Brief Therapy Research Articles

Brief strategic therapy in first myocardial infarction patients with increased levels of stress: a randomized clinical trial

Background: Little is known about the impact of interventions targeting chronic stress levels on clinical outcomes among myocardial infarction (MI) patients with increased levels of stress. Objectives: To examine the impact of the addition of brief strategic therapy (BST) to usual care (UC) on clinical outcomes in first MI patients with increased levels of stress. Design: Eighty-one patients were randomly assigned to BST in conjunction with UC (medical treatment, risk factor information, and guidance on unhealthy behavior change) or to UC. Methods: The outcome measures were scores on the Perceived Stress Scale, reinfarction and cardiac mortality rates, and scores on the Health Survey. Measures were taken before, post-treatment, and at two follow-ups. Results: Patients subjected to BST showed reduced perceived stress at post-treatment and maintained decreased levels at follow-ups. At 1-year follow-up, they had a lower rate of non-fatal reinfarction, and at 2.5-year follow-up, they had a lower rate of fatal reinfarction. Their mental and physical health was improved at post-treatment and this was sustained at follow-ups. Conclusion: The addition of BST to UC favorably influences the disease course after MI in patients with increased levels of stress.

A Letter Does Not Blush: In-Session Writing to Deal with Shame in Brief Therapy

A Letter Does Not Blush: In-Session Writing to Deal with Shame in Brief Therapy

Integrating Motivational Interviewing with Brief Strategic Therapy for Heart Patients

Problem statementpsychological distress, obesity and unhealthy lifestyles may contribute to a worse prognosis of cardiac diseases; an important public health challenge is to motivate people and facilitate health behavior change. Research questionspecifically, aim of the current study is to test the mediating effect of motivation in improving lifestyle changes in a long term. Purpose of the studythe MOTIV-HEART (MOTivational strategies for HEART patients) study, a two-arm randomized controlled clinical trial, compares the efficacy of an alternative-integrative brief motivational intervention (MI) with the cardiac rehabilitation programmed treatment - Brief Strategic Therapy (BST) - in order to develop interventions able to improve lifestyle change among heart patients. Research methodinpatients with Coronary Artery Disease (CAD) referred to a single clinical center for cardiac rehabilitation (CR) and weight loss treatment will be randomly allocated into two conditions: a) 3 sessions of BST, b) 3 sessions of BST combined with Motivational Interviewing (MI) techniques. Data are going to be collected at baseline, discharge (1 month after) and after 3, 6, 12 months follow-up. Findingthree kinds of outcomes are going to be relieved: behavioral, psychological and biomedical. Primary outcome is the improvement of patients’ diet and physical activity at 3 months follow-up. Secondary outcomes are (a) the maintenance of healthy lifestyle habits, (b) the reduction of patients’ body mass index (BMI) and specific cardiac parameters levels, (c) the improvement of adequate psychological outcomes. Conclusionobese patients with cardiovascular diseases face numerous difficulties in achieving self-care. Motivational interviewing showed encouraging results in eliciting adoption of high-risk behavioral change, such as initiating an exercise regimen and changing diet. The rationale behind this investigation is that focusing on enhancing motivation would result in better outcomes than those brought about by existing therapy. Study is currently ongoing.

Effectiveness of Natural Killer (NK) Cells in Peripheral Blood Stem-Cell towards Expression of EZH2, Ki-67, and Apoptosis in Retinoblastoma (RB) Cells Culture

Abstract A natural killer (NK) cell is a large granular lymphocyte having a cytotoxic activity against malignant tumor cells in the cellular immune response. NK cells play an important role to inhibit the metastasis of tumor and express glikoprotein molecule antigen (IgG) and variable cytotoxic factors like perforin, granzyme, cytolysin such as TNF-α against retinoblastoma cells. The aim of the study was to investigate the role of Natural Killer Cells (NK cells) as an alternative therapy, especially in cases of retinoblastoma. It is highly expected that the study can be used as a starting point in determining the strategic therapy, e.g. the cell targeted therapy to inhibit EZH2 and retinoblastoma cell proliferation. There were 2 groups of retinoblastoma cell cultures in this study, the groups of control (n=10) and exposure (n=10). The control group was a group of retinoblastoma cell cultures that did not get any therapy, while the exposure group was a group of retinoblastoma cell cultures with NK Cell exposure in vitro for 3 days. The data obtained were analyzed using the T- test and Pearson Correlation. In T-test, the results of the two groups indicated a significant difference in the positive expression of cell count of EZH2, Ki-67 and Apoptotic cells. The Pearson Correlation test showed that the expression of EZH2 was statistically negative significant (α: -0.930; p<0.05) towards the apoptotic cells expression. While in the proliferation cell expression (Ki-67) towards the apoptotic cell expression, the correlation was significantly negative (α: -0,868; p<0.05). The study showed that NK cells played an important role in the aggressiveness of RB cell cultures by changing the expression of EZH2, Ki-67 and apoptosis in RB cells. It is expected that the research can be used as a reference to determine the strategic therapy in retinoblastoma. Keywords: NK cells, retinoblastoma, EZH2, proliferation, apoptosis

Primary Cancer Cell Metastasis and Secondary Niches: Novel Cues from Metabolomics for Strategic Therapy

Primary Cancer Cell Metastasis and Secondary Niches: Novel Cues from Metabolomics for Strategic Therapy

Effect of the miracle questions in solution-focused brief therapy on memory tend and emotional stage in college students

Objective To evaluate the effect of the miracle questions in solution-focused brief therapy on memory tend and emotional stage in a non-clinical situation in college students. Methods A quasi-experimental design was adopted, and two kinds of materials for self-coaