomas (BSTSs) of the pelvis. Methods and Materials: From May 2005 to December 2014, 91 patients with nonmetastatic histologically proven unresectable or incompletely resected pelvic BSTSs underwent particle therapy with curative intent. The particle therapy used protons (52 patients) or carbon ions (39 patients). All patients received a dose of 70.4 Gy (relative biologic effectiveness) in 32 fractions (55 patients) or 16 fractions (36 patients). Results: The median patient age was 67 years (range 18-87). The median planning targetmore » volume (PTV) was 455 cm{sup 3} (range 108-1984). The histologic type was chordoma in 53 patients, chondrosarcoma in 14, osteosarcoma in 10, malignant fibrous histiocytoma/undifferentiated pleomorphic sarcoma in 5, and other in 9 patients. Of the 91 patients, 82 had a primary tumor and 9 a recurrent tumor. The median follow-up period was 32 months (range 3-112). The 3-year rate of overall survival (OS), progression-free survival (PFS), and local control was 83%, 72%, and 92%, respectively. A Cox proportional hazards model revealed that chordoma histologic features and a PTV of ≤500 cm{sup 3} were significantly associated with better OS, and a primary tumor and PTV of ≤500 cm{sup 3} were significantly associated with better PFS. Ion type and number of fractions were not significantly associated with OS, PFS, or local control. Late grade ≥3 toxicities were observed in 23 patients. Compared with the 32-fraction protocol, the 16-fraction protocol was associated with significantly more frequent late grade ≥3 toxicities (18 of 36 vs 5 of 55; P<.001). Conclusions: Particle therapy using protons or carbon ions was effective for unresectable or incompletely resected pelvic BSTS, and the 32-fraction protocol was effective and relatively less toxic

Particle Therapy Using Protons or Carbon Ions for Unresectable or Incompletely Resected Bone and Soft Tissue Sarcomas of the Pelvis.

PubMed

Demizu, Yusuke; Jin, Dongcun; Sulaiman, Nor Shazrina; Nagano, Fumiko; Terashima, Kazuki; Tokumaru, Sunao; Akagi, Takashi; Fujii, Osamu; Daimon, Takashi; Sasaki, Ryohei; Fuwa, Nobukazu; Okimoto, Tomoaki

2017-06-01

To retrospectively analyze the treatment outcomes of particle therapy using protons or carbon ions for unresectable or incompletely resected bone and soft tissue sarcomas (BSTSs) of the pelvis. From May 2005 to December 2014, 91 patients with nonmetastatic histologically proven unresectable or incompletely resected pelvic BSTSs underwent particle therapy with curative intent. The particle therapy used protons (52 patients) or carbon ions (39 patients). All patients received a dose of 70.4 Gy (relative biologic effectiveness) in 32 fractions (55 patients) or 16 fractions (36 patients). The median patient age was 67 years (range 18-87). The median planning target volume (PTV) was 455 cm 3 (range 108-1984). The histologic type was chordoma in 53 patients, chondrosarcoma in 14, osteosarcoma in 10, malignant fibrous histiocytoma/undifferentiated pleomorphic sarcoma in 5, and other in 9 patients. Of the 91 patients, 82 had a primary tumor and 9 a recurrent tumor. The median follow-up period was 32 months (range 3-112). The 3-year rate of overall survival (OS), progression-free survival (PFS), and local control was 83%, 72%, and 92%, respectively. A Cox proportional hazards model revealed that chordoma histologic features and a PTV of ≤500 cm 3 were significantly associated with better OS, and a primary tumor and PTV of ≤500 cm 3 were significantly associated with better PFS. Ion type and number of fractions were not significantly associated with OS, PFS, or local control. Late grade ≥3 toxicities were observed in 23 patients. Compared with the 32-fraction protocol, the 16-fraction protocol was associated with significantly more frequent late grade ≥3 toxicities (18 of 36 vs 5 of 55; P<.001). Particle therapy using protons or carbon ions was effective for unresectable or incompletely resected pelvic BSTS, and the 32-fraction protocol was effective and relatively less toxic. Nevertheless, a longer follow-up period is needed to confirm these results

Effects of Aquatic Therapy and Land-Based Therapy versus Land-Based Therapy Alone on Range of Motion, Edema, and Function after Hip or Knee Replacement: A Systematic Review and Meta-analysis

PubMed Central

Shields, Nora

2015-01-01

ABSTRACT Purpose: To determine whether aquatic therapy in combination with land-based therapy improves patient outcomes after hip or knee arthroplasty compared with land-based therapy alone. Methods: For this systematic review, six online databases (MEDLINE, CINAHL, AMED, EMBASE, Cochrane, and PEDro) were searched from the earliest date available until September 2013. Controlled trials published in English in a peer-reviewed journal that compared aquatic therapy in combination with land-based therapy with land-based therapy alone were included; trial quality was assessed using the PEDro scale. Data were presented as standardized mean differences (SMDs), their associated 95% CIs, and meta-analyses. Results: Three small trials of moderate quality were included in the qualitative analysis. Meta-analysis of two of these studies found moderate-quality evidence that aquatic therapy in combination with land-based therapy improves functional outcomes (SMD=0.53; 95% CI, 0.03–1.03), knee range of motion (measured in knee or hip arthroplasty; SMD=0.78; 95% CI, 0.27–1.29), and edema (SMD=−0.66; 95% CI, −1.16 to −0.15) compared with land-based therapy alone. The results for improved functional outcomes were not considered clinically significant. Conclusions: It is not possible to draw confident conclusions from this review because of the small number of studies of limited quality and the modest differences found. Further studies of sound methodological quality are required to confirm the results. Economic analysis alongside randomized controlled trials is needed to examine the cost-effectiveness of these clinical outcomes. PMID:25931664

Ultrafine Particle Metrics and Research Considerations: Review of the 2015 UFP Workshop.

PubMed

Baldauf, Richard W; Devlin, Robert B; Gehr, Peter; Giannelli, Robert; Hassett-Sipple, Beth; Jung, Heejung; Martini, Giorgio; McDonald, Joseph; Sacks, Jason D; Walker, Katherine

2016-10-28

In February 2015, the United States Environmental Protection Agency (EPA) sponsored a workshop in Research Triangle Park, NC, USA to review the current state of the science one missions, air quality impacts, and health effects associated with exposures to ultrafine particles[1].[...].

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

ERIC Educational Resources Information Center

Burford, B.; Jahoda, A.

2012-01-01

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

Review of current therapies for secondary hypertrophic pulmonary osteoarthropathy.

PubMed

Nguyen, Sheila; Hojjati, Mehrnaz

2011-01-01

Hypertrophic osteoarthropathy (HOA) is a disabling condition that may occur secondarily to primary lung cancer. It is characterized by digital clubbing, arthralgia/arthritis, and periostosis of the tubular bones. The pain associated with HOA can be disabling and often refractory to conventional analgesics. We performed a comprehensive review of the literature using the PubMed database on treatment modalities available for HOA. We found 52 relevant articles-40 case reports, six case series, two review papers, and four combined case series and review papers. There were no randomized controlled trials reported. We then classified treatments used for HOA into two categories: (1) treatment of primary cause (i.e., resection of tumor, chemotherapy, radiotherapy, treatment of infection, etc.) and (2) symptomatic treatments (i.e., bisphosphonates, octreotide, NSAIDs, vagotomy, etc.). Subsequently, we summarized the main findings for each treatment. Although the clinical diagnosis of HOA has existed for over 100 years, the pathogenesis mechanism has not yet been elucidated, and treatment options for this condition remain experimental. Primary treatment is the most widely reported modality to be efficacious. In cases which primary therapy is not possible, several symptomatic treatment modalities are suggested, with various degree of success. Further research is needed to clarify the pathophysiological mechanism of HOA as to appropriately direct therapy.

Patients’ perception and adherence to vaginal dilator therapy: a systematic review and synthesis employing symbolic interactionism

PubMed Central

Lee, Yaelim

2018-01-01

Background Vaginal dilator (VD) therapy is often recommended for women receiving pelvic radiation therapy or experiencing pain and discomfort during intercourse, as well as for women with a congenital malformation of the vagina. VD use has both physical and psychological benefits; however, it often causes pain, discomfort, and adverse emotions, including embarrassment and loss of modesty, which often result in low adherence to therapy. Objectives The aims of this study were to explore the use and adherence of VD therapy in women, identify barriers and facilitators of therapy adherence, and suggest improvement strategies from the theoretical perspective of symbolic interactionism. Methods A systematic review of the literature was conducted using PubMed, CINAHL, and Scopus databases, with no year restrictions. Articles addressing the experience of women using VD therapy, as well as barriers and facilitators of therapy adherence were selected and analyzed. Then, the theoretical perspective of symbolic interactionism was introduced and applied to synthesize the results. Results A total of 21 articles were selected for the review. Most of the reviewed studies explored VD therapy in women who had undergone pelvic radiation therapy for gynecological cancer. Women’s adherence to the therapy ranged between 25% and 89.2%, with great variance in definitions and methods for assessing therapy adherence. Among the five categories of identified barriers to therapy adherence, “unhelpful circumstances” and “negative perceptions toward the VD” were the two most frequently mentioned. The two most frequently reported facilitators of adherence among the six identified categories were “supportive interactions with health care providers” and “risk perception and positive outcome expectancies”. On the basis of the perspective of symbolic interactionism, strategies for strengthening interactions with others (eg, health care providers, significant others, and support

Apoptotic induction by photodynamic therapy using hexaminolevulinate with a literature review

NASA Astrophysics Data System (ADS)

Furre, Ingegerd E.; Nesland, Jahn M.; Peng, Qian

2009-06-01

Since the first report by Agarwal et al in 1991 on apoptotic induction by photodynamic therapy (PDT) with chloroaluminium phthalocyanine a large number of papers have come out to show that PDT can induce cell death through apoptosis. This finding may provide potential clinical impact on, for example, those tumor cells resistant to any cancer therapy. The present paper briefly reviews apoptosis with emphasis on PDT-induced apoptosis with hexaminolevulinate.

Review Article: Advances in modeling of bed particle entrainment sheared by turbulent flow

NASA Astrophysics Data System (ADS)

Dey, Subhasish; Ali, Sk Zeeshan

2018-06-01

Bed particle entrainment by turbulent wall-shear flow is a key topic of interest in hydrodynamics because it plays a major role to govern the planetary morphodynamics. In this paper, the state-of-the-art review of the essential mechanisms governing the bed particle entrainment by turbulent wall-shear flow and their mathematical modeling is presented. The paper starts with the appraisal of the earlier multifaceted ideas in modeling the particle entrainment highlighting the rolling, sliding, and lifting modes of entrainment. Then, various modeling approaches of bed particle entrainment, such as deterministic, stochastic, and spatiotemporal approaches, are critically analyzed. The modeling criteria of particle entrainment are distinguished for hydraulically smooth, transitional, and rough flow regimes. In this context, the responses of particle size, particle exposure, and packing condition to the near-bed turbulent flow that shears the particles to entrain are discussed. From the modern experimental outcomes, the conceptual mechanism of particle entrainment from the viewpoint of near-bed turbulent coherent structures is delineated. As the latest advancement of the subject, the paper sheds light on the origin of the primitive empirical formulations of bed particle entrainment deriving the scaling laws of threshold flow velocity of bed particle motion from the perspective of the phenomenological theory of turbulence. Besides, a model framework that provides a new look on the bed particle entrainment phenomenon stemming from the stochastic-cum-spatiotemporal approach is introduced. Finally, the future scope of research is articulated with open questions.

Particle Data Group - 2017 Review

Science.gov Websites

, Tables, Plots Particle Listings Search Order: Book & Booklet Download or Print: Book, Booklet Astrophysics & Cosmology PDG Outreach Particle Adventure & Apps CPEP Charts History book Non-PDG

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

NASA Astrophysics Data System (ADS)

Scifoni, Emanuele

2015-06-01

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

A Literature Review and Analysis of Mode Deactivation Therapy

ERIC Educational Resources Information Center

Apsche, Jack A.

2010-01-01

This article is a review of articles, chapters and current research examining Mode Deactivation Therapy. Current applications of MDT suggest that mindfulness is a core component of MDT, as well as acceptance, defusion and validation, clarification and redirection of the functional alternative beliefs. These components are the core of MDT and a…

Particle Analysis Pitfalls

NASA Technical Reports Server (NTRS)

Hughes, David; Dazzo, Tony

2007-01-01

This viewgraph presentation reviews the use of particle analysis to assist in preparing for the 4th Hubble Space Telescope (HST) Servicing mission. During this mission the Space Telescope Imaging Spectrograph (STIS) will be repaired. The particle analysis consisted of Finite element mesh creation, Black-body viewfactors generated using I-DEAS TMG Thermal Analysis, Grey-body viewfactors calculated using Markov method, Particle distribution modeled using an iterative Monte Carlo process, (time-consuming); in house software called MASTRAM, Differential analysis performed in Excel, and Visualization provided by Tecplot and I-DEAS. Several tests were performed and are reviewed: Conformal Coat Particle Study, Card Extraction Study, Cover Fastener Removal Particle Generation Study, and E-Graf Vibration Particulate Study. The lessons learned during this analysis are also reviewed.

SU-F-J-197: A Novel Intra-Beam Range Detection and Adaptation Strategy for Particle Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, M; Jiang, S; Shao, Y

2016-06-15

Purpose: In-vivo range detection/verification is crucial in particle therapy for effective and safe delivery. The state-of-art techniques are not sufficient for in-vivo on-line range verification due to conflicts among patient dose, signal statistics and imaging time. We propose a novel intra-beam range detection and adaptation strategy for particle therapy. Methods: This strategy uses the planned mid-range spots as probing beams without adding extra radiation to patients. Such choice of probing beams ensures the Bragg peaks to remain inside the tumor even with significant range variation from the plan. It offers sufficient signal statistics for in-beam positron emission tomography (PET) duemore » to high positron activity of therapeutic dose. The probing beam signal can be acquired and reconstructed using in-beam PET that allows for delineation of the Bragg peaks and detection of range shift with ease of detection enabled by single-layered spots. If the detected range shift is within a pre-defined tolerance, the remaining spots will be delivered as the original plan. Otherwise, a fast re-optimization using range-shifted beamlets and accounting for the probing beam dose is applied to consider the tradeoffs posed by the online anatomy. Simulated planning and delivery studies were used to demonstrate the effectiveness of the proposed techniques. Results: Simulations with online range variations due to shifts of various foreign objects into the beam path showed successful delineation of the Bragg peaks as a result of delivering probing beams. Without on-line delivery adaptation, dose distribution was significantly distorted. In contrast, delivery adaptation incorporating detected range shift recovered well the planned dose. Conclusion: The proposed intra-beam range detection and adaptation utilizing the planned mid-range spots as probing beams, which illuminate the beam range with strong and accurate PET signals, is a safe, practical, yet effective approach to

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

PubMed

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

2013-01-01

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

Ice Nucleating Particles around the world - a global review

NASA Astrophysics Data System (ADS)

Kanji, Zamin A.; Atkinson, James; Sierau, Berko; Lohmann, Ulrike

2017-04-01

In the atmosphere the formation of new ice particles at temperatures above -36 °C is due to a subset of aerosol called Ice Nucleating Particles (INP). However, the spatial and temporal evolution of such particles is poorly understood. Current modelling of INP is attempting to estimate the sources and transport of INP, but is hampered by the availability and convenience of INP observations. As part of the EU FP7 project impact of Biogenic versus Anthropogenic emissions on Clouds and Climate: towards a Holistic UnderStanding (BACCHUS), historical and contemporary observations of INP have been collated into a database (http://www.bacchus-env.eu/in/) and are reviewed here. Outside of Europe and North America the coverage of measurements is sparse, especially for modern day climate - in many areas the only measurements available are from the mid-20th century. As well as an overview of all the data in the database, correlations with several accompanying variables are presented. For example, immersion freezing INP seem to be negatively correlated with altitude, whereas CFDC based condensation freezing INP show no height correlation. An initial global parameterisation of INP concentrations taking into account freezing temperature and relative humidity for use in modelling is provided.

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

PubMed

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

2015-01-01

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

Long-Term Effect of Four Surgical Periodontal Therapies and One Non-Surgical Therapy: A Systematic Review and Meta-Analysis.

PubMed

Mailoa, James; Lin, Guo-Hao; Khoshkam, Vahid; MacEachern, Mark; Chan, Hsun-Liang; Wang, Hom-Lay

2015-10-01

The aim of this systematic review is to evaluate the long term (≥ 2 years) effect of four surgical and non-surgical therapies in treating periodontal disease. An electronic search of four databases and a hand search of peer-reviewed journals for relevant articles were conducted. Prospective human controlled clinical trials were included that compared surgical therapy to non-surgical therapy in ≥ 10 patients diagnosed with chronic periodontitis with a follow-up period of ≥ 2 years and that reported change in probing depth (PD) and clinical attachment level (CAL) after the therapy. Random effect meta-analysis was performed to compare the outcome of surgical and non-surgical therapy in shallow, moderate, and deep PD. Eight human prospective clinical trials were included. In 1- to 3-mm PD, scaling and root planing (SRP), modified Widman flap (MWF), and osseous surgery (OS) resulted in 23.2%, 39.4%, and 61.39% CAL loss, respectively; SRP, MWF, and OS resulted in increased mean PD of 2.5%, 3.3%, and 6.3%, respectively. In 4- to 6-mm PD, SRP, MWF, and OS resulted in 8.4%, 6.5%, and 5.22% CAL gain, respectively; SRP, MWF, and OS resulted in 18.7%, 25.4%, and 30.8% PD reduction, respectively. In PD ≥ 7 mm, SRP, MWF, and OS resulted in 9.8%, 14.2%, and 9.38% CAL gain, respectively; SRP, MWF, and OS resulted in mean PD reduction of 21.6%, 33.1%, and 42.8%, respectively. Surgical therapy had significantly more CAL loss than non-surgical therapy in shallow PD. In moderate PD, MWF had significantly more PD reduction than SRP, and there was significantly less CAL gain with surgical therapy. In deep PD, OS had significantly higher PD reduction than SRP.

Considerations for Clinical Review of Cellular Therapy Products: Perspectives of the China Food and Drug Administration Center for Drug Evaluation.

PubMed

Liu, Yantong; Zhao, Chenyang; Gao, Liucun; Yang, Huan; He, Ruyi; Gao, Chenyan

2018-02-01

With increasing numbers of technical developments and clinical studies, pioneering cellular/gene therapies are now available that could cure life-threatening disease. Cellular/gene therapy products are broad-ranging and complicated, and thereby bring challenges for clinical review by regulatory agencies. This review discusses principles for the clinical review of cellular therapy products, including protection of clinical trial populations, pharmacodynamics, pharmacokinetics, dose evaluation, clinical efficacy, clinical safety, and risk-management plans. Based on these principles, key points in the clinical review of chimeric antigen receptor T-cell therapy are also discussed.

Electroconvulsive therapy in the continuation and maintenance treatment of depression: Systematic review and meta-analyses.

PubMed

Elias, Alby; Phutane, Vivek H; Clarke, Sandy; Prudic, Joan

2018-05-01

Acute course of electroconvulsive therapy is effective in inducing remission from depression, but recurrence rate is unacceptably high following termination of electroconvulsive therapy despite continued pharmacotherapy. Continuation electroconvulsive therapy and maintenance electroconvulsive therapy have been studied for their efficacy in preventing relapse and recurrence of depression. The purpose of this meta-analysis was to examine the efficacy of continuation electroconvulsive therapy and maintenance electroconvulsive therapy in preventing relapse and recurrence of depression in comparison to antidepressant pharmacotherapy alone. We searched MEDLINE, Embase, PsycINFO, clinicaltrials.gov and Cochrane register of controlled trials from the database inception to December 2016 without restriction on language or publication status for randomized trials of continuation electroconvulsive therapy and maintenance electroconvulsive therapy. Two independent Cochrane reviewers extracted the data in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews and meta-analyses. The risk of bias was assessed using four domains of the Cochrane Collaboration Risk of Bias Tool. Outcomes were pooled using random effect model. The primary outcome was relapse or recurrence of depression. Five studies involving 436 patients were included in the meta-analysis. Analysis of the pooled data showed that continuation electroconvulsive therapy and maintenance electroconvulsive therapy, both with pharmacotherapy, were associated with significantly fewer relapses and recurrences than pharmacotherapy alone at 6 months and 1 year after a successful acute course of electroconvulsive therapy (risk ratio = 0.64, 95% confidence interval = [0.41, 0.98], p = 0.04, risk ratio = 0.46, 95% confidence interval = [0.21, 0.98], p = 0.05, respectively). There was insufficient data to perform a meta-analysis of stand

SU-E-T-211: Peer Review System for Ensuring Quality of Radiation Therapy Treatments.

PubMed

Kapoor, R; Kapur, P; Kumar, S A; Alex, D; Ranka, S; Palta, J

2012-06-01

To demonstrate a Web-based electronic peer review system that has the potential to improve quality of care for radiation therapy patients. The system provides tools that allow radiation oncologists to seek peer review of target and critical structure delineation, treatment plans, and share clinical data with peers to optimize radiation therapy treatments. Peer review of radiation therapy treatment planning data prior to its initiation improves the quality of radiation therapy and clinical outcomes. Web-based access to radiation therapy treatment planning data and medical records mitigate existing geographical and temporal constraints. With internet access, the healthcare provider can access the data from any location and review it in an interactive and collaborative manner. Interoperability standard like DICOM-RT and IHE-RO compliant RT Systems have facilitated the design and implementation of PRS with Silverlight Web technology, .net Framework and SQL Server. Local DICOM-RT archive and cloud based services are deployed to facilitate remote peer reviews. To validate the PRS system, we tested the system for 100 patients with Philips Pinnacle v 9.0 and Varian Eclipse v 8.9 treatment planning system (TPS). We transmitted the DICOM RT data from the TPS to the cloud based services via the PRS local DICOM RT Archive. Various CT simulation based parameters such as orientation of CT, properties of RT structures etc. were compared between the TPS and PRS system. Data integrity of other parameters such as patient demographics (patient name, ID, attending physician etc.) and dose volume related parameters were also evaluated. Such rigorous testing allowed us to optimize the functionalities and clinical implementation of the PRS. We believe that the PRS will improve the quality and safety of a broad spectrum of radiation therapy patients treated in underserved areas while discouraging the overutilization of expensive radiation treatment modalities. This research and

Faster-than-light particles: A review of tachyon characteristics

NASA Astrophysics Data System (ADS)

Puscher, E. A.

1980-10-01

This report documents an analytical prediction of some of the characteristics which presently undiscovered faster-than-light sub-atomic particles (called tachyons) must possess if they are to exist without violating the Theory of Special Relativity. A brief review of necessary concepts from the Special Theory is included so that the reader might more readily understand the reasoning as it is developed. Necessary, but not all characteristics of tachyons are then identified and presented. Finally, an interesting potential relationship between tachyons and anti-gravity is discussed.

Intensity-modulated radiation therapy: a review with a physics perspective.

PubMed

Cho, Byungchul

2018-03-01

Intensity-modulated radiation therapy (IMRT) has been considered the most successful development in radiation oncology since the introduction of computed tomography into treatment planning that enabled three-dimensional conformal radiotherapy in 1980s. More than three decades have passed since the concept of inverse planning was first introduced in 1982, and IMRT has become the most important and common modality in radiation therapy. This review will present developments in inverse IMRT treatment planning and IMRT delivery using multileaf collimators, along with the associated key concepts. Other relevant issues and future perspectives are also presented.

A Review of Progress in Clinical Photodynamic Therapy

PubMed Central

Huang, Zheng

2005-01-01

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

Atopic dermatitis: a review of topical nonsteroid therapy.

PubMed

Papier, Ariana; Strowd, Lindsay C

2018-01-01

Atopic dermatitis is a chronic inflammatory skin condition that affects up to 20% of children and 3% of adults globally. Although topical corticosteroids are considered to be the first-line agents, they can be associated with cutaneous and systemic adverse effects. Since the early 2000s, two new classes of nonsteroid topical therapies, topical calcineurin inhibitors and phosphodiesterase 4 (PDE4) inhibitors, have been introduced and provide a safe treatment alternative. We performed a search and review of clinical trials that examined the safety and efficacy of topical calcineurin inhibitors and PDE4 inhibitors. The search was conducted using the PubMed database as well as preselected keywords and filters. This review focuses on the safety and efficacy of each therapy. Sixty-nine clinical trials identified in this study have demonstrated the efficacy and safety of topical calcineurin and a single novel PDE4 inhibitor in the treatment of atopic dermatitis. Topical calcineurin inhibitors have been shown to be effective in both achieving lesion clearance as well as reducing relapse when used long-term and proactively. Similarly, in clinical trials the PDE4 inhibitor showed success in lesion clearance and symptom management. All three therapies (pimecrolimus, tacrolimus, crisaborole) are associated with low systemic absorption. No clinical trials to date have shown an increased risk of systemic adverse events or malignancy such as lymphoma. The most commonly reported treatment-related adverse event across all three therapies was application-site discomfort, pain or pruritus. It is important to note that long-term studies are not yet available for the novel PDE4 inhibitor. Topical calcineurin inhibitors provide a safe and effective alternative to topical corticosteroid use in the treatment of atopic dermatitis. Although the US Food and Drug Administration (FDA) black box warning for topical calcineurin inhibitors remains, studies have not shown an increased risk of

Safety and efficacy of photobiomodulation therapy for weight loss: a review

NASA Astrophysics Data System (ADS)

Ahmed, Ambereen

2018-02-01

Photobiomodulation therapy uses light from a laser and is, therefore, a non-invasive, non-thermal treatment that is effective in reducing chronic pain and inflammation, stimulating wound healing and tissue regeneration. Due to its accessibility and ease of use, it is also being explored as an alternative to lipoplasty for fat removal. This review covers literature focusing on the applications of photobiomodulation therapy, with particular emphasis on the safety and efficacy of this therapy on fat loss. Based on the studies reported, photobiomodulation therapy is a safe technique that showed promising results in reducing the circumference of treated body parts. Also, photobiomodulation therapy is particularly effective when used in combination with exercise and physical therapy. The mechanism of action of how photobiomodulation therapy removes fat from the cells is controversial and requires further investigation. Very little scientific indication endures in support of the claims that infrared light, whether dispensed by laser, lamp, or while in a body wrap, can assist people to lose extra weight or shape their physique. Moreover, additional studies demonstrating the efficacy of photo modulation therapy in larger groups would be helpful in establishing this technique for regular clinical use.

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

PubMed Central

Harrington, Richard; Whittaker, Jane; Shoebridge, Philip; Campbell, Fiona

1998-01-01

Objective: To determine whether cognitive behaviour therapy is an effective treatment for childhood and adolescent depressive disorder. Design: Systematic review of six randomised trials comparing the efficacy of cognitive behaviour therapy with inactive interventions in subjects aged 8 to 19 years with depressive disorder. Main outcome measure: Remission from depressive disorder. Results: The rate of remission from depressive disorder was higher in the therapy group (129/208; 62%) than in the comparison group (61/168; 36%). The pooled odds ratio was 3.2 (95% confidence interval 1.9 to 5.2), suggesting a significant benefit of active treatment. Most studies, however, were based on relatively mild cases of depression and were of only moderate quality. Conclusions: Cognitive behaviour therapy may be of benefit for depressive disorder of moderate severity in children and adolescents. It cannot, however, yet be recommended for severe depression. Definitive large trials will be required to determine whether the results of this systematic review are reliable. Key messages Depressive disorders are a common problem in child psychiatric clinics, but a recent systematic review found that tricyclic medication was of unproved benefit This systematic review identified six randomised trials of a psychological treatment—cognitive behaviour therapy—in subjects aged 8 to 19 years with depressive disorder The results seemed to show that cognitive behaviour therapy is an effective treatment for depressive disorder of moderate severity Because of the small number of trials available for this quantitative analysis definitive large trials will be required to determine whether the present results are reliable PMID:9596592

A systematic review and meta-analysis of music therapy for the older adults with depression.

PubMed

Zhao, K; Bai, Z G; Bo, A; Chi, I

2016-11-01

To determine the efficacy of music therapy in the management of depression in the elderly. We conducted a systematic review and meta-analysis of randomized controlled trials. Change in depressive symptoms was measured with various scales. Standardized mean differences were calculated for each therapy-control contrast. A comprehensive search yielded 2,692 citations; 19 articles met inclusion criteria. Meta-analysis suggests that music therapy plus standard treatment has statistical significance in reducing depressive symptoms among older adults (standardized mean differences = 1.02; 95% CI = 0.87, 1.17). This systematic review and meta-analysis suggests that music therapy has an effect on reducing depressive symptoms to some extent. However, high-quality trials evaluating the effects of music therapy on depression are required. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Light therapy for non-seasonal depression: systematic review and meta-analysis.

PubMed

Perera, Stefan; Eisen, Rebecca; Bhatt, Meha; Bhatnagar, Neera; de Souza, Russell; Thabane, Lehana; Samaan, Zainab

2016-03-01

Light therapy is a known treatment for patients with seasonal affective disorder. However, the efficacy of light therapy in treating patients with non-seasonal depression remains inconclusive. To provide the current state of evidence for efficacy of light therapy in non-seasonal depressive disorders. Systematic review of randomised controlled trials (RCTs) was conducted by searching MEDLINE, EMBASE, PsycINFO, CINAHL, and CENTRAL from their inception to September 2015. Study selection, data abstraction and risk of bias assessment were independently conducted in duplicate. Meta-analyses were performed to provide a summary statistic for the included RCTs. The reporting of this systematic review follows the PRISMA guidelines. A meta-analysis including 881 participants from 20 RCTs demonstrated a beneficial effect of light therapy in non-seasonal depression (standardised mean difference in depression score -0.41 (95% CI -0.64 to -0.18)). This estimate was associated with significant heterogeneity ( I 2 =60%, P =0.0003) that was not sufficiently explained by subgroup analyses. There was also high risk of bias in the included trials limiting the study interpretation. The overall quality of evidence is poor due to high risk of bias and inconsistency. However, considering that light therapy has minimal side-effects and our meta-analysis demonstrated that a significant proportion of patients achieved a clinically significant response, light therapy may be effective for patients with non-seasonal depression and can be a helpful additional therapeutic intervention for depression. None. © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

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

PubMed

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

2009-01-01

A systematic review of randomized controlled trials (RCTs). To determine if injection therapy is more effective than placebo or other treatments for patients with subacute or chronic low back pain. The effectiveness of injection therapy for low back pain is still debatable. Heterogeneity of target tissue, pharmacological agent, and dosage, generally found in RCTs, point to the need for clinically valid comparisons in a literature synthesis. We updated the search of the earlier systematic review and searched the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE databases up to March 2007 for relevant trials reported in English, French, German, Dutch, and Nordic languages. We also screened references from trials identified. RCTs on the effects of injection therapy involving epidural, facet, or local sites for subacute or chronic low back pain were included. Studies that compared the effects of intradiscal injections, prolotherapy, or ozone therapy with other treatments were excluded unless injection therapy with another pharmaceutical agent (no placebo treatment) was part of one of the treatment arms. Studies about injections in sacroiliac joints and studies evaluating the effects of epidural steroids for radicular pain were also excluded. Eighteen trials (1179 participants) were included in this review. The injection sites varied from epidural sites and facet joints (i.e. intra-articular injections, peri-articular injections and nerve blocks) to local sites (i.e. tender-and trigger points). The drugs that were studied consisted of corticosteroids, local anesthetics, and a variety of other drugs. The methodologic quality of the trials was limited with 10 of 18 trials rated as having a high methodologic quality. Statistical pooling was not possible because of clinical heterogeneity in the trials. Overall, the results indicated that there is no strong evidence for or against the use of any type of injection therapy. There is insufficient evidence to

Nano-sized calcium phosphate particles for periodontal gene therapy.

PubMed

Elangovan, Satheesh; Jain, Shardool; Tsai, Pei-Chin; Margolis, Henry C; Amiji, Mansoor

2013-01-01

Growth factors such as platelet-derived growth factor (PDGF) have significantly enhanced periodontal therapy outcomes with a high degree of variability, mostly due to the lack of continual supply for a required period of time. One method to overcome this barrier is gene therapy. The aim of this in vitro study is to evaluate PDGF-B gene delivery in fibroblasts using nano-sized calcium phosphate particles (NCaPP) as vectors. NCaPP incorporating green fluorescent protein (NCaPP-GFP) and PDGF-B (NCaPP-PDGF-B) plasmids were synthesized using an established precipitation system and characterized using transmission electron microscopy and 1.2% agarose gel electrophoresis. Biocompatibility and transfection of the nanoplexes in fibroblasts were evaluated using cytotoxicity assay and florescence microscopy, respectively. Polymerase chain reaction and enzyme-linked immunosorbent assay were performed to evaluate PDGF-B transfection after different time points of treatments, and the functionality of PDGF-B transfection was evaluated using the cell proliferation assay. Synthesized NCaPP nanoplexes incorporating the genes of GFP and PDGF-B were spherical in shape and measured about 30 to 50 nm in diameter. Gel electrophoresis confirmed DNA incorporation and stability within the nanoplexes, and 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium reagent assay demonstrated their biocompatibility in fibroblasts. In vitro transfection studies revealed a higher and longer lasting transfection after NCaPP-PDGF-B treatment, which lasted up to 96 hours. Significantly enhanced fibroblast proliferation observed in NCaPP-PDGF-B-treated cells confirmed the functionality of these nanoplexes. NCaPP demonstrated higher levels of biocompatibility and efficiently transfected PDGF plasmids into fibroblasts under described in vitro conditions.

Relaxation therapies for asthma: a systematic review

PubMed Central

Huntley, A; White, A; Ernst, E

2002-01-01

Background: Emotional stress can either precipitate or exacerbate both acute and chronic asthma. There is a large body of literature available on the use of relaxation techniques for the treatment of asthma symptoms. The aim of this systematic review was to determine if there is any evidence for or against the clinical efficacy of such interventions. Methods: Four independent literature searches were performed on Medline, Cochrane Library, CISCOM, and Embase. Only randomised clinical trials (RCTs) were included. There were no restrictions on the language of publication. The data from trials that statistically compared the treatment group with that of the control were extracted in a standardised predefined manner and assessed critically by two independent reviewers. Results: Fifteen trials were identified, of which nine compared the treatment group with the control group appropriately. Five RCTs tested progressive muscle relaxation or mental and muscular relaxation, two of which showed significant effects of therapy. One RCT investigating hypnotherapy, one of autogenic training, and two of biofeedback techniques revealed no therapeutic effects. Overall, the methodological quality of the studies was poor. Conclusions: There is a lack of evidence for the efficacy of relaxation therapies in the management of asthma. This deficiency is due to the poor methodology of the studies as well as the inherent problems of conducting such trials. There is some evidence that muscular relaxation improves lung function of patients with asthma but no evidence for any other relaxation technique. PMID:11828041

Relaxation therapies for asthma: a systematic review.

PubMed

Huntley, A; White, A R; Ernst, E

2002-02-01

Emotional stress can either precipitate or exacerbate both acute and chronic asthma. There is a large body of literature available on the use of relaxation techniques for the treatment of asthma symptoms. The aim of this systematic review was to determine if there is any evidence for or against the clinical efficacy of such interventions. Four independent literature searches were performed on Medline, Cochrane Library, CISCOM, and Embase. Only randomised clinical trials (RCTs) were included. There were no restrictions on the language of publication. The data from trials that statistically compared the treatment group with that of the control were extracted in a standardised predefined manner and assessed critically by two independent reviewers. Fifteen trials were identified, of which nine compared the treatment group with the control group appropriately. Five RCTs tested progressive muscle relaxation or mental and muscular relaxation, two of which showed significant effects of therapy. One RCT investigating hypnotherapy, one of autogenic training, and two of biofeedback techniques revealed no therapeutic effects. Overall, the methodological quality of the studies was poor. There is a lack of evidence for the efficacy of relaxation therapies in the management of asthma. This deficiency is due to the poor methodology of the studies as well as the inherent problems of conducting such trials. There is some evidence that muscular relaxation improves lung function of patients with asthma but no evidence for any other relaxation technique.

A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome

PubMed Central

Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

2015-01-01

Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety. PMID:26246841

A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome.

PubMed

Lauche, Romy; Cramer, Holger; Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

2015-01-01

Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety.

Aquatic Therapy for People with Lymphedema: A Systematic Review and Meta-analysis.

PubMed

Yeung, Wai; Semciw, Adam I

2018-02-01

Aquatic therapy has several proposed benefits for people with lymphedema. A systematic review of the evidence for aquatic therapy in lymphedema management has not been conducted. Systematic review and meta-analysis were conducted. Five electronic databases were searched to identify randomized controlled trials (RCTs) of people with lymphedema, which compared aquatic therapy with other lymphedema interventions. Qualitative analysis was undertaken where quantitative analysis was not possible. Study quality was assessed using physiotherapy evidence database (PEDro) scores. The strength of evidence was evaluated using the Grades of Recommendations Assessment, Development and Evaluation (GRADE) approach. Four RCTs of moderate quality (average PEDro score 6.5/10) were included in the review. Two studies provided results for inclusion in meta-analysis. There was moderate-level evidence of no significant short-term differences in lymphedema status (as measured by lymphedema relative volume) between patients who completed aqua lymphatic therapy (ALT) compared to land-based standard care (standardized mean difference [SMD]: 0.14; 95% confidence interval [CI]: -0.37 to 0.64, I 2  = 0%, p = 0.59); and low-quality evidence of no significant difference between ALT and standard care for improving upper limb (UL) physical function (SMD -0.27, 95% CI: -0.78 to 0.23, I 2  = 0%, p = 0.29). No adverse events reported. Current evidence indicates no significant benefit of ALT over standard land-based care for improving lymphedema status or physical function in people with UL lymphedema. Patient preference should guide the choice of care to facilitate adherence. Further research is required to strengthen the evidence from four studies in people with UL lymphedema, and to establish the efficacy of this intervention in people with lower limb lymphedema. Review registration: PROSPERO (CRD42015019900).

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

PubMed Central

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

2013-01-01

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

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

PubMed Central

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

2014-01-01

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

Physical interactions of charged particles for radiotherapy and space applications.

PubMed

Zeitlin, Cary

2012-11-01

In this paper, the basic physics by which energetic charged particles deposit energy in matter is reviewed. Energetic charged particles are used for radiotherapy and are encountered in spaceflight, where they pose a health risk to astronauts. They interact with matter through nuclear and electromagnetic forces. Deposition of energy occurs mostly along the trajectory of the incoming particle, but depending on the type of incident particle and its energy, there is some nonzero probability for energy deposition relatively far from the nominal trajectory, either due to long-ranged knock-on electrons (sometimes called delta rays) or from the products of nuclear fragmentation, including neutrons. In the therapy setting, dose localization is of paramount importance, and the deposition of energy outside nominal treatment volumes complicates planning and increases the risk of secondary cancers as well as noncancer effects in normal tissue. Statistical effects are also important and will be discussed. In contrast to radiation therapy patients, astronauts in space receive comparatively small whole-body radiation doses from energetic charged particles and associated secondary radiation. A unique aspect of space radiation exposures is the high-energy heavy-ion component of the dose. This is not present in terrestrial exposures except in carbon-ion radiotherapy. Designers of space missions must limit exposures to keep risk within acceptable limits. These limits are, at present, defined for low-Earth orbit, but not for deep-space missions outside the geomagnetosphere. Most of the uncertainty in risk assessment for such missions comes from the lack of understanding of the biological effectiveness of the heavy-ion component, with a smaller component due to uncertainties in transport physics and dosimetry. These same uncertainties are also critical in the therapy setting.

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

NASA Astrophysics Data System (ADS)

Reeves, Daniel B.; Weaver, John B.

2015-11-01

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

Patient values and preferences for antithrombotic therapy in atrial fibrillation. A Narrative Systematic Review.

PubMed

Loewen, Peter S; Ji, Angela Tianshu; Kapanen, Anita; McClean, Alison

2017-06-02

Guidelines recommend that patients' values and preferences should be considered when selecting stroke prevention therapy for atrial fibrillation (SPAF). However, doing so is difficult, and tools to assist clinicians are sparse. We performed a narrative systematic review to provide clinicians with insights into the values and preferences of AF patients for SPAF antithrombotic therapy. Narrative systematic review of published literature from database inception. 1) What are patients' AF and SPAF therapy values and preferences? 2) How are SPAF therapy values and preferences affected by patient factors? 3) How does conveying risk information affect SPAF therapy preferences? and 4) What is known about patient values and preferences regarding novel oral anticoagulants (NOACs) for SPAF? Twenty-five studies were included. Overall study quality was moderate. Severe stroke was associated with the greatest disutility among AF outcomes and most patients value the stroke prevention efficacy of therapy more than other attributes. Utilities, values, and preferences about other outcomes and attributes of therapy are heterogeneous and unpredictable. Patients' therapy preferences usually align with their values when individualised risk information is presented, although divergence from this is common. Patients value the attributes of NOACs but frequently do not prefer NOACs over warfarin when all therapy-related attributes are considered. In conclusion, patients' values and preferences for SPAF antithrombotic therapy are heterogeneous and there is no substitute for directly clarifying patients' individual values and preferences. Research using choice modelling and tools to help clinicians and patients clarify their SPAF therapy values and preferences are needed.

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

ERIC Educational Resources Information Center

Gellis, Zvi D.; Kenaley, Bonnie

2008-01-01

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

A review on noise suppression and aberration compensation in holographic particle image velocimetry

NASA Astrophysics Data System (ADS)

Tamrin, K. F.; Rahmatullah, B.

2016-12-01

Understanding three-dimensional (3D) fluid flow behaviour is undeniably crucial in improving performance and efficiency in a wide range of applications in engineering and medical fields. Holographic particle image velocimetry (HPIV) is a potential tool to probe and characterize complex flow dynamics since it is a truly three-dimensional three-component measurement technique. The technique relies on the coherent light scattered by small seeding particles that are assumed to faithfully follow the flow for subsequent reconstruction of the same the event afterward. However, extraction of useful 3D displacement data from these particle images is usually aggravated by noise and aberration which are inherent within the optical system. Noise and aberration have been considered as major hurdles in HPIV in obtaining accurate particle image identification and its corresponding 3D position. Major contributions to noise include zero-order diffraction, out-of-focus particles, virtual image and emulsion grain scattering. Noise suppression is crucial to ensure that particle image can be distinctly differentiated from background noise while aberration compensation forms particle image with high integrity. This paper reviews a number of HPIV configurations that have been proposed to address these issues, summarizes the key findings and outlines a basis for follow-on research.

Play Therapy: A Review

ERIC Educational Resources Information Center

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

2009-01-01

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

Optimal CINAHL search strategies for identifying therapy studies and review articles.

PubMed

Wong, Sharon S L; Wilczynski, Nancy L; Haynes, R Brian

2006-01-01

To design optimal search strategies for locating sound therapy studies and review articles in CiNAHL in the year 2000. An analytic survey was conducted, comparing hand searches of 75 journals with retrievals from CINAHL for 5,020 candidate search terms and 17,900 combinations for therapy and 5,977 combinations for review articles. All articles were rated with purpose and quality indicators. Candidate search strategies were used in CINAHL, and the retrievals were compared with results of the hand searches. The proposed search strategies were treated as "diagnostic tests" for sound studies and the manual review of the literature was treated as the "gold standard." Operating characteristics of the search strategies were calculated. Of the 1,383 articles about treatment, 506 (36.6%) met basic criteria for scientific merit and 127 (17.9%) of the 711 articles classified as a review met the criteria for systematic reviews. For locating sound treatment studies, a three-term strategy maximized sensitivity at 99.4% but with compromised specificity at 58.3%, and a two-term strategy maximized specificity at 98.5% but with compromised sensitivity at 52.0%. For detecting systematic reviews, a three-term strategy maximized sensitivity at 91.3% while keeping specificity high at 95.4%, and a single-term strategy maximized specificity at 99.6% but with compromised sensitivity at 42.5%. Three-term search strategies optimizing sensitivity and specificity achieved these values over 91% for detecting sound treatment studies and over 76% for detecting systematic reviews. Search strategies combining indexing terms and text words can achieve high sensitivity and specificity for retrieving sound treatment studies and review articles in CINAHL.

SU-F-J-202: Secondary Radiation Measurements for Charged Particle Therapy Monitoring: Fragmentation of Therapeutic He, C and O Ion Beams Impinging On a PMMA Target

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rucinski, A; Mancini-Terracciano, C; Paramatti, R

Purpose: In Charged Particle Therapy (CPT), besides protons, there has been recently a growing interest in 4He, 12C and 16O beams. The secondary radiation produced in the interaction of those beams with a patient could be potentially used for on-line monitoring of range uncertainties in order to fully exploit the advantages of those light ions resulting from increased Radio Biological Effectiveness, reduced multiple scattering and Oxygen Enhancement Ratio. The study and precise characterization of secondary radiation (beta+, prompt gamma, charged fragments) is the cornerstone of any R&D activity aiming for online monitoring development and purpose of the analysis presented here.more » Methods: We present the measurements of the secondary radiation generated by He, C and O beams impinging on a beam stopping PMMA target. The data has been collected at the Heidelberg Ionbeam Therapy center (HIT), where several millions of collisions were recorded at different energies, relevant for therapeutical applications. Results: The experimental setup, as well as the analysis strategies will be reviewed. The detected particle fluxes as a function of the primary beam energy and the emission angle with respect to the beam direction will be presented and compared to the results of other available measurements. In addition, the energy spectra and emission shapes of charged secondary particles will be shown and discussed in the context of the primary beam range monitoring technique that is being developed by the ARPG collaboration, within the INSIDE project funded by the Italian research ministry. The implications for dose monitoring applications will be discussed, in the context of the current (or planned) state-of- the-art detector solutions. Conclusion: The characterization of the radiation produced by 12C, 4He and 16O beams fully supports the feasibility of on-line range monitoring in the clinical practice of CPT by means of secondary particles detection.« less

A Systematic Review of Clinical Practice Guidelines' Recommendations on Levothyroxine Therapy Alone versus Combination Therapy (LT4 plus LT3) for Hypothyroidism.

PubMed

Kraut, Eyal; Farahani, Pendar

2015-12-04

Patients with hypothyroidism are increasingly enquiring about the benefit of using combination therapy of levothyroxine (LT4) and liothyronine (LT3) as a potential treatment for hypothyroidism. Combination therapy, however, remains controversial. The purpose of this study was to systematically review available hypothyroidism treatment recommendations from clinical practice guidelines from around the world to identify the consensus regarding combination therapy. Clinical practice guidelines were obtained from searches of PubMed, EMBASE, and MEDLINE, using several combinations of MeSH terms. The search was limited to clinical guidelines in English-language publications, published between January 1, 1990 and May 1, 2015. A quantitative approach was utilized for data synthesis. Thirteen guidelines were identified, including three regarding pregnancy, two regarding pediatric populations and eight regarding adult populations. There were six guidelines from North America, four guidelines from Europe and three guidelines from South America. Twelve of the guidelines were published after 2010. Nine guidelines addressed combination therapy of LT4 plus LT3, and all nine concluded that LT4 therapy alone is the standard of care, with insufficient evidence to recommend widespread combination therapy. Only the 2012 ETA Guidelines and the 2015 BTA Guidelines concluded that combination therapy could be used, although only in certain circumstances and as an experimental treatment. This systematic review illustrates that clinical practice guidelines worldwide do not recommend and do not support routine use of combination LT4 and LT3 therapy to treat hypothyroidism.

A Systematic Review of the Evidence Regarding Cognitive Therapy Skills That Assist Cognitive Behavioural Therapy in Adults Who Have an Intellectual Disability

ERIC Educational Resources Information Center

Cooney, Patricia; Tunney, Conall; O'Reilly, Gary

2018-01-01

Background: Cognitive behavioural therapy (CBT) is being increasingly adapted for use with people who have an intellectual disability. However, it remains unclear whether inherent cognitive deficits that are present in adults who have an intellectual disability preclude the use of cognitive-based therapies. This review aims to systematically…

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

PubMed Central

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

2013-01-01

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

Alginate Particles with Ovalbumin (OVA) Peptide Can Serve as a Carrier and Adjuvant for Immune Therapy in B16-OVA Cancer Model.

PubMed

Zhu, Longbao; Ge, Fei; Yang, Liangjun; Li, Wanzhen; Wei, Shenghua; Tao, Yugui; Du, Guocheng

2017-04-28

BACKGROUND Alginate is a natural polysaccharide obtained from brown algae and has been shown to have numerous applications in biomedical science, such as wound healing, delivery of bioactive agents, and cell transplantation. Ovalbumin (OVA) peptide 323-339 has been reported to be involved in immune response.  MATERIAL AND METHODS This work investigated the use of alginate particles as a carrier and adjuvant for the immune therapy of cancer. Alginate particles loaded with OVA peptide were produced via emulsion. A tumor model was established in C57BL/6J mice via subcutaneous injection of 3×105 B16-OVA tumor cells. The effect of alginate/OVA peptide on cell viability was analyzed by use of the CCK-8 assay kit. Activation of macrophages was examined by checking cell surface makers CD40 and CD86 by FACs. RESULTS Alginate/OVA peptide inhibited tumor progression more effectively than using the peptide alone. The viability and uptake study illustrated that this particle is safe and non-toxic. The activation study demonstrated that alginate particles can promote the activation of surface markers on macrophages. ELISA assay showed that the particles with peptide can promote the secretion of inflammatory and effector cytokines from macrophages.  CONCLUSIONS This study demonstrated that alginate has dual functions in immune therapy of cancer, serving both as a carrier and an adjuvant.

Readiness Review of BWXT for Fabrication of AGR-5/6/7 TRISO Particles

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marshall, Douglas William; Sharp, Michelle Tracy

2016-02-01

INL readiness review assessment of BWXT readiness to commence fabrication of low-enriched TRISO coated fuel particles for the AGR-5/6/7 irradiation experiments. BWXT self-identified equipment issues preventing operation. INL identified two findings. The first was that disposition codes had not been assigned and documented on BWXT forms to ensure that off-specification materials could not be used in the fabrication of TRISO particles. The second was that chemical purity specifications were not reliably passed on to chemical suppliers, which resulted in the receipt of one acetylene cylinder with suspect impurity levels.

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

PubMed

Zhu, Jiahua; Penfold, Scott N

2016-06-01

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

The gender gap in peer-reviewed publications by physical therapy faculty members: a productivity puzzle.

PubMed

Kaufman, Regina R; Chevan, Julia

2011-01-01

Studies of peer-reviewed article publication by faculty in higher education show men publish more than women. Part of the difference in publishing appears to be attributable directly to gender. Gender differences in publishing productivity have not been explored in physical therapy. The purpose of this study was to explore effects of gender on peer-reviewed publication productivity in physical therapy. This was a cross-sectional study using survey methods. A survey was administered to a random sample of 881 physical therapy faculty members; 459 responses were used for analysis. Men were more likely than women to be married, have children, hold a PhD degree, be tenured or on a tenure track, and hold the position of department chair. There was a significant difference in peer-reviewed publication rates between male and female respondents. Negative binomial regression models revealed that female gender was a negative predictor of peer-reviewed publication, accounting for between 0.51 and 0.58 fewer articles per year for women than for men over the course of a career. Reasons for the gender differences are not clear. Factors such as grant funding, laboratory resources, nature of collaborative relationships, values for different elements of the teaching/research/service triad, and ability to negotiate the academic culture were not captured by our model. The gender gap in peer-reviewed publishing productivity may have implications for individuals and the profession of physical therapy and should be subject to further exploration.

Beam angle selection incorporation of anatomical heterogeneities for pencil beam scanning charged-particle therapy

NASA Astrophysics Data System (ADS)

Toramatsu, Chie; Inaniwa, Taku

2016-12-01

In charged particle therapy with pencil beam scanning (PBS), localization of the dose in the Bragg peak makes dose distributions sensitive to lateral tissue heterogeneities. The sensitivity of a PBS plan to lateral tissue heterogeneities can be reduced by selecting appropriate beam angles. The purpose of this study is to develop a fast and accurate method of beam angle selection for PBS. The lateral tissue heterogeneity surrounding the path of the pencil beams at a given angle was quantified with the heterogeneity number representing the variation of the Bragg peak depth across the cross section of the beams using the stopping power ratio of body tissues with respect to water. To shorten the computation time, one-dimensional dose optimization was conducted along the central axis of the pencil beams as they were directed by the scanning magnets. The heterogeneity numbers were derived for all possible beam angles for treatment. The angles leading to the minimum mean heterogeneity number were selected as the optimal beam angle. Three clinical cases of head and neck cancer were used to evaluate the developed method. Dose distributions and their robustness to setup and range errors were evaluated for all tested angles, and their relation to the heterogeneity numbers was investigated. The mean heterogeneity number varied from 1.2 mm-10.6 mm in the evaluated cases. By selecting a field with a low mean heterogeneity number, target dose coverage and robustness against setup and range errors were improved. The developed method is simple, fast, accurate and applicable for beam angle selection in charged particle therapy with PBS.

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

PubMed Central

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

2001-01-01

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

A review of research into the uses of low level ultrasound in cancer therapy.

PubMed

Yu, Tinghe; Wang, Zhibiao; Mason, Timothy J

2004-04-01

The use of low power ultrasound in therapeutic medicine is a developing field and this review will concentrate on the applications of this technology in cancer therapy. The effects of low power ultrasound have been evaluated in terms of the biological changes induced in the structure and function of tissue. The main fields of study have been in sonodynamic therapy, improving chemotherapy, gene therapy and apoptosis therapy. The range of ultrasonic power levels that can be effectively employed in therapy appears to be narrow and this may have hindered past research in the applications in cancer treatment.

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

PubMed

Shenderova, Olga A; McGuire, Gary E

2015-09-05

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

Couple Therapy for Intimate Partner Violence: A Systematic Review and Meta-Analysis

PubMed Central

Karakurt, Gunnur; Whiting, Kate; Van Esch, Chantal; Bolen, Shari; Calabrese, Joseph

2016-01-01

Intimate partner violence is a serious public health problem accompanied by substantial morbidity and mortality. Despite its documented impact on health, there is no widely recognized treatment of choice. Some studies indicate that couples suffering from situational violence may benefit from couples therapy, but professionals are cautious to risk the possibility of violent retaliation between partners. After a comprehensive literature search of 1733 citations, this systematic review and meta-analysis compiles the results of six studies to investigate the effectiveness of couple therapy as a treatment for violence. Preliminary data suggest that couples therapy is a viable treatment in select situations. PMID:27377617

Application of stem cells in targeted therapy of breast cancer: a systematic review.

PubMed

Madjd, Zahra; Gheytanchi, Elmira; Erfani, Elham; Asadi-Lari, Mohsen

2013-01-01

The aim of this systematic review was to investigate whether stem cells could be effectively applied in targeted therapy of breast cancer. A systematic literature search was performed for original articles published from January 2007 until May 2012. Nine studies met the inclusion criteria for phase I or II clinical trials, of which three used stem cells as vehicles, two trials used autologous hematopoetic stem cells and in four trials cancer stem cells were targeted. Mesenchymal stem cells (MSCs) were applied as cellular vehicles to transfer therapeutic agents. Cell therapy with MSC can successfully target resistant cancers. Cancer stem cells were selectively targeted via a proteasome-dependent suicide gene leading to tumor regression. Wnt/β-catenin signaling pathway has been also evidenced to be an attractive CSC-target. This systematic review focused on two different concepts of stem cells and breast cancer marking a turning point in the trials that applied stem cells as cellular vehicles for targeted delivery therapy as well as CSC-targeted therapies. Applying stem cells as targeted therapy could be an effective therapeutic approach for treatment of breast cancer in the clinic and in therapeutic marketing; however this needs to be confirmed with further clinical investigations.

Proton beam therapy in the management of skull base chordomas: systematic review of indications, outcomes, and implications for neurosurgeons.

PubMed

Matloob, Samir A; Nasir, Haleema A; Choi, David

2016-08-01

Chordomas are rare tumours affecting the skull base. There is currently no clear consensus on the post-surgical radiation treatments that should be used after maximal tumour resection. However, high-dose proton beam therapy is an accepted option for post-operative radiotherapy to maximise local control, and in the UK, National Health Service approval for funding abroad is granted for specific patient criteria. To review the indications and efficacy of proton beam therapy in the management of skull base chordomas. The primary outcome measure for review was the efficacy of proton beam therapy in the prevention of local occurrence. A systematic review of English and non-English articles using MEDLINE (1946-present) and EMBASE (1974-present) databases was performed. Additional studies were reviewed when referenced in other studies and not available on these databases. Search terms included chordoma or chordomas. The PRISMA guidelines were followed for reporting our findings as a systematic review. A total of 76 articles met the inclusion and exclusion criteria for this review. Limitations included the lack of documentation of the extent of primary surgery, tumour size, and lack of standardised outcome measures. Level IIb/III evidence suggests proton beam therapy given post operatively for skull base chordomas results in better survival with less damage to surrounding tissue. Proton beam therapy is a grade B/C recommended treatment modality for post-operative radiation therapy to skull base chordomas. In comparison to other treatment modalities long-term local control and survival is probably improved with proton beam therapy. Further, studies are required to directly compare proton beam therapy to other treatment modalities in selected patients.

Virtual reality therapy for adults post-stroke: a systematic review and meta-analysis exploring virtual environments and commercial games in therapy.

PubMed

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

2014-01-01

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

Understanding the uncertainty associated with particle-bound pollutant build-up and wash-off: A critical review.

PubMed

Wijesiri, Buddhi; Egodawatta, Prasanna; McGree, James; Goonetilleke, Ashantha

2016-09-15

Accurate prediction of stormwater quality is essential for developing effective pollution mitigation strategies. The use of models incorporating simplified mathematical replications of pollutant processes is the common practice for determining stormwater quality. However, an inherent process uncertainty arises due to the intrinsic variability associated with pollutant processes, which has neither been comprehensively understood, nor well accounted for in uncertainty assessment of stormwater quality modelling. This review provides the context for defining and quantifying the uncertainty associated with pollutant build-up and wash-off on urban impervious surfaces based on the hypothesis that particle size is predominant in influencing process variability. Critical analysis of published research literature brings scientific evidence together in order to establish the fact that particle size changes with time, and different sized particles exhibit distinct behaviour during build-up and wash-off, resulting in process variability. Analysis of the different adsorption behaviour of particles confirmed that the variations in pollutant load and composition are influenced by particle size. Particle behaviour and variations in pollutant load and composition are related due to the strong affinity of pollutants such as heavy metals and hydrocarbons for specific particle size ranges. As such, the temporal variation in particle size is identified as the key to establishing a basis for assessing build-up and wash-off process uncertainty. Therefore, accounting for pollutant build-up and wash-off process variability, which is influenced by particle size, would facilitate the assessment of the uncertainty associated with modelling outcomes. Furthermore, the review identified fundamental knowledge gaps where further research is needed in relation to: (1) the aggregation of particles suspended in the atmosphere during build-up; (2) particle re-suspension during wash-off; (3) pollutant

Effectiveness of Occupational Therapy Interventions for Musculoskeletal Shoulder Conditions: A Systematic Review

PubMed Central

Roll, Shawn C.

2017-01-01

People with musculoskeletal disorders of the shoulder commonly experience pain, decreased strength, and restricted range of motion (ROM) that limit participation in meaningful occupational activities. The purpose of this systematic review was to evaluate the current evidence for interventions within the occupational therapy scope of practice that address pain reduction and increase participation in functional activities. Seventy-six studies were reviewed for this study—67 of Level I evidence, 7 of Level II evidence, and 2 of Level III evidence. Strong evidence was found that ROM, strengthening exercises, and joint mobilizations can improve function and decrease pain. The evidence to support physical modalities is moderate to mixed, depending on the shoulder disorder. Occupational therapy practitioners can use this evidence to guide daily clinical decision making. PMID:28027039

Effectiveness and efficacy of nutritional therapy: A systematic review following Cochrane methodology.

PubMed

Muscaritoli, Maurizio; Krznarić, Zeljko; Singer, Pierre; Barazzoni, Rocco; Cederholm, Tommy; Golay, Alain; Van Gossum, André; Kennedy, Nicholas; Kreymann, Georg; Laviano, Alessandro; Pavić, Tajana; Puljak, Livia; Sambunjak, Dario; Utrobičić, Ana; Schneider, Stéphane M

2017-08-01

Disease-related malnutrition has deleterious consequences on patients' outcome and healthcare costs. The demonstration of improved outcome by appropriate nutritional management is on occasion difficult. The European Society of Clinical Nutrition and Metabolism (ESPEN) appointed the Nutrition Education Study Group (ESPEN-NESG) to increase recognition of nutritional knowledge and support in health services. To obtain the best available evidence on the potential effects of malnutrition on morbidity, mortality and hospital stay; cost of malnutrition; effect of nutritional treatment on outcome parameters and pharmaco-economics of nutritional therapy, a systematic review of the literature was performed following Cochrane methodology, to answer the following key questions: Q1) Is malnutrition an independent predictive factor for readmission within 30 days from hospital discharge? Q2) Does nutritional therapy reduce the risk of readmission within 30 days from hospital discharge? Q3) Is nutritional therapy cost-effective/does it reduce costs in hospitalized patients? and Q4) Is nutritional therapy cost effective/does it reduce costs in outpatients? For Q1 six of 15 identified observational studies indicated that malnutrition was predictive of re-admissions, whereas the remainder did not. For Q2 nine randomized controlled trials and two meta-analyses gave non-conclusive results whether re-admissions could be reduced by nutritional therapy. Economic benefit and cost-effectiveness of nutritional therapy was consistently reported in 16 identified studies for hospitalized patients (Q3), whereas the heterogeneous and limited corresponding data on out-patients (Q4) indicated cost-benefits in some selected sub-groups. This result of this review supports the use of nutritional therapy to reduce healthcare costs, most evident from large, homogeneous studies. In general, reports are too heterogeneous and overall of limited quality for conclusions on impact of malnutrition and its

Do asthmatics benefit from music therapy? A systematic review.

PubMed

Sliwka, Agnieszka; Wloch, Tomasz; Tynor, Dariusz; Nowobilski, Roman

2014-08-01

To determine the effectiveness of music therapy in asthma. Searches for experimental and observational studies published between 01.01.92 and 31.12.13 were conducted through electronic databases: Medline/PubMed, Embase, SportDiscus, Cochrane Library, Teacher Reference Centre, Web of Science, Academic Search Complete, PsycINFO, PsycARTICLES, PEDro and Scopus. The selection criteria included any method of music therapy applied to patients with asthma, with respect to asthma symptoms and lung function. Two reviewers screened the records independently. The risk of bias was assessed using the Cochrane Collaboration's tool. Strength of recommendation was graded according to GRADE recommendation. The literature search identified 867 citations, from which 8 (three RCTs and five nRCTs) low and high risk of bias studies were included in the review. All RCTs used music listening as a form of complementary treatment. One RCT of the low risk of bias indicated positive effects on lung function in mild asthma. In two others, despite the decrease in asthma symptoms, music was not more effective than the control condition. In two nRCTs a decrease in asthma symptoms was reported as an effect of playing a brass or wind instrument; in two nRCTs the same effect was observed after music assisted vocal breathing exercises and singing. Mood improvement, decrease of depression and anxiety were also observed. The paucity, heterogeneity, and significant methodological limitations of available studies allow for only a weak recommendation for music therapy in asthma. This study highlights the need for further research of mixed methodology. Copyright © 2014 Elsevier Ltd. All rights reserved.

Life review therapy for older adults with moderate depressive symptomatology: a pragmatic randomized controlled trial.

PubMed

Korte, J; Bohlmeijer, E T; Cappeliez, P; Smit, F; Westerhof, G J

2012-06-01

BACKGROUND. Although there is substantial evidence for the efficacy of life review therapy as an early treatment of depression in later life, its effectiveness in natural settings has not been studied. The present study evaluates an intervention based on life review and narrative therapy in a large multi-site, pragmatic randomized controlled trial(RCT). METHOD. Life review therapy was compared with care as usual. The primary outcome was depressive symptoms;secondary outcomes were anxiety symptoms, positive mental health, quality of life, and current major depressive episode (MDE). To identify groups for whom the intervention was particularly effective, moderator analyses were carried out (on sociodemographic variables, personality traits, reminiscence functions, clinically relevant depressive and anxiety symptoms, and past MDEs). RESULTS. Compared with care as usual (n=102), life review therapy (n=100) was effective in reducing depressive symptoms, at post-treatment (d=0.60, B= -5.3, p<0.001), at 3-month follow-up (d=0.50, B= -5.0, p<0.001) and for the intervention also at 9-month follow-up (t=5.7, p<0.001). The likelihood of a clinically significant change in depressive symptoms was significantly higher [odds ratio (OR) 3.77, p<0.001 at post-treatment ; OR 3.76, p<0.001 at the 3-month follow-up]. Small significant effects were found for symptoms of anxiety and positive mental health.Moderator analyses showed only two significant moderators, the personality trait of extraversion and the reminiscence function of boredom reduction. CONCLUSIONS. This study shows the effectiveness of life review therapy as an early intervention for depression in an ecologically valid context, supporting its applicability to a broad target group. The intervention is also effective in reducing anxiety symptoms and strengthening positive mental health.

Enhancement of bone consolidation in mandibular distraction osteogenesis: a contemporary review of experimental studies involving adjuvant therapies.

PubMed

Hong, Paul; Boyd, Daniel; Beyea, Steven D; Bezuhly, Michael

2013-07-01

One of the major disadvantages of mandibular distraction osteogenesis (MDO) is the prolonged time required for consolidation of the regenerate bone. The objective of the present study is to perform a contemporary review of various adjuvant therapies to enhance bone consolidation in MDO. A PubMed search for articles related to MDO, along with the references of those articles, was performed. Inclusion and exclusion criteria were applied to all experimental studies assessing adjuvant therapies to enhance bone consolidation. A total of 1414 titles and abstracts were initially reviewed; 61 studies were included for full review. Many studies involved growth factors, hormones, pharmacological agents, gene therapy, and stem cells. Other adjuvant therapies included mechanical stimulation, laser therapy, and hyperbaric oxygen. Majority of the studies demonstrated positive bone healing effects and thus adjuvant therapies remain a viable strategy to enhance and hasten the consolidation period. Although most studies have demonstrated promising results, many questions still remain, such as optimal amount, timing, and delivery methods required to stimulate the most favorable bone regeneration. As well, further studies comparing various adjuvant therapies and documentation of long-term adverse effects are required prior to clinical application. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Psychological Therapy for People with Tinnitus: A Scoping Review of Treatment Components.

PubMed

Thompson, Dean M; Hall, Deborah A; Walker, Dawn-Marie; Hoare, Derek J

Tinnitus is associated with depression and anxiety disorders, severely and adversely affecting the quality of life and functional health status for some people. With the dearth of clinical psychologists embedded in audiology services and the cessation of training for hearing therapists in the UK, it is left to audiologists to meet the psychological needs of many patients with tinnitus. However, there is no universally standardized training or manualized intervention specifically for audiologists across the whole UK public healthcare system and similar systems elsewhere across the world. The primary aim of this scoping review was to catalog the components of psychological therapies for people with tinnitus, which have been used or tested by psychologists, so that they might inform the development of a standardized audiologist-delivered psychological intervention. Secondary aims of this article were to identify the types of psychological therapy for people with tinnitus, who were reported but not tested in any clinical trial, as well as the job roles of clinicians who delivered psychological therapy for people with tinnitus in the literature. The authors searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; Cochrane Central Register of Controlled Trials; PubMed; EMBASE; CINAHL; LILACS; KoreaMed; IndMed; PakMediNet; CAB Abstracts; Web of Science; BIOSIS Previews; ISRCTN; ClinicalTrials.gov; IC-TRP; and Google Scholar. In addition, the authors searched the gray literature including conference abstracts, dissertations, and editorials. No records were excluded on the basis of controls used, outcomes reached, timing, setting, or study design (except for reviews-of the search results. Records were included in which a psychological therapy intervention was reported to address adults (≤18 years) tinnitus-related distress. No restrictive criteria were placed upon the term tinnitus. Records were excluded in which the intervention included biofeedback

Systematic review of hyperbaric oxygen therapy for the treatment of radiation-induced skin necrosis.

