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Search Results: 1 - 10 of 12454 matches for " Immunosppressive Therapy "
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Brief review: management of lupus nephritis–randomized controlled trials: an update  [PDF]
Shih-Han S. Huang, Ainslie Hildebrand, William F. Clark
Open Journal of Internal Medicine (OJIM) , 2011, DOI: 10.4236/ojim.2011.12006
Abstract: Lupus nephritis leads to significant morbidity and mortality in patients with systemic lupus erythematous. Immunosuppressive agents are recommended in management of Class III, IV and V lupus nephritis. The goals of therapy are to control the disease and to prevent relapse while minimizing side-effects of therapy. Most of the evidences in managements of Class III and IV lupus nephritis comes from randomized controlled trials using intravenous cyclophosphamides, oral mycophenolate mofetil and oral azathioprine. In Class V lupus nephritis, there are few studies available and they have assessed the use of intravenous cyclophsophamide, oral mycophenolates mofetil and oral cyclosporine. In this review article, we have summarized the major randomized controlled trials in managements of Class III, IV and V lupus nephritis and offer an interpretation of the evidence to date.
Intercultural Therapy and Ethnopsychoanalysis: are They Both 'Possession'?
Francesca Zanatta
Opticon1826 , 2008, DOI: 10.5334/opt.040810
Abstract: The assumption that such a delicate practice as therapy is universal is a fault belonging to the past. The universality of therapy has been questioned for a long time without any consistent or final answer. The biggest contribution of Anthropology to therapy has been to open up new approaches to and points of view about therapy. Therefore the problems linked to assumptions about therapy’s universality have been overcome partially through the analysis and the understanding of differences and peculiarities of cultures. Ethnopsychoanalysis and Intercultural Therapy are two approaches to therapy that have been developed in response to the Anthropological critique and its identification of cultural variance. They both give effect to Littlewood’s suggestion (1990), which was developed in his article that promoted the rise of a new cross-cultural psychiatry: According to Littlewood, ‘we need to take into account the whole context of a particular experience and its personal meaning even if it leads us to such areas as local politics or social structure’. Each of the new therapies referred to above give effect to Littlewood’s suggestion in different ways. On the one hand, Intercultural Therapy, starting from the Western traditional theories, has been modeled on other cultures; on the other hand, Ethnopsychiatry has been based on traditional therapy belonging to non-Western cultures, with some help from psychoanalytic theories. Both these therapies are an attempt to overcome the problems caused by the assumption of universality. A question still remains: is this effort just another way to make therapy fit into non-Western cultures? Is this effort simply another way to ‘possess’ cultures?
Editorial: Is Electroconvulsive Therapy a Therapy with Future?  [PDF]
Jér?me Palazzolo
Open Journal of Depression (OJD) , 2013, DOI: 10.4236/ojd.2013.23004
Abstract: Editorial: Is Electroconvulsive Therapy a Therapy with Future?
Clinical Feature of Japanese Patients with Fulminant Myocarditis—Myocarditis in Japanese Patients  [PDF]
Hiroaki Kawano, Yasuhiro Nagayoshi, Sunao Kojima, Nahoko Kakihara, Satoshi Sakuma, Masumi Uchino, Aiko Komatsu, Machiko Asaka, Mitsuhiro Shimomura, Hiroshige Yamabe, Hisao Ogawa, Koichi Node
International Journal of Clinical Medicine (IJCM) , 2011, DOI: 10.4236/ijcm.2011.23041
Abstract: Fulminant myocarditis is commonly recognized as an acute myocarditis with cardiogenic shock requiring mechanical support systems. Before the development of mechanical assist devices, previous study described that most of patients with fulminant myocarditis die at acute phase because of rapidly progressive cardiac decompensation. To investigate the feature of myocarditis, we checked consecutive 18 patients (10 men, 8 women, 12yr-80yr) from April in 2001 to September 2008 in University. Of these patients 3 needed intraaortic balloon pumping (IABP) (2 men, 1 woman), 6 did both IABP and percutaneous cardiopulmonary support (PCPS) (2 men, 4 women). Three patients who need both IABP and PCPS died (2 men, 49yr and 65yr, 1 woman, 54yr) because of uncontrolled bacterial infection. No patients whose age was under 40yr (5 men, 4 women) died although a man needed IABP and 3 women did both IABP and PCPS. Sixteen patients were able to resume a normal life although 1 male patient needed permanent pacemaker, 1 female did cardiac resynchronization therapy, and a male and a female had left ventricular systolic dysfunction. In conclusion, the young patients had better prognosis than older even if mechanical assist is needed. Although half of patients needed mechanical assist, the prevention of multi-organ complications including bacterial infection is one of the most important keys in the treatment of fulminant myocarditis.
Recent Developments and Current Issues in the Treatment of Pancreatic Cancer  [PDF]
Helmut Oettle
Journal of Cancer Therapy (JCT) , 2013, DOI: 10.4236/jct.2013.410A003
Abstract:

Presently, many questions exist about what the optimal regimen comprises for all stages and treatment settings for pancreatic cancer. Since the CONKO-001 trial, adjuvant therapy following resection has become standard of care; however, outcomes are poor, with most patients experiencing disease recurrence, and new therapies have yet to be validated. Furthermore, the value of adjuvant radiotherapy has still not been clearly defined. Targeted treatment in combination with chemotherapy has been mostly disappointing so far in the adjuvant setting but immunotherapy holds potential for improving survival outcomes. Neoadjuvant treatment does not appear to provide much benefit in resectable patients but in the small subgroup of patients with borderline resectable/unresectable locally advanced disease it may increase the possibility of an R0 resection and, consequently, a substantial increase in survival duration. Use of capecitabine-based radiotherapy in patients with unresectable locally advanced disease appears to be more efficacious and better tolerated than gemcitabine-based chemoradiotherapy, with respect to survival outcomes. However, as with adjuvant treatment, the benefit of adding radiotherapy has not yet been definitively demonstrated. In patients with metastatic pancreatic cancer, targeting the stroma with nab-paclitaxel has shown promising results in a phase III trial setting when administered in combination with gemcitabine and, furthermore, this regimen is suitable for a broad range of patients due to its generally good tolerability profile. Because of its high toxicity, FOLFIRINOX is more suitable for younger patients with an excellent performance status who can withstand aggressive treatment and in patients with a worse performance status, gemcitabine monotherapy is considered to be a more appropriate treatment. Alternatively, gemcitabine in combination with erlotinib, the only targeted compound that has resulted in significant albeit small improvements in survival in patients with advanced disease, could be selected. However, the benefit-risk profile of this regimen is only favorable in a strictly defined, small patient subgroup who develop a treatment-related rash. Finally, with the elucidation of prognostic and predictive markers, treatment is expected to become ever more individualized, leading to improved efficacy outcomes and less unnecessary

Effectiveness of Cognitive Therapy and Mindfulness Tools in Reducing Depression and Anxiety: A Mixed Method Study  [PDF]
Valerie L. Alexander, B. Charles Tatum
Psychology (PSYCH) , 2014, DOI: 10.4236/psych.2014.515178
Abstract: Depression and anxiety continue to be among the most common mental disorders. This study looked at three tracks of participants diagnosed with a mood disorder. The three tracks were Cognitive Therapy (CT), Mindfulness Training (MT), and Treatment As Usual (TAU). All participants had been trained in CT and then randomly separated into three groups. These three tracks were assessed at 3, 6, and 12 months in terms of their stated level of depression (measured on the Beck Depression Inventory) and anxiety (measured by the Beck Anxiety Inventory). This study was a follow-up to two previous studies (Alexander et al., 2012; Alexander & Tatum, 2013). In the current study, the participants reported the tools and skills they used to manage their mood and anxiety and then the effectiveness of these tools/skills was examined. Two tools were identified by three independent coders as the most frequently used by the participants. Both of these tools related to thought management (“thought records” and “thought distortions”). The two tools were combined into a single category (“thought tools”) and the frequency of their use was examined in relation to reductions in depression and anxiety. The results showed that a high use of these tools was connected to a significant reduction in reported depression. There was also a reduction in reported anxiety, but this effect was not statistically significant. Other tools that were reported (e.g., mood tracking, relaxation) showed no significant effects on depression and anxiety. Future research will now focus not on reported tool use, but rather on manipulating the incidence of tool use and determine the direct causal path between using a thought tool and reductions in negative moods.