PubMed

Borab, Zachary; Mirmanesh, Michael D; Gantz, Madeleine; Cusano, Alessandro; Pu, Lee L Q

2017-04-01

Every year, 1.2 million cancer patients receive radiation therapy in the United States. Late radiation tissue injury occurs in an estimated 5-15% of these patients. Tissue injury can include skin necrosis, which can lead to chronic nonhealing wounds. Despite many treatments available to help heal skin necrosis such as hyperbaric oxygen therapy, no clinical guidelines exist and evidence is lacking. The purpose of this review is to identify and comprehensively summarize studies published to date to evaluate the effectiveness of hyperbaric oxygen therapy for the treatment of radiation-induced skin necrosis. Adhering to PRISMA guidelines, a systematic review of currently published articles was performed, evaluating the use of hyperbaric oxygen to treat skin necrosis. Eight articles were identified, including one observational cohort, five case series, and two case reports. The articles describe changes in symptoms and alteration in wound healing of radiation-induced skin necrosis after treatment with hyperbaric oxygen therapy. Hyperbaric oxygen therapy is a safe intervention with promising outcomes; however, additional evidence is needed to endorse its application as a relevant therapy in the treatment of radiation-induced skin necrosis. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Atopic dermatitis: a review of topical nonsteroid therapy

PubMed Central

Papier, Ariana

2018-01-01

Background Atopic dermatitis is a chronic inflammatory skin condition that affects up to 20% of children and 3% of adults globally. Although topical corticosteroids are considered to be the first-line agents, they can be associated with cutaneous and systemic adverse effects. Since the early 2000s, two new classes of nonsteroid topical therapies, topical calcineurin inhibitors and phosphodiesterase 4 (PDE4) inhibitors, have been introduced and provide a safe treatment alternative. Method We performed a search and review of clinical trials that examined the safety and efficacy of topical calcineurin inhibitors and PDE4 inhibitors. The search was conducted using the PubMed database as well as preselected keywords and filters. This review focuses on the safety and efficacy of each therapy. Results Sixty-nine clinical trials identified in this study have demonstrated the efficacy and safety of topical calcineurin and a single novel PDE4 inhibitor in the treatment of atopic dermatitis. Topical calcineurin inhibitors have been shown to be effective in both achieving lesion clearance as well as reducing relapse when used long-term and proactively. Similarly, in clinical trials the PDE4 inhibitor showed success in lesion clearance and symptom management. All three therapies (pimecrolimus, tacrolimus, crisaborole) are associated with low systemic absorption. No clinical trials to date have shown an increased risk of systemic adverse events or malignancy such as lymphoma. The most commonly reported treatment-related adverse event across all three therapies was application-site discomfort, pain or pruritus. It is important to note that long-term studies are not yet available for the novel PDE4 inhibitor. Discussion Topical calcineurin inhibitors provide a safe and effective alternative to topical corticosteroid use in the treatment of atopic dermatitis. Although the US Food and Drug Administration (FDA) black box warning for topical calcineurin inhibitors remains, studies

Small Animal Massage Therapy: A Brief Review and Relevant Observations.

PubMed

Formenton, Maira Rezende; Pereira, Marco Aurélio Amador; Fantoni, Denise Tabacchi

2017-12-01

Massage therapy is becoming increasingly popular in human and animal physiotherapy and rehabilitation. Wider application of the technique led to research efforts aimed at providing scientific support to anecdotal beneficial effects, particularly pain relief. Recent studies have shown that massage therapy alters dopamine and serotonin levels, decreases noradrenaline levels, and modulates the immune system. Psychological effects such as reduction of stress and anxiety, with improvement of depressive patients, have been reported in humans. This article set out to review the major aspects of massage therapy based on recent publications on the topic, and to extrapolate concepts and practical aspects described in human physiotherapy to the veterinary patient, particularly the applicability of different techniques in Small Animal Medicine. Indications of massage therapy in small animals include pain relief, orthopedic rehabilitation, Canine Sports Medicine, intensive care, and management of nonspecific edema. Techniques described in this article were originally intended for use in humans and scientific data supporting anecdotal, beneficial effects in domestic animals are still lacking; this fruitful area for research is therefore open to veterinary professionals. Copyright © 2017 Elsevier Inc. All rights reserved.

The Current Status of Stem-Cell Therapy in Erectile Dysfunction: A Review

PubMed Central

Reed-Maldonado, Amanda B

2016-01-01

Stem cells are undifferentiated cells that are capable of renewal and repair of tissue due to their capacity for division and differentiation. The purpose of this review is to describe recent advances in the use of stem cell (SC) therapy for male erectile dysfunction (ED). We performed a MEDLINE database search of all relevant articles regarding the use of SCs for ED. We present a concise summary of the scientific principles behind the usage of SC for ED. We discuss the different types of SCs, delivery methods, current pre-clinical literature, and published clinical trials. Four clinical trials employing SC for ED have been published. These articles are summarized in this review. All four report improvements in ED after SC therapy. SC therapy remains under investigation for the treatment of ED. It is reassuring that clinical trials thus far have reported positive effects on erectile function and few adverse events. Safety and methodical concerns about SC acquisition, preparation and delivery remain and require continued investigation prior to wide-spread application of these methods. PMID:28053944

The effectiveness of manual therapy in treating cervicogenic dizziness: a systematic review.

PubMed

Yaseen, Khalid; Hendrick, Paul; Ismail, Ayah; Felemban, Mohannad; Alshehri, Mansour Abdullah

2018-01-01

[Purpose] This review provides an evaluation of the evidence for the effectiveness of using manual therapy to treat cervicogenic dizziness. [Subjects and Methods] The literature was systematically searched on the May 2, 2016 using the following online databases: Medline, EMBASE, CINAHL and PEDro. This review included randomised controlled trials and compared the efficacy of manual therapy for the treatment of cervicogenic dizziness, compared to other types of intervention. This study measured changes based on dizziness intensity and frequency. [Results] The primary search found 30 articles, but only four articles met the inclusion criteria. Assessment of methodological quality was performed by two researchers using the PEDro scale. The level of evidence was determined using a recognised grading scale. Three out of the four articles were deemed to have high methodological quality, while the fourth was rated as moderate quality. The attributed level of evidence was moderate (level 2). [Conclusion] Manual therapy is potentially effective for managing cervicogenic dizziness. However, due to the heterogeneity of the results and techniques and the low number of studies, further research is recommended to provide conclusive evidence.

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

NASA Astrophysics Data System (ADS)

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

2015-02-01

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

Current Therapy of Acquired Ocular Toxoplasmosis: A Review.

PubMed

Lima, Guilherme Sturzeneker Cerqueira; Saraiva, Patricia Grativol Costa; Saraiva, Fábio Petersen

2015-11-01

Caused by the parasite Toxoplasma gondii, ocular toxoplasmosis (OT) is the most common form of posterior infectious uveitis. Combined antiparasitic therapy is the standard treatment for OT, but several other schemes have been proposed. The purpose of the present study was to review the literature on the treatment of OT and provide ophthalmologists with up-to-date information to help reduce OT-related visual morbidity. In conclusion, no ideal treatment scheme was identified; currently prescribed therapeutic schemes yield statistically similar functional outcomes.

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

PubMed

Song, Chorong; Ikei, Harumi; Miyazaki, Yoshifumi

2016-08-03

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

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

PubMed Central

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

2013-01-01

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

A systematic review on reminder systems in physical therapy

PubMed Central

Jangi, Majid; Ferandez-de-las-Penas, Cesar; Tara, Mahmoud; Moghbeli, Fateme; Ghaderi, Fariba; Javanshir, Khodabakhsh

2018-01-01

Background: The main goal of physical therapy is to help the patient gain a better health status. Several studies have investigated the use of reminders to prevent such failures on the patients’ side. This article presents a systematic review of the literature concerning reminders in physical therapy. Methods: Databases were searched until May 2017 and literatures were found from April 1992 until 2017. The literature recruitment strategy was based on applying several keywords and Medical Subject Heading (MeSH) combination running against title and abstract, including concepts such as reminder, physical therapy. The finally selected articles were categorized through reminder aspects such as how, who feedback. Data were extracted according to PRISMA guidelines. Results: In 47% of studies, the reminder was sent to the patients, 29% to the physical therapists and 12% to the caretaker team. In 24% of the studies, paper-based letters were main medium for reminders while the rest were various types of media like emails and SMS mobile text messages. 35% of the articles showed positive effects of the reminders. Conclusions: Many reminder methods consisted of SMS, phone calls, letters, emails and notices on the wall were used in physical therapy. Reminders may be used to improve patients' adherence to exercise programs. PMID:29387313

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

NASA Technical Reports Server (NTRS)

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

2010-01-01

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

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

PubMed

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

2013-04-01

Borderline personality disorder is a serious psychiatric disorder for which the effectiveness of the current pharmacotherapeutical and psychotherapeutic approaches has shown to be limited. In the last decades, schema therapy has increased in popularity as a treatment of borderline personality disorder; however, systematic evaluation of both effectiveness and empirical evidence for the theoretical background of the therapy is limited. This literature review comprehensively evaluates the current empirical status of schema therapy for borderline personality disorder. We first described the theoretical framework and reviewed its empirical foundations. Next, we examined the evidence regarding effectiveness and implementability. We found evidence for a considerable number of elements of Young's schema model; however, the strength of the results varies and there are also mixed results and some empirical blanks in the theory. The number of studies on effectiveness is small, but reviewed findings suggest that schema therapy is a promising treatment. In Western-European societies, the therapy could be readily implemented as a cost-effective strategy with positive economic consequences. Copyright © 2012 Elsevier Ltd. All rights reserved.

Radiation dose constraints for organs at risk in neuro-oncology; the European Particle Therapy Network consensus.

PubMed

Lambrecht, Maarten; Eekers, Daniëlle B P; Alapetite, Claire; Burnet, Neil G; Calugaru, Valentin; Coremans, Ida E M; Fossati, Piero; Høyer, Morten; Langendijk, Johannes A; Romero, Alejandra Méndez; Paulsen, Frank; Perpar, Ana; Renard, Laurette; de Ruysscher, Dirk; Timmermann, Beate; Vitek, Pavel; Weber, Damien C; van der Weide, Hiske L; Whitfield, Gillian A; Wiggenraad, Ruud; Roelofs, Erik; Nyström, Petra Witt; Troost, Esther G C

2018-05-17

For unbiased comparison of different radiation modalities and techniques, consensus on delineation of radiation sensitive organs at risk (OARs) and on their dose constraints is warranted. Following the publication of a digital, online atlas for OAR delineation in neuro-oncology by the same group, we assessed the brain OAR-dose constraints in a follow-up study. We performed a comprehensive search to identify the current papers on OAR dose constraints for normofractionated photon and particle therapy in PubMed, Ovid Medline, Cochrane Library, Embase and Web of Science. Moreover, the included articles' reference lists were cross-checked for potential studies that met the inclusion criteria. Consensus was reached among 20 radiation oncology experts in the field of neuro-oncology. For the OARs published in the neuro-oncology literature, we summarized the available literature and recommended dose constraints associated with certain levels of normal tissue complication probability (NTCP) according to the recent ICRU recommendations. For those OARs with lacking or insufficient NTCP data, a proposal for effective and efficient data collection is given. The use of the European Particle Therapy Network-consensus OAR dose constraints summarized in this article is recommended for the model-based approach comparing photon and proton beam irradiation as well as for prospective clinical trials including novel radiation techniques and/or modalities. Copyright © 2018 Elsevier B.V. All rights reserved.

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

PubMed

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

2015-12-01

The neutron source of BNCT is currently changing from reactor to accelerator, but peripheral facilities such as a dose-planning system and blood boron analysis have still not been established. To evaluate the potential application of particle-induced gamma-ray emission (PIGE) for boron measurement in clinical boron neutron capture therapy, boronophenylalanine dissolved within a cell culture medium was measured using PIGE. PIGE detected 18 μgB/mL f-BPA in the culture medium, and all measurements of any given sample were taken within 20 min. Two hours of f-BPA exposure was required to create a boron distribution image. However, even though boron remained in the cells, the boron on the cell membrane could not be distinguished from the boron in the cytoplasm. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

PubMed Central

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

2013-01-01

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

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

PubMed Central

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

2014-01-01

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

Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review

PubMed Central

Tibbles, Alana; Topolovec-Vranic, Jane

2017-01-01

Neurofeedback therapy (NFT) has been used within a number of populations however it has not been applied or thoroughly examined as a form of cognitive rehabilitation within a stroke population. Objectives for this systematic review included: i) identifying how NFT is utilized to treat cognitive deficits following stroke, ii) examining the strength and quality of evidence to support the use of NFT as a form of cognitive rehabilitation therapy (CRT) and iii) providing recommendations for future investigations. Searches were conducted using OVID (Medline, Health Star, Embase + Embase Classic) and PubMed databases. Additional searches were completed using the Cochrane Reviews library database, Google Scholar, the University of Toronto online library catalogue, ClinicalTrials.gov website and select journals. Searches were completed Feb/March 2015 and updated in June/July/Aug 2015. Eight studies were eligible for inclusion in this review. Studies were eligible for inclusion if they: i) were specific to a stroke population, ii) delivered CRT via a NFT protocol, iii) included participants who were affected by a cognitive deficit(s) following stroke (i.e. memory loss, loss of executive function, speech impairment etc.). NFT protocols were highly specific and varied within each study. The majority of studies identified improvements in participant cognitive deficits following the initiation of therapy. Reviewers assessed study quality using the Downs and Black Checklist for Measuring Study Quality tool; limited study quality and strength of evidence restricted generalizability of conclusions regarding the use of this therapy to the greater stroke population. Progression in this field requires further inquiry to strengthen methodology quality and study design. Future investigations should aim to standardize NFT protocols in an effort to understand the dose-response relationship between NFT and improvements in functional outcome. Future investigations should also place a large

Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review.

PubMed

Renton, Tian; Tibbles, Alana; Topolovec-Vranic, Jane

2017-01-01

Neurofeedback therapy (NFT) has been used within a number of populations however it has not been applied or thoroughly examined as a form of cognitive rehabilitation within a stroke population. Objectives for this systematic review included: i) identifying how NFT is utilized to treat cognitive deficits following stroke, ii) examining the strength and quality of evidence to support the use of NFT as a form of cognitive rehabilitation therapy (CRT) and iii) providing recommendations for future investigations. Searches were conducted using OVID (Medline, Health Star, Embase + Embase Classic) and PubMed databases. Additional searches were completed using the Cochrane Reviews library database, Google Scholar, the University of Toronto online library catalogue, ClinicalTrials.gov website and select journals. Searches were completed Feb/March 2015 and updated in June/July/Aug 2015. Eight studies were eligible for inclusion in this review. Studies were eligible for inclusion if they: i) were specific to a stroke population, ii) delivered CRT via a NFT protocol, iii) included participants who were affected by a cognitive deficit(s) following stroke (i.e. memory loss, loss of executive function, speech impairment etc.). NFT protocols were highly specific and varied within each study. The majority of studies identified improvements in participant cognitive deficits following the initiation of therapy. Reviewers assessed study quality using the Downs and Black Checklist for Measuring Study Quality tool; limited study quality and strength of evidence restricted generalizability of conclusions regarding the use of this therapy to the greater stroke population. Progression in this field requires further inquiry to strengthen methodology quality and study design. Future investigations should aim to standardize NFT protocols in an effort to understand the dose-response relationship between NFT and improvements in functional outcome. Future investigations should also place a large

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

PubMed Central

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

2014-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2016-03-01

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

Laser induced thermal therapy (LITT) for pediatric brain tumors: case-based review

PubMed Central

Riordan, Margaret

2014-01-01

Integration of Laser induced thermal therapy (LITT) to magnetic resonance imaging (MRI) have created new options for treating surgically challenging tumors in locations that would otherwise have represented an intrinsic comorbidity by the approach itself. As new applications and variations of the use are discussed, we present a case-based review of the history, development, and subsequent updates of minimally invasive MRI-guided laser interstitial thermal therapy (MRgLITT) ablation in pediatric brain tumors. PMID:26835340

Review of the Research: Are Therapy Dogs in Classrooms Beneficial?

ERIC Educational Resources Information Center

Kropp, Jerri J.; Shupp, Mikaela M.

2017-01-01

Research findings on the presence of a therapy dog in the classroom are summarized. The authors reviewed 30 articles, book chapters, and other sources on the topic of the various uses of dogs in classrooms, published between 2001 and 2017. Ages studied ranged from 3 years to adolescence (high school). In our analysis, three categories of…

Permanent Leadless Cardiac Pacemaker Therapy: A Comprehensive Review.

PubMed

Tjong, Fleur V Y; Reddy, Vivek Y

2017-04-11

A new technology, leadless pacemaker therapy, was recently introduced clinically to address lead- and pocket-related complications in conventional transvenous pacemaker therapy. These leadless devices are self-contained right ventricular single-chamber pacemakers implanted by using a femoral percutaneous approach. In this review of available clinical data on leadless pacemakers, early results with leadless devices are compared with historical results with conventional single-chamber pacing. Both presently manufactured leadless pacemakers show similar complications, which are mostly related to the implant procedure: cardiac perforation, device dislocation, and femoral vascular access site complications. In comparison with conventional transvenous single-chamber pacemakers, slightly higher short-term complication rates have been observed: 4.8% for leadless pacemakers versus 4.1% for conventional pacemakers. The complication rate of the leadless pacemakers is influenced by the implanter learning curve for this new procedure. No long-term outcome data are yet available for the leadless pacemakers. Larger leadless pacing trials, with long-term follow-up and direct randomized comparison with conventional pacing systems, will be required to define the proper clinical role of these leadless systems. Although current leadless pacemakers are limited to right ventricular pacing, future advanced, communicating, multicomponent systems are expected to expand the potential benefits of leadless therapy to a larger patient population. © 2017 American Heart Association, Inc.

A narrative review of schemas and schema therapy outcomes in the eating disorders.

PubMed

Pugh, Matthew

2015-07-01

Whilst cognitive-behavioural therapy has demonstrated efficacy in the treatment of eating disorders, therapy outcomes and current conceptualizations still remain inadequate. In light of these shortcomings there has been growing interest in the utility of schema therapy applied to eating pathology. The present article first provides a narrative review of empirical literature exploring schemas and schema processes in eating disorders. Secondly, it critically evaluates outcome studies assessing schema therapy applied to eating disorders. Current evidence lends support to schema-focused conceptualizations of eating pathology and confirms that eating disorders are characterised by pronounced maladaptive schemas. Treatment outcomes also indicate that schema therapy, the schema-mode approach, and associated techniques are promising interventions for complex eating disorders. Implications for clinical practice and future directions for research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Manual therapy for unsettled, distressed and excessively crying infants: a systematic review and meta-analyses

PubMed Central

Carnes, Dawn; Plunkett, Austin; Ellwood, Julie; Miles, Clare

2018-01-01

Objective To conduct a systematic review and meta-analyses to assess the effect of manual therapy interventions for healthy but unsettled, distressed and excessively crying infants and to provide information to help clinicians and parents inform decisions about care. Methods We reviewed published peer-reviewed primary research articles in the last 26 years from nine databases (Medline Ovid, Embase, Web of Science, Physiotherapy Evidence Database, Osteopathic Medicine Digital Repository, Cochrane (all databases), Index of Chiropractic Literature, Open Access Theses and Dissertations and Cumulative Index to Nursing and Allied Health Literature). Our inclusion criteria were: manual therapy (by regulated or registered professionals) of unsettled, distressed and excessively crying infants who were otherwise healthy and treated in a primary care setting. Outcomes of interest were: crying, feeding, sleep, parent–child relations, parent experience/satisfaction and parent-reported global change. Results Nineteen studies were selected for full review: seven randomised controlled trials, seven case series, three cohort studies, one service evaluation study and one qualitative study. We found moderate strength evidence for the effectiveness of manual therapy on: reduction in crying time (favourable: −1.27 hours per day (95% CI −2.19 to –0.36)), sleep (inconclusive), parent–child relations (inconclusive) and global improvement (no effect). The risk of reported adverse events was low: seven non-serious events per 1000 infants exposed to manual therapy (n=1308) and 110 per 1000 in those not exposed. Conclusions Some small benefits were found, but whether these are meaningful to parents remains unclear as does the mechanisms of action. Manual therapy appears relatively safe. PROSPERO registration number CRD42016037353. PMID:29371279

Integrative Therapies for Low Back Pain That Include Complementary and Alternative Medicine Care: A Systematic Review

PubMed Central

Rose, Kevin; Kadar, Gena E.

2014-01-01

Study Design: Systematic review of the literature. Objective: To evaluate whether an integrated approach that includes different Complementary and Alternative Medicine (CAM) therapies combined or CAM therapies combined with conventional medical care is more effective for the management of low back pain (LBP) than single modalities alone. Summary of Background Data: LBP is one of the leading causes of disability worldwide, yet its optimal management is still unresolved. Methods: The PRISMA Statement guidelines were followed. The Cochrane Back Review Group scale was used to rate the quality of the studies found. Results: Twenty-one studies were found that met the inclusion criteria. The CAM modalities used in the studies included spinal manipulative therapy, acupuncture, exercise therapy, physiotherapy, massage therapy, and a topical ointment. Twenty studies included acupuncture and/or spinal manipulative therapy. Nine high quality studies showed that integrative care was clinically effective for the management of LBP. Spinal manipulative therapy combined with exercise therapy and acupuncture combined with conventional medical care or with exercise therapy appears to be promising approaches to the management of chronic cases of LBP. Conclusions: There is support in the literature for integrated CAM and conventional medical therapy for the management of chronic LBP. Further research into the integrated management of LBP is clearly needed to provide better guidance for patients and clinicians. PMID:25568825

Effects of physical therapy in older women with urinary incontinence: a systematic review.

PubMed

Pereira, Vanessa S; Escobar, Adriana C; Driusso, Patricia

2012-01-01

Urinary incontinence (UI) is one of the most common public health problems among older women. Despite conservative treatment being recommended as the first treatment option, the effects of physical therapy in older women with UI is unclear. This study aimed to systematically review the evidence about the effects of physical therapy on urinary symptoms in older women with UI. The literature search for studies evaluating conservative treatment for incontinent in elderly women was conducted on Pubmed/Medline, Lilacs, Scielo, ISI Web of Knowledge and PEDro. We selected clinical trials published in English and Portuguese after the year 2000. The methodological quality of the studies was assessed using the PEDro scale. The results were analyzed using a critical review method. Six studies were reviewed in full revealing that pelvic floor muscle training was the treatment option in most studies. Five of the six selected studies were classified as having high methodological quality. There was significant improvement in urinary symptoms after treatment in five of the six selected studies. It was concluded that physical therapy treatment seems to be effective to decrease urinary incontinence symptoms in older women. However, the small number of studies and the use of concurrent interventions limit the conclusions on this issue.

Boron Neutron Capture Therapy - A Literature Review

PubMed Central

Nedunchezhian, Kavitaa; Thiruppathy, Manigandan; Thirugnanamurthy, Sarumathi

2016-01-01

Boron Neutron Capture Therapy (BNCT) is a radiation science which is emerging as a hopeful tool in treating cancer, by selectively concentrating boron compounds in tumour cells and then subjecting the tumour cells to epithermal neutron beam radiation. BNCT bestows upon the nuclear reaction that occurs when Boron-10, a stable isotope, is irradiated with low-energy thermal neutrons to yield α particles (Helium-4) and recoiling lithium-7 nuclei. A large number of 10 Boron (10B) atoms have to be localized on or within neoplastic cells for BNCT to be effective, and an adequate number of thermal neutrons have to be absorbed by the 10B atoms to maintain a lethal 10B (n, α) lithium-7 reaction. The most exclusive property of BNCT is that it can deposit an immense dose gradient between the tumour cells and normal cells. BNCT integrates the fundamental focusing perception of chemotherapy and the gross anatomical localization proposition of traditional radiotherapy. PMID:28209015

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

PubMed Central

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

2013-01-01

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

A review of topical negative pressure therapy in wound healing: sufficient evidence?

PubMed

Mouës, C M; Heule, F; Hovius, S E R

2011-04-01

Topical negative pressure (TNP) therapy has become a useful adjunct in the management of various types of wounds. However, the TNP system still has characteristics of a "black box" with uncertain efficacy for many users. We extensively examined the effectiveness of TNP therapy reported in research studies. A database search was undertaken, and over 400 peer-reviewed articles related to the use of TNP therapy (animal, human, and in vitro studies) were identified. Almost all encountered studies were related to the use of the commercial VAC device (KCI Medical, United States). Mechanisms of action that can be attributed to TNP therapy are an increase in blood flow, the promotion of angiogenesis, a reduction of wound surface area in certain types of wounds, a modulation of the inhibitory contents in wound fluid, and the induction of cell proliferation. Edema reduction and bacterial clearance, mechanisms that were attributed to TNP therapy, were not proven in basic research. Copyright © 2011 Elsevier Inc. All rights reserved.

Antioxidants and cancer therapy: a systematic review.

PubMed

Ladas, Elena J; Jacobson, Judith S; Kennedy, Deborah D; Teel, Katherine; Fleischauer, Aaron; Kelly, Kara M

2004-02-01

Many patients with cancer take antioxidant nutritional supplements during cancer treatment to alleviate treatment toxicities and to improve long-term outcomes, but little is known about the efficacy and safety of antioxidant use during cancer treatment. We reviewed English-language manuscripts published in the biomedical literature, reporting the results of observational studies of antioxidant status and cancer outcomes and of intervention trials of antioxidants among patients receiving chemotherapy with or without radiation for various malignancies. We searched the Medline database and the bibliographies of the retrieved manuscripts, reviews, and books on antioxidants and cancer. The retrieved studies are grouped by study design, malignancy, and end points. More than 100 citations were retrieved; 52 met our criteria, 31 were observational studies, and 21 were intervention trials. The studies varied in study design, timing of observation/intervention, intervention protocol, malignancy, and anticancer regimen. These inconsistencies preclude a definitive conclusion as to the effect of chemotherapy on antioxidant status in patients undergoing anticancer therapy. However, our review suggests that total antioxidant status (measured by total radical antioxidant parameter) declines during cancer treatment. Adequately powered trials or observational studies among patients with a specific cancer diagnosis receiving a specific treatment regimen are needed to address patients' and physicians' concerns regarding these associations.

Commissioning and quality assurance of an integrated system for patient positioning and setup verification in particle therapy.

PubMed

Pella, A; Riboldi, M; Tagaste, B; Bianculli, D; Desplanques, M; Fontana, G; Cerveri, P; Seregni, M; Fattori, G; Orecchia, R; Baroni, G

2014-08-01

In an increasing number of clinical indications, radiotherapy with accelerated particles shows relevant advantages when compared with high energy X-ray irradiation. However, due to the finite range of ions, particle therapy can be severely compromised by setup errors and geometric uncertainties. The purpose of this work is to describe the commissioning and the design of the quality assurance procedures for patient positioning and setup verification systems at the Italian National Center for Oncological Hadrontherapy (CNAO). The accuracy of systems installed in CNAO and devoted to patient positioning and setup verification have been assessed using a laser tracking device. The accuracy in calibration and image based setup verification relying on in room X-ray imaging system was also quantified. Quality assurance tests to check the integration among all patient setup systems were designed, and records of daily QA tests since the start of clinical operation (2011) are presented. The overall accuracy of the patient positioning system and the patient verification system motion was proved to be below 0.5 mm under all the examined conditions, with median values below the 0.3 mm threshold. Image based registration in phantom studies exhibited sub-millimetric accuracy in setup verification at both cranial and extra-cranial sites. The calibration residuals of the OTS were found consistent with the expectations, with peak values below 0.3 mm. Quality assurance tests, daily performed before clinical operation, confirm adequate integration and sub-millimetric setup accuracy. Robotic patient positioning was successfully integrated with optical tracking and stereoscopic X-ray verification for patient setup in particle therapy. Sub-millimetric setup accuracy was achieved and consistently verified in daily clinical operation.

Low level laser therapy and hair regrowth: an evidence-based review.

PubMed

Zarei, Mina; Wikramanayake, Tongyu C; Falto-Aizpurua, Leyre; Schachner, Lawrence A; Jimenez, Joaquin J

2016-02-01

Despite the current treatment options for different types of alopecia, there is a need for more effective management options. Recently, low-level laser therapy (LLLT) was evaluated for stimulating hair growth. Here, we reviewed the current evidence on the LLLT effects with an evidence-based approach, focusing more on randomized controlled studies by critically evaluating them. In order to investigate whether in individuals presenting with hair loss (male pattern hair loss (MPHL), female pattern hair loss (FPHL), alopecia areata (AA), and chemotherapy-induced alopecia (CIA)) LLLT is effective for hair regrowth, several databases including PubMed, Google Scholar, Medline, Embase, and Cochrane Database were searched using the following keywords: Alopecia, Hair loss, Hair growth, Low level laser therapy, Low level light therapy, Low energy laser irradiation, and Photobiomodulation. From the searches, 21 relevant studies were summarized in this review including 2 in vitro, 7 animal, and 12 clinical studies. Among clinical studies, only five were randomized controlled trials (RCTs), which evaluated LLLT effect on male and female pattern hair loss. The RCTs were critically appraised using the created checklist according to the Critical Appraisal for Therapy Articles Worksheet created by the Center of Evidence-Based Medicine, Oxford. The results demonstrated that all the performed RCTs have moderate to high quality of evidence. However, only one out of five studies performed intention-to-treat analysis, and only another study reported the method of randomization and subsequent concealment of allocation clearly; all other studies did not include this very important information in their reports. None of these studies reported the treatment effect of factors such as number needed to treat. Based on this review on all the available evidence about effect of LLLT in alopecia, we found that the FDA-cleared LLLT devices are both safe and effective in patients with MPHL and FPHL

Long-term Results of the UCSF-LBNL Randomized Trial: Charged Particle With Helium Ion Versus Iodine-125 Plaque Therapy for Choroidal and Ciliary Body Melanoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mishra, Kavita K., E-mail: Kavita.mishra@ucsf.edu; Quivey, Jeanne M.; Daftari, Inder K.

Purpose: Relevant clinical data are needed given the increasing national interest in charged particle radiation therapy (CPT) programs. Here we report long-term outcomes from the only randomized, stratified trial comparing CPT with iodine-125 plaque therapy for choroidal and ciliary body melanoma. Methods and Materials: From 1985 to 1991, 184 patients met eligibility criteria and were randomized to receive particle (86 patients) or plaque therapy (98 patients). Patients were stratified by tumor diameter, thickness, distance to disc/fovea, anterior extension, and visual acuity. Tumors close to the optic disc were included. Local tumor control, as well as eye preservation, metastases due tomore » melanoma, and survival were evaluated. Results: Median follow-up times for particle and plaque arm patients were 14.6 years and 12.3 years, respectively (P=.22), and for those alive at last follow-up, 18.5 and 16.5 years, respectively (P=.81). Local control (LC) for particle versus plaque treatment was 100% versus 84% at 5 years, and 98% versus 79% at 12 years, respectively (log rank: P=.0006). If patients with tumors close to the disc (<2 mm) were excluded, CPT still resulted in significantly improved LC: 100% versus 90% at 5 years and 98% versus 86% at 12 years, respectively (log rank: P=.048). Enucleation rate was lower after CPT: 11% versus 22% at 5 years and 17% versus 37% at 12 years, respectively (log rank: P=.01). Using Cox regression model, likelihood ratio test, treatment was the most important predictor of LC (P=.0002) and eye preservation (P=.01). CPT was a significant predictor of prolonged disease-free survival (log rank: P=.001). Conclusions: Particle therapy resulted in significantly improved local control, eye preservation, and disease-free survival as confirmed by long-term outcomes from the only randomized study available to date comparing radiation modalities in choroidal and ciliary body melanoma.« less

Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review.

PubMed

Chiu, Hsiu-Ching; Ada, Louise

2016-07-01

Does constraint-induced movement therapy improve activity and participation in children with hemiplegic cerebral palsy? Does it improve activity and participation more than the same dose of upper limb therapy without restraint? Is the effect of constraint-induced movement therapy related to the duration of intervention or the age of the children? Systematic review of randomised trials with meta-analysis. Children with hemiplegic cerebral palsy with any level of motor disability. The experimental group received constraint-induced movement therapy (defined as restraint of the less affected upper limb during supervised activity practice of the more affected upper limb). The control group received no intervention, sham intervention, or the same dose of upper limb therapy. Measures of upper limb activity and participation were used in the analysis. Constraint-induced movement therapy was more effective than no/sham intervention in terms of upper limb activity (SMD 0.63, 95% CI 0.20 to 1.06) and participation (SMD 1.21, 95% CI 0.41 to 2.02). However, constraint-induced movement therapy was no better than the same dose of upper limb therapy without restraint either in terms of upper limb activity (SMD 0.05, 95% CI -0.21 to 0.32) or participation (SMD -0.02, 95% CI -0.34 to 0.31). The effect of constraint-induced movement therapy was not related to the duration of intervention or the age of the children. This review suggests that constraint-induced movement therapy is more effective than no intervention, but no more effective than the same dose of upper limb practice without restraint. PROSPERO CRD42015024665. [Chiu H-C, Ada L (2016) Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review.Journal of Physiotherapy62: 130-137]. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Low level laser therapy (Photobiomodulation therapy) for breast cancer-related lymphedema: a systematic review.

PubMed

Baxter, G David; Liu, Lizhou; Petrich, Simone; Gisselman, Angela Spontelli; Chapple, Cathy; Anders, Juanita J; Tumilty, Steve

2017-12-07

Breast cancer related lymphedema (BCRL) is a prevalent complication secondary to cancer treatments which significantly impacts the physical and psychological health of breast cancer survivors. Previous research shows increasing use of low level laser therapy (LLLT), now commonly referred to as photobiomodulation (PBM) therapy, for BCRL. This systematic review evaluated the effectiveness of LLLT (PBM) in the management of BCRL. Clinical trials were searched in PubMed, AMED, Web of Science, and China National Knowledge Infrastructure up to November 2016. Two reviewers independently assessed the methodological quality and adequacy of LLLT (PBM) in these clinical trials. Primary outcome measures were limb circumference/volume, and secondary outcomes included pain intensity and range of motion. Because data were clinically heterogeneous, best evidence synthesis was performed. Eleven clinical trials were identified, of which seven randomized controlled trials (RCTs) were chosen for analysis. Overall, the methodological quality of included RCTs was high, whereas the reporting of treatment parameters was poor. Results indicated that there is strong evidence (three high quality trials) showing LLLT (PBM) was more effective than sham treatment for limb circumference/volume reduction at a short-term follow-up. There is moderate evidence (one high quality trial) indicating that LLLT (PBM) was more effective than sham laser for short-term pain relief, and limited evidence (one low quality trial) that LLLT (PBM) was more effective than no treatment for decreasing limb swelling at short-term follow-up. Based upon the current systematic review, LLLT (PBM) may be considered an effective treatment approach for women with BCRL. Due to the limited numbers of published trials available, there is a clear need for well-designed high-quality trials in this area. The optimal treatment parameters for clinical application have yet to be elucidated.

[Acceptance and commitment therapy (ACT) and addiction: a literature review].

PubMed

De Groot, F; Morrens, M; Dom, G

2014-01-01

Acceptance and commitment therapy (ACT) is a recent form of cognitive behavioural therapy, based on the relational frame theory (RFT). act is being used to treat a wide range of problems, including addiction. To review the literature on the use of act to treat addiction. We searched the literature systematically using PubMed en Psycinfo. We found 16 studies, 10 of which were rct's. Eight studies dealt with drug problems or mixed substance problems, 7 studies focused on cigarette smoking, and only 1 publication concerned alcohol treatment. The majority of studies reported positive results for act following treatment and at follow-up. Although more research is needed, act is shown itself to be a promising treatment for addiction.

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

ERIC Educational Resources Information Center

Swiderski, Michael J.; Mitten, Denise

1994-01-01

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

Executive functioning: a scoping review of the occupational therapy literature.