Ozone Therapy in Patients with Burn Disease  [PDF]
Andrew K. Martusevich, Sergey P. Peretyagin, Mikhail V. Ruchin, Andrew A. Struchkov
Journal of Biomedical Science and Engineering (JBiSE) , 2018, DOI: 10.4236/jbise.2018.112003
Abstract: Objectives. Using of systemic ozone therapy connecting with antioxidants in early period of burn disease for detoxication and metabolic disorders correction is investigated. Materials and Methods. We used active preventive metabolic detoxication in early period of burn disease (5th - 15th days after shock stage). It includes, besides complex infusion and transfusion therapy and classic pharmacological treatment, employment of antioxidants with succinic acid (reamberin, mexidol), systemic ozone therapy (intravenous injections of ozonated sodium chloride solution with ozone concentration 120 - 240 μg/mL; saturating ozone concentration in gas flow—5000 μg/L, sparging speed—2 l/min), major autohemotherapy (twice a week; ozone dose—250 - 300 μg/mL) and monitor cleansing of bowels with rectal ozone insufflations (ozone dose—1000 μg/mL). Estimation of personal oxidant dose and treatment effectiveness is carried out by biochemiluminescence control of pro- and antioxidant system state. Complex patient study also includes endotoxicosis markers (blood level of glucose, creatinine, bilirubin, urea and intermediate molecular weight peptides), proteolytic enzymes activity (tripsin, antitripsin, elastase), cardiovascular and microcirculation function examination (tetrapolar rheography, spirography, laser Doppler flowmetry) at burn disease dynamics. We formed two patients groups: first control group (20 burned patients) received a traditional therapy; second group (20 burned patients) got a described detoxication complex additional to treatment of first group. All patients had large burns (more than 20% body square). Indications for parenteral ozone therapy are signs of hypoxia (hypoxemia, elevated lactate level, depressed lactate dehydrogenase activity) and toxemia (increased blood level of glucose, creatinine, urea, intermediate molecular weight peptides, fibrine degradation products, lypoperoxidation intensification); cardiovascular dysfunction; respiratory function disorders. Results. Method of ozone dose individualization in intravenous ozone therapy and pharmacological treatment as oxidation stress correction is shown. This method is based on biochemiluminescence detection of patient blood antioxidant system reaction in ozonization in vitro. It is important that first stage of method is pro- and antioxidant potential estimation. Conclusions. It was shown that this algorithm use determines fully correction of oxygen homeostasis disorders and endotoxicosis. It optimizes results of complex treatment of burned patients.
Comparison of the Effectiveness of the Transactional Analysis, Existential, Cognitive, and Integrated Group Therapies on Improving Problem-Solving Skills  [PDF]
Bahramali A. Ghanbari-e-Hashem-Abadi, Mustafa Bolghan-Abadi, Zahra Vafaei-e-Jahan, Raheleh Maddah-Shoorcheh, Elaheh Maddah-Shoorcheh
Psychology (PSYCH) , 2011, DOI: 10.4236/psych.2011.24048
Abstract: Problem-solving is one of the necessities of life in twenty first century. Therefore, Psychologists consider it as a skill that everyone must learn it. The purpose of the present study is to compare the effectiveness of the transactional analysis, existential, cognitive, and integrated group therapies on improving problem–solving skills. For this purpose, 65 subjects of the clients who were referring to the Ferdowsi University of Mashhad's Mental Health Centre were selected randomly and subjects placed in 5 groups in random assignment method (13 participants in each group). The research method is Pre-test/Post-test control group design. To gather the data, Long & Cassidy’s problem solving styles questionnaire (1996) was used. In the descriptive level, the data were analyzed using mean and standard deviation, and in the inferential level Analysis of Covariance test (ANCOVA) was used. The results of data analysis were indicative of the fact that after modifying pretest scores, there was a significant difference between group’s subjects. The results showed that group therapies were effective on improving problem-solving skills and that cognitive and integrated group therapies were more effective on improving problem-solving skills comparing to other groups. Regarding the results of the present study, it can be concluded that transactional analysis, existential, cognitive and integrated group therapies were effective on improving problem-solving skills of the clients who were referring to the Ferdowsi University of Mashhad's Mental Health Centre.
Therapeutic Modalities in Diabetic Nephropathy: Future Approaches  [PDF]
William Brian Reeves, Bishal B. Rawal, Emaad M. Abdel-Rahman, Alaa S. Awad
Open Journal of Nephrology (OJNeph) , 2012, DOI: 10.4236/ojneph.2012.22002
Abstract: Diabetes mellitus is the leading cause of end stage renal disease and is responsible for more than 40% of all cases in the United States. Several therapeutic interventions for the treatment of diabetic nephropathy have been developed and implemented over the past few decades with some degree of success. However, the renal protection provided by these therapeutic modalities is incomplete. More effective approaches are therefore urgently needed. Recently, several novel therapeutic strategies have been explored in treating DN patients including Islet cell transplant, Aldose reductase inhibitors, Sulodexide (GAC), Protein Kinase C (PKC) inhibitors, Connective tissue growth factor (CTGF) inhibitors, Transforming growth factor-beta (TGF-β) inhibitors and bardoxolone. The benefits and risks of these agents are still under investigation. This review aims to summarize the utility of these novel therapeutic approaches.
An Instance of Somatoform Disorder  [PDF]
Armando Simon
Open Journal of Medical Psychology (OJMP) , 2013, DOI: 10.4236/ojmp.2013.21004
Abstract: A case study is presented of a prison inmate with Somatoform Disorder, a relatively rare type of mental illness. In this particular case symptomatology revolved around his claim that some of his teeth were rotten, resulting in great pain, in spite of several diagnoses by dentists. When said teeth were extracted, inmate would express satisfaction, whereupon several weeks later the same complaint would resurface and the cycle began anew. Of the various types of mental illnesses listed in the DSM, there are some that are infrequently seen [1,2] One of these is Somatoform Disorder, a category of mental illness for which there is a paucity of research, partly due to diagnostic difficulties and controversies [3,4] and we would like to present a case study of just such an instance.
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