PubMed

Cramm, Heidi A; Krupa, Terry M; Missiuna, Cheryl A; Lysaght, Rosemary M; Parker, Kevin H

2013-06-01

Increasingly recognized as an important factor in the performance of complex, goal-directed tasks, executive functioning is understood in different ways across disciplines. The aim was to explore the ways in which executive functioning is conceptualized, discussed, described, and implied in the occupational therapy literature. A scoping review of the occupational therapy literature was conducted following Levac, Colquhoun, and O'Brien's (2010) recommended methodology. Executive functioning is described both as a set of performance component skills or processes and as the executive occupational performance inherent in complex occupations. Executive functioning is implicit in occupational performance and engagement, and some health conditions seem to be commonly associated with impaired executive functioning. Assessing executive functioning requires dynamic occupation- and performance-based assessment. Interventions targeting executive functioning are grounded in metacognitive approaches. Executive functioning is a complex construct that is conceptualized with considerable variance within the occupational therapy literature, creating barriers to effective service delivery.

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Big Bang Day: 5 Particles - 5. The Next Particle

ScienceCinema

None

2017-12-09

Simon Singh looks at the stories behind the discovery of 5 of the universe's most significant subatomic particles: the Electron, the Quark, the Anti-particle, the Neutrino and the "next particle". 5. The Next Particle The "sparticle" - a super symmetric partner to all the known particles could be the answer to uniting all the known particles and their interactions under one grand theoretical pattern of activity. But how do researchers know where to look for such phenomena and how do they know if they find them? Simon Singh reviews the next particle that physicists would like to find if the current particle theories are to ring true.

Advances in nutritional therapy in inflammatory bowel diseases: Review

PubMed Central

Wędrychowicz, Andrzej; Zając, Andrzej; Tomasik, Przemysław

2016-01-01

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

Effectiveness of postoperative physical therapy for upper-limb impairments after breast cancer treatment: a systematic review.

PubMed

De Groef, An; Van Kampen, Marijke; Dieltjens, Evi; Christiaens, Marie-Rose; Neven, Patrick; Geraerts, Inge; Devoogdt, Nele

2015-06-01

To systematically review the effectiveness of various postoperative physical therapy modalities and timing of physical therapy after treatment of breast cancer on pain and impaired range of motion (ROM) of the upper limb. We searched the following databases: PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Physiotherapy Evidence Database, and Cochrane. Articles published until October 2012 were included. Only (pseudo) randomized controlled trials and nonrandomized experimental trials investigating the effectiveness of passive mobilization, manual stretching, myofascial therapy, and/or exercise therapy and timing of physical therapy after treatment for breast cancer are reviewed. Primary outcomes are pain of the upper limb and/or ROM of the shoulder. Secondary outcomes are decreased shoulder strength, arm lymphedema, limitations in activities of daily living, decreased quality of life, and wound drainage volume. Physical therapy modalities had to be started in the first 6 weeks after surgery. Articles were selected by 2 independent researchers in 3 phases and compared for consensus. First the titles were analyzed, and then the selected abstracts and finally the full texts were reviewed. Eighteen randomized controlled trials were included in the review. Three studies investigated the effect of multifactorial therapy: 2 studies confirmed that the combination of general exercises and stretching is effective for the treatment of impaired ROM another study showed that passive mobilization combined with massage had no beneficial effects on pain and impaired ROM. Fifteen studies investigated the effectiveness of a single physical therapy modality. One study of poor quality found evidence supporting the beneficial effects of passive mobilization. The only study investigating the effect of stretching did not find any beneficial effects. No studies were found about the effectiveness of myofascial therapy in the postoperative phase. Five

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

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

2009-01-01

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

Psychological therapy for inpatients receiving acute mental health care: A systematic review and meta-analysis of controlled trials.

PubMed

Paterson, Charlotte; Karatzias, Thanos; Dickson, Adele; Harper, Sean; Dougall, Nadine; Hutton, Paul

2018-04-16

The effectiveness of psychological therapies for those receiving acute adult mental health inpatient care remains unclear, partly because of the difficulty in conducting randomized controlled trials (RCTs) in this setting. The aim of this meta-analysis was to synthesize evidence from all controlled trials of psychological therapy carried out with this group, to estimate its effects on a number of important outcomes and examine whether the presence of randomization and rater blinding moderated these estimates. A systematic review and meta-analysis of all controlled trials of psychological therapy delivered in acute inpatient settings was conducted, with a focus on psychotic symptoms, readmissions or emotional distress (anxiety and depression). Studies were identified through ASSIA, EMBASE, CINAHL, Cochrane, MEDLINE, and PsycINFO using a combination of the key terms 'inpatient', 'psychological therapy', and 'acute'. No restriction was placed on diagnosis. The moderating effect of the use of assessor-blind RCT methodology was examined via subgroup and sensitivity analyses. Overall, psychological therapy was associated with small-to-moderate improvements in psychotic symptoms at end of therapy but the effect was smaller and not significant at follow-up. Psychological therapy was also associated with reduced readmissions, depression, and anxiety. The use of single-blind randomized controlled trial methodology was associated with significantly reduced benefits on psychotic symptoms and was also associated with reduced benefits on readmission and depression; however, these reductions were not statistically significant. The provision of psychological therapy to acute psychiatric inpatients is associated with improvements; however, the use of single-blind RCT methodology was associated with reduced therapy-attributable improvements. Whether this is a consequence of increased internal validity or reduced external validity is unclear. Trials with both high internal and

Special report: workshop on 4D-treatment planning in actively scanned particle therapy--recommendations, technical challenges, and future research directions.

PubMed

Knopf, Antje; Bert, Christoph; Heath, Emily; Nill, Simeon; Kraus, Kim; Richter, Daniel; Hug, Eugen; Pedroni, Eros; Safai, Sairos; Albertini, Francesca; Zenklusen, Silvan; Boye, Dirk; Söhn, Matthias; Soukup, Martin; Sobotta, Benjamin; Lomax, Antony

2010-09-01

This article reports on a 4D-treatment planning workshop (4DTPW), held on 7-8 December 2009 at the Paul Scherrer Institut (PSI) in Villigen, Switzerland. The participants were all members of institutions actively involved in particle therapy delivery and research. The purpose of the 4DTPW was to discuss current approaches, challenges, and future research directions in 4D-treatment planning in the context of actively scanned particle radiotherapy. Key aspects were addressed in plenary sessions, in which leaders of the field summarized the state-of-the-art. Each plenary session was followed by an extensive discussion. As a result, this article presents a summary of recommendations for the treatment of mobile targets (intrafractional changes) with actively scanned particles and a list of requirements to elaborate and apply these guidelines clinically.

Stem cell transplantation as rescue therapy for refractory Crohn's disease: a sytematic review.

PubMed

Labidi, Asma; Serghini, Meriem; Ben Mustapha, Nadia; Fekih, Monia; Boubaker, Jalel; Filali, Azza

2014-11-01

Crohn's disease is a chronic relapsing- remitting affection. It has a strong immunologic component which represent the target of standard therapies including immunosppressants and biological therapies. However, many patients remain refracory or intolerant to these therapies. The aim of this review is to determine the effects of stem cell transplantation in patients with refractory Crohn's disease. Systematic review of observational studies, clinical trials and case reports that focused on the effectiveness and safety of stem cell transplantation in patients with refractory Crohn's disease. Hematopoietic stem cell transplantation seems to be efficient in maintaining clinical and endoscopic remission in patients with Crohn's disease refractory or intolerant to current therapies. However, it has been associated to high morbidity and mortality due to chemotherapy. Mesenchymal stem cell transplantation could induce remission in patients with fistulising refractory Crohns disease with no severe side effects. Its impact on luminal Crohns disease is still controversial. Stem cell transplantation seems to hold promising in patients with refractory Crohn's disease. However, because of the high morbidity and mortality related to chemotherapy, hematopoietic stem cell transplantation should be used as last resort to control this disease. Effectiveness of mesenchymal stem cell transplantation in luminal Crohn's disease has yet to be proven.

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

PubMed

Blackburn, R; Bradshaw, T

2014-12-01

Dementia is an organic mental health problem that has been estimated to affect over 23 million people worldwide. With increasing life expectancy in most countries, it has been estimated that the prevalence of dementia will continue to significantly increase in the next two decades. Dementia leads to cognitive impairments most notably short-term memory loss and impairments in functioning and quality of life (QOL). National policy in the UK advocates the importance of early diagnosis, treatment and social inclusion in maintaining a good QOL. First-line treatment options often involve drug therapies aimed at slowing down the progression of the illness and antipsychotic medication to address challenging behaviours. To date, research into non-pharmacological interventions has been limited. In this manuscript, we review the literature that has reported evaluations of the effects of music therapy, a non-pharmacological intervention. The results of six studies reviewed suggest that music therapy may have potential benefits in reducing anxiety, depression and agitated behaviour displayed by elderly people with dementia as well as improving cognitive functioning and QOL. Furthermore, music therapy is a safe and low-cost intervention that could potentially be offered by mental health nurses and other carers working in residential settings. © 2014 John Wiley & Sons Ltd.

Manual therapy for unsettled, distressed and excessively crying infants: a systematic review and meta-analyses.

PubMed

Carnes, Dawn; Plunkett, Austin; Ellwood, Julie; Miles, Clare

2018-01-24

To conduct a systematic review and meta-analyses to assess the effect of manual therapy interventions for healthy but unsettled, distressed and excessively crying infants and to provide information to help clinicians and parents inform decisions about care. We reviewed published peer-reviewed primary research articles in the last 26 years from nine databases (Medline Ovid, Embase, Web of Science, Physiotherapy Evidence Database, Osteopathic Medicine Digital Repository , Cochrane (all databases), Index of Chiropractic Literature, Open Access Theses and Dissertations and Cumulative Index to Nursing and Allied Health Literature). Our inclusion criteria were: manual therapy (by regulated or registered professionals) of unsettled, distressed and excessively crying infants who were otherwise healthy and treated in a primary care setting. Outcomes of interest were: crying, feeding, sleep, parent-child relations, parent experience/satisfaction and parent-reported global change. Nineteen studies were selected for full review: seven randomised controlled trials, seven case series, three cohort studies, one service evaluation study and one qualitative study.We found moderate strength evidence for the effectiveness of manual therapy on: reduction in crying time (favourable: -1.27 hours per day (95% CI -2.19 to -0.36)), sleep (inconclusive), parent-child relations (inconclusive) and global improvement (no effect). The risk of reported adverse events was low: seven non-serious events per 1000 infants exposed to manual therapy (n=1308) and 110 per 1000 in those not exposed. Some small benefits were found, but whether these are meaningful to parents remains unclear as does the mechanisms of action. Manual therapy appears relatively safe. CRD42016037353. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Physical Therapy and Exercise Interventions in Huntington's Disease: A Mixed Methods Systematic Review.

PubMed

Fritz, Nora E; Rao, Ashwini K; Kegelmeyer, Deb; Kloos, Anne; Busse, Monica; Hartel, Lynda; Carrier, Judith; Quinn, Lori

2017-01-01

A number of studies evaluating physical therapy and exercise interventions in Huntington's disease have been conducted over the past 15 years. However, an assessment of the quality and strength of the evidence in support of these interventions is lacking. The purpose of this systematic review was to investigate the effectiveness of physical therapy and exercise interventions in people with Huntington's disease, and to examine the perceptions of patients, families and caregivers of these interventions. This mixed-methods systematic review utilized the Joanna Briggs Institute (JBI) approach and extraction tools to evaluate the literature from January 2003 until May 2016. The review considered interventions that included exercise and physical therapy interventions, and included both quantitative and qualitative outcome measures. Twenty (20) studies met the inclusion criteria, including eighteen (18) that had quantitative outcome measures and two (2) that utilized qualitative methods. JBI Levels of evidence for the 18 quantitative studies were as follows: Eight studies were at evidence Level 1, seven were at Level 2, two were at Level 3, and one was at Level 4. Our review suggests that there is preliminary support for the benefits of exercise and physical activity in Huntington's disease in terms of motor function, gait speed, and balance, as well as a range of physical and social benefits identified through patient-reported outcomes. Variability in mode of intervention as well as outcome measures limits the interpretability of these studies, and high-quality studies that incorporate adaptive trial designs for this rare disease are needed.

Approach to magnetic neutron capture therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kuznetsov, Anatoly A.; Podoynitsyn, Sergey N.; Filippov, Victor I.

2005-11-01

Purpose: The method of magnetic neutron capture therapy can be described as a combination of two methods: magnetic localization of drugs using magnetically targeted carriers and neutron capture therapy itself. Methods and Materials: In this work, we produced and tested two types of particles for such therapy. Composite ultradispersed ferro-carbon (Fe-C) and iron-boron (Fe-B) particles were formed from vapors of respective materials. Results: Two-component ultradispersed particles, containing Fe and C, were tested as magnetic adsorbent of L-boronophenylalanine and borax and were shown that borax sorption could be effective for creation of high concentration of boron atoms in the area ofmore » tumor. Kinetics of boron release into the physiologic solution demonstrate that ultradispersed Fe-B (10%) could be applied for an effective magnetic neutron capture therapy. Conclusion: Both types of the particles have high magnetization and magnetic homogeneity, allow to form stable magnetic suspensions, and have low toxicity.« less

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

ERIC Educational Resources Information Center

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

2011-01-01

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

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

PubMed Central

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

2015-01-01

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

Cancer Nanotheranostics: Improving Imaging and Therapy by Targeted Delivery across Biological Barriers

PubMed Central

Kievit, Forrest M.; Zhang, Miqin

2012-01-01

Cancer nanotheranostics aims to combine imaging and therapy of cancer through use of nanotechnology. The ability to engineer nanomaterials to interact with cancer cells at the molecular level can significantly improve the effectiveness and specificity of therapy to cancers that are currently difficult to treat. In particular, metastatic cancers, drug-resistant cancers, and cancer stem cells impose the greatest therapeutic challenge that requires targeted therapy to treat effectively. Targeted therapy can be achieved with appropriate designed drug delivery vehicles such as nanoparticles, adult stem cells, or T cells in immunotherapy. In this article, we first review the different types of materials commonly used to synthesize nanotheranostic particles and their use in imaging. We then discuss biological barriers that these nanoparticles encounter and must bypass to reach the target cancer cells, including the blood, liver, kidneys, spleen, and particularly the blood-brain barrier. We then review how nanotheranostics can be used to improve targeted delivery and treatment of cancer cells using nanoparticles, adult stem cells, and T cells in immunotherapy. Finally, we discuss development of nanoparticles to overcome current limitations in cancer therapy. PMID:21842473

Computational analysis of non-spherical particle transport and deposition in shear flow with application to lung aerosol dynamics--a review.

PubMed

Kleinstreuer, Clement; Feng, Yu

2013-02-01

All naturally occurring and most man-made solid particles are nonspherical. Examples include air-pollutants in the nano- to micro-meter range as well as blood constituents, drug particles, and industrial fluid-particle streams. Focusing on the modeling and simulation of inhaled aerosols, theories for both spherical and nonspherical particles are reviewed to analyze the contrasting transport and deposition phenomena of spheres and equivalent spheres versus ellipsoids and fibers.

Systematic review of mirror therapy compared with conventional rehabilitation in upper extremity function in stroke survivors.

PubMed

Pérez-Cruzado, David; Merchán-Baeza, Jose Antonio; González-Sánchez, Manuel; Cuesta-Vargas, Antonio I

2017-04-01

Stroke is a leading cause of disability in developed countries. One of the most widespread techniques in clinical practice is mirror therapy (MT). To determine the effectiveness of MT over other methods of intervention in the recovery of upper limb function in people who have had a stroke. A systematic review was conducted. The search string was established based on the last systematic review about MT that dated from 2009: "upper extremity" OR "upper limb "AND "mirror therapy" AND stroke. For this search Pubmed, Scopus and SciELO databases were used. Fifteen studies were included in the systematic review. Recovery of the upper limb, upper limb function and gross manual dexterity were frequently measured in these studies. In the primary variables in promoting recovery, MT alone showed better results in acute and chronic stroke patients in upper limb functioning than either conventional rehabilitation (CR) or CR plus MT. PROSPERO registration number: CRD42015026869. © 2016 Occupational Therapy Australia.

Big Bang Day: 5 Particles - 5. The Next Particle

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2009-10-08

Simon Singh looks at the stories behind the discovery of 5 of the universe's most significant subatomic particles: the Electron, the Quark, the Anti-particle, the Neutrino and the "next particle". 5. The Next Particle The "sparticle" - a super symmetric partner to all the known particles could be the answer to uniting all the known particles and their interactions under one grand theoretical pattern of activity. But how do researchers know where to look for such phenomena and how do they know if they find them? Simon Singh reviews the next particle that physicists would like to find if themore » current particle theories are to ring true.« less

Automatic speech recognition (ASR) based approach for speech therapy of aphasic patients: A review

NASA Astrophysics Data System (ADS)

Jamal, Norezmi; Shanta, Shahnoor; Mahmud, Farhanahani; Sha'abani, MNAH

2017-09-01

This paper reviews the state-of-the-art an automatic speech recognition (ASR) based approach for speech therapy of aphasic patients. Aphasia is a condition in which the affected person suffers from speech and language disorder resulting from a stroke or brain injury. Since there is a growing body of evidence indicating the possibility of improving the symptoms at an early stage, ASR based solutions are increasingly being researched for speech and language therapy. ASR is a technology that transfers human speech into transcript text by matching with the system's library. This is particularly useful in speech rehabilitation therapies as they provide accurate, real-time evaluation for speech input from an individual with speech disorder. ASR based approaches for speech therapy recognize the speech input from the aphasic patient and provide real-time feedback response to their mistakes. However, the accuracy of ASR is dependent on many factors such as, phoneme recognition, speech continuity, speaker and environmental differences as well as our depth of knowledge on human language understanding. Hence, the review examines recent development of ASR technologies and its performance for individuals with speech and language disorders.

Animal-Assisted Therapies for Youth with or at risk for Mental Health Problems: A Systematic Review.

PubMed

Hoagwood, Kimberly Eaton; Acri, Mary; Morrissey, Meghan; Peth-Pierce, Robin

2017-01-01

To systematically review experimental evidence about animal-assisted therapies (AAT) for children or adolescents with or at risk for mental health conditions, we reviewed all experimental AAT studies published between 2000-2015, and compared studies by animal type, intervention, and outcomes. Studies were included if used therapeutically for children and adolescents (≤21 years) with or at risk for a mental health problem; used random assignment or a waitlist comparison/control group; and included child-specific outcome data. Of 1,535 studies, 24 met inclusion criteria. Of 24 studies identified, almost half were randomized controlled trials, with 9 of 11 published in the past two years. The largest group addresses equine therapies for autism. Findings are generally promising for positive effects associated with equine therapies for autism and canine therapies for childhood trauma. The AAT research base is slim; a more focused research agenda is outlined.

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

NASA Astrophysics Data System (ADS)

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

2015-09-01

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

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

NASA Astrophysics Data System (ADS)

Wilson, Brian C.; Patterson, Michael S.

2008-05-01

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

Pharmaceutical Particle Engineering via Spray Drying

PubMed Central

2007-01-01

This review covers recent developments in the area of particle engineering via spray drying. The last decade has seen a shift from empirical formulation efforts to an engineering approach based on a better understanding of particle formation in the spray drying process. Microparticles with nanoscale substructures can now be designed and their functionality has contributed significantly to stability and efficacy of the particulate dosage form. The review provides concepts and a theoretical framework for particle design calculations. It reviews experimental research into parameters that influence particle formation. A classification based on dimensionless numbers is presented that can be used to estimate how excipient properties in combination with process parameters influence the morphology of the engineered particles. A wide range of pharmaceutical application examples—low density particles, composite particles, microencapsulation, and glass stabilization—is discussed, with specific emphasis on the underlying particle formation mechanisms and design concepts. PMID:18040761

Characterization of complete particles (VSV-G/SIN-GFP) and empty particles (VSV-G/EMPTY) in human immunodeficiency virus type 1-based lentiviral products for gene therapy: potential applications for improvement of product quality and safety.

PubMed

Zhao, Yuan; Keating, Kenneth; Dolman, Carl; Thorpe, Robin

2008-05-01

Lentiviral vectors persist in the host and are therefore ideally suited for long-term gene therapy. To advance the use of lentiviral vectors in humans, improvement of their production, purification, and characterization has become increasingly important and challenging. In addition to cellular contaminants derived from packaging cells, empty particles without therapeutic function are the major impurities that compromise product safety and efficacy. Removal of empty particles is difficult because of their innate similarity in particle size and protein composition to the complete particles. We propose that comparison of the properties of lentiviral products with those of purposely expressed empty particles may reveal potential differences between empty and complete particles. For this, three forms of recombinant lentiviral samples, that is, recombinant vesicular stomatitis virus glycoprotein (VSV-G) proteins, empty particles (VSV-G/Empty), and complete particles (VSV-G/SIN-GFP) carrying viral RNA, were purified by size-exclusion chromatography (SEC). The SEC-purified samples were further analyzed by immunoblotting with six antibodies to examine viral and cellular proteins associated with the particles. This study has demonstrated, for the first time, important differences between VSV-G/Empty particles and complete VSV-G/SIN-GFP particles. Differences include the processing of Gag protein and the inclusion of cellular proteins in the particles. Our findings support the development of improved production, purification, and characterization methods for lentiviral products.

Cognitive behavioral therapy for schizophrenia: an empirical review.

PubMed

Rector, Neil A; Beck, Aaron T

2012-10-01

Early case studies and noncontrolled trial studies focusing on the treatment of delusions and hallucinations have laid the foundation for more recent developments in comprehensive cognitive behavioral therapy (CBT) interventions for schizophrenia. Seven randomized, controlled trial studies testing the efficacy of CBT for schizophrenia were identified by electronic search (MEDLINE and PsychInfo) and by personal correspondence. After a review of these studies, effect size (ES) estimates were computed to determine the statistical magnitude of clinical change in CBT and control treatment conditions. CBT has been shown to produce large clinical effects on measures of positive and negative symptoms of schizophrenia. Patients receiving routine care and adjunctive CBT have experienced additional benefits above and beyond the gains achieved with routine care and adjunctive supportive therapy. These results reveal promise for the role of CBT in the treatment of schizophrenia although additional research is required to test its efficacy, long-term durability, and impact on relapse rates and quality of life. Clinical refinements are needed also to help those who show only minimal benefit with the intervention.

The Effects of Massage Therapy on Pain and Anxiety after Surgery: A Systematic Review and Meta-Analysis.

PubMed

Kukimoto, Yukiko; Ooe, Noriko; Ideguchi, Norio

2017-12-01

Pain management is critical for patients after surgery, but current pain management methods are not always adequate. Massage therapy may be a therapeutic complementary therapy for pain. Many researchers have investigated the effects of massage therapy on post-operative pain, but there have been no systematic reviews and meta-analysis of its efficacy for post-operative patients. Our objective was to assess the effects of massage therapy on pain management among post-operative patients by conducting a systematic review and meta-analysis. The databases searched included MEDLINE, CINAHL, and the Cochrane Library's CENTRAL. To assess the effects of massage therapy on post-operative pain and anxiety, we performed a meta-analysis and calculated standardized mean difference with 95% CIs (Confidential Intervals) as a summary effect. Ten randomized controlled trials were selected (total sample size = 1,157). Meta-analysis was conducted using subgroup analysis. The effect of single dosage massage therapy on post-operative pain showed significant improvement (-0.49; 95% confidence intervals -0.64, -0.34; p < .00001) and low heterogeneity (p = .39, I 2 = 4%), sternal incisions showed significant improvement in pain (-0.68; -0.91, -0.46; p< .00001) and low heterogeneity (p = .76, I 2 = 0%). The anxiety subgroups showed substantial heterogeneity. The findings of this study revealed that massage therapy may alleviate post-operative pain, although there are limits on generalization of these findings due to low methodological quality in the reviewed studies. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2011-08-01

The purpose of this study is to review the effects of low-level laser therapy (LLLT) in the prevention and treatment of cancer therapy-induced oral mucositis (OM). A systematic review and meta-analysis of randomised placebo-controlled trials of LLLT performed during chemotherapy or radiation therapy in head and neck cancer patients. We found 11 randomised placebo-controlled trials with a total of 415 patients; methodological quality was acceptable at 4.10 (SD ± 0.74) on the 5-point Jadad scale. The relative risk (RR) for developing OM was significantly (p = 0.02) reduced after LLLT compared with placebo LLLT (RR = 2.03 (95% CI, 1.11 to 3.69)). This preventive effect of LLLT improved to RR = 2.72 (95% CI, 1.98 to 3.74) when only trials with adequate doses above 1 J were included. For treatment of OM ulcers, the number of days with OM grade 2 or worse was significantly reduced after LLLT to 4.38 (95% CI, 3.35 to 5.40) days less than placebo LLLT. Oral mucositis severity was also reduced after LLLT with a standardised mean difference of 1.33 (95% CI, 0.68 to 1.98) over placebo LLLT. All studies registered possible side-effects, but they were not significantly different from placebo LLLT. There is consistent evidence from small high-quality studies that red and infrared LLLT can partly prevent development of cancer therapy-induced OM. LLLT also significantly reduced pain, severity and duration of symptoms in patients with cancer therapy-induced OM.

Proton therapy for locally advanced breast cancer: A systematic review of the literature.

PubMed

Kammerer, Emmanuel; Guevelou, Jennifer Le; Chaikh, Abdulhamid; Danhier, Serge; Geffrelot, Julien; Levy, Christelle; Saloux, Eric; Habrand, Jean-Louis; Thariat, Juliette

2018-02-01

Radiation therapy plays a major role in the management of adjuvant breast cancer with nodal involvement, with an iatrogenic increase of cardio-vascular risk. Photon therapy, even with intensity modulation, has the downsides of high mean heart dose and heterogeneous target coverage, particularly in the case of internal mammary irradiation. This systematic review of the literature aims to evaluate proton therapy in locally advanced breast cancer. PubMed was searched for original full-text articles with the following search terms: «Proton Therapy» and «Breast Cancer». On-going trials were collected using the words "Breast Cancer" and "Protons". 13 articles met the criteria: 6 with passive proton therapy (Double Scattering), 5 with Pencil Beam Scanning (PBS) and 2 with a combination of both. Proton therapy offered a better target coverage than photons, even compared with intensity modulation radiation therapy (including static or rotational IMRT or tomotherapy). With proton therapy, volumes receiving 95% of the dose were around 98%, with low volumes receiving 105% of the dose. Proton therapy often decreased mean heart dose by a factor of 2 or 3, i.e. 1 Gy with proton therapy versus 3 Gy with conventional 3D, and 6 Gy for IMRT. Lungs were better spared with proton therapy than with photon therapy. Cutaneous toxicity observed with double scattering is improved with PBS. Proton therapy reduces mean heart dose in breast cancer irradiation, probably reducing late cardio-vascular toxicity. Large clinical studies will likely confirm a clinical benefit of proton therapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

Impact of Music Therapy on Dementia Behaviors: A Literature Review.

PubMed

Fakhoury, Nora; Wilhelm, Nathaniel; Sobota, Kristen F; Kroustos, Kelly R

2017-10-01

Worldwide, dementia is the most important contributor to disability in elderly patients. Treating patients with dementia can be challenging for clinicians because of the numerous behavioral and psychological symptoms of dementia (BPSD). The Dementia Action Alliance and American Geriatrics Society Beers criteria promote nonpharmacological and behavioral treatments as first-line therapy to manage BPSD to avoid adverse events associated with antipsychotic medications. Some of the nonpharmacologic therapies proposed for BPSD include: music therapy (MT), light therapy, acupressure, aromatherapy, massage, and animal-assisted therapy. However, several are supported with only limited literature findings. Among these, MT has the most substantial data. MT has demonstrated benefit throughout mild-severe stages of dementia. The extended impact is attributed to associated brain pathology. MT's mode of delivery is essential to the evidencebased use of music interventions and delivery methods. The literature citations show that adequately trained individuals should ideally conduct several forms of MT to obtain optimal benefit. There are several studies investigating the impact of the various forms of MT on alleviating BPSD. Among the numerous reviewed studies, six trials and three meta-analyses were included in this article. While the literature conflicts, MT is noninvasive, poses little to no risk to patients, requires minimal training, and offers large potential for implementation in the patient-care setting. In addition, MT can have an important role in fostering student pharmacist development, because an emphasis on the aging demographic is becoming increasingly important.

Emerging applications of nanotechnology for diagnosis and therapy of disease: a review.

PubMed

Bayford, Richard; Rademacher, Tom; Roitt, Ivan; Wang, Scarlet Xiaoyan

2017-07-24

Nanotechnology is of increasing interest in the fields of medicine and physiology over recent years. Its application could considerably improve disease detection and therapy, and although the potential is considerable, there are still many challenges that need to be addressed before it is accepted in routine clinical use. This review focuses on emerging applications that nanotechnology could enhance or provide new approaches in diagnoses and therapy. The main focus of recent research centres on targeted therapies and enhancing imaging; however, the introduction of nanomaterial into the human body must be controlled, as there are many issues with possible toxicity and long-term effects. Despite these issues, the potential for nanotechnology to provide new methods of combating cancer and other disease conditions is considerable. There are still key challenges for researchers in this field, including the means of delivery and targeting in the body to provide effective treatment for specific disease conditions. Nanoparticles are difficult to measure due to their size and physical properties; hence there is still a great need to improve physiological measurement methods in the field to ascertain how effective their use is in the human subject. This review is a brief snapshot into the fast changing research field of measurement and physiological links to nanoparticle use and its potential in the future.

Faster-than-light particles: a review of tachyon characteristics. Interim report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Puscher, E.A.

1980-10-01

This report documents an analytical prediction of some of the characteristics which presently undiscovered faster-than-light sub-atomic particles (called tachyons) must possess if they are to exist without violating the Theory of Special Relativity. A brief review of necessary concepts from the Special Theory is included so that the reader might more readily understand the reasoning as it is developed. Necessary, but not all, characteristics of tachyons are then identified and presented. Finally, an interesting potential relationship between tachyons and anti-gravity is discussed.

Assessing the Efficacy of Mobile Health Apps Using the Basic Principles of Cognitive Behavioral Therapy: Systematic Review.

PubMed

Rathbone, Amy Leigh; Clarry, Laura; Prescott, Julie

2017-11-28

Cognitive behavioral therapy (CBT) in its basic principle has developed itself as a stand-alone, substantial method of therapy. With effective application in therapy for a range of mental health issues, the spread of CBT methods to Web-based therapy sources is evident. The development of mobile phone apps using CBT principles is increasing within the research area. Despite the move to Web-based methods of therapy, it is argued that these methods lack the same efficacy of face-to-face therapy sessions. The aim of this review was to assess extent research findings with regard to the effectiveness of CBT-related mobile health (mHealth) apps. By assessing only studies employing a randomized controlled trial design, the review aimed to determine app efficacy within the highly regarded method of investigation. A comprehensive literature search was conducted across several databases. Search results were filtered, and results were subject to strict inclusion and exclusion criteria because of the nature of the review. Where possible, analysis of effect size was calculated and results reported. A total of 8 studies investigating the effectiveness of mHealth CBT-related apps across a range of mental health issues were reviewed. Three studies used the app against a control group, and 5 studies used the app intervention against another form of treatment or intervention. A range of effect sizes were seen across all included studies (d=-0.13 to 1.83; 0.03-1.44), with the largest effects often being seen when comparing the data from pre- to posttest for the app engaged group. The studies reviewed support the use of mHealth apps containing CBT principles for a range of mental health issues. However, the effectiveness over longer time periods should be assessed. Researchers and professionals should seek to collaborate effectively when creating new apps to enhance their effectiveness as a treatment for the general public. ©Amy Leigh Rathbone, Laura Clarry, Julie Prescott

A systematic review of left unilateral electroconvulsive therapy.

PubMed

Kellner, C H; Farber, K G; Chen, X R; Mehrotra, A; Zipursky, G D N

2017-08-01

To systematically review the published clinical trials, case series, and case reports on left unilateral (LUL) electrode placement for clinical electroconvulsive therapy (ECT). PubMed, Ovid Medline, and the Cochrane Library were searched for articles concerning LUL ECT. Number of patients, efficacy, and cognitive outcomes were extracted from the papers that met our inclusion criteria. A total of 52 articles were included in this review, consisting of 33 clinical trials, seven case series, and 12 case reports. Overall, the efficacy of LUL electrode placement for the treatment of depression and psychosis is similar to that of right unilateral (RUL) and bilateral (BL) electrode placements. Patients receiving LUL ECT tend to experience more verbal memory impairment than patients receiving RUL ECT, but less verbal impairment than patients receiving BL ECT. In contrast, patients receiving LUL ECT tended to experience the least visual and nonverbal memory impairment, compared to patients receiving RUL or BL ECT. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Preterm Infant Massage Therapy Research: A Review

PubMed Central

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

2010-01-01

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

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

PubMed Central

Kumar, Senthil P

2011-01-01

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

Application of nanodimensional particles and aluminum hydroxide nanostructures for cancer diagnosis and therapy

NASA Astrophysics Data System (ADS)

Korovin, M. S.; Fomenko, A. N.

2017-09-01

Nanoparticles and nanostructured materials are one of the most promising developments for cancer therapy. Gold nanoparticles, magnetic nanoparticles based on iron and its oxides and other metal oxides have been widely used in diagnosis and treatment of cancer. Much less researchers' attention has been paid to nanoparticles and nanostructures based on aluminum oxides and hydroxides as materials for cancer diagnosis and treatment. However, recent investigations have shown promising results regarding these objects. Here, we review the antitumor results obtained with different aluminum oxide/hydroxide nanoparticles and nanostructures.

Cognitive-Behavioral Therapy for Depression in Individuals with Intellectual Disabilities: A Review

ERIC Educational Resources Information Center

James, Jessica S.

2017-01-01

Depression is common in individuals with intellectual disabilities, but evidence regarding treatment for this population is lacking. Through a systematic literature review of cognitive-behavioral therapy (CBT) with individuals with intellectual disabilities, a total of six studies were identified that used pretest-post-test nonequivalent control…

Construction of the radiation oncology teaching files system for charged particle radiotherapy.

PubMed

Masami, Mukai; Yutaka, Ando; Yasuo, Okuda; Naoto, Takahashi; Yoshihisa, Yoda; Hiroshi, Tsuji; Tadashi, Kamada

2013-01-01

Our hospital started the charged particle therapy since 1996. New institutions for charged particle therapy are planned in the world. Our hospital are accepting many visitors from those newly planned medical institutions and having many opportunities to provide with the training to them. Based upon our experiences, we have developed the radiation oncology teaching files system for charged particle therapy. We adopted the PowerPoint of Microsoft as a basic framework of our teaching files system. By using our export function of the viewer any physician can create teaching files easily and effectively. Now our teaching file system has 33 cases for clinical and physics contents. We expect that we can improve the safety and accuracy of charged particle therapy by using our teaching files system substantially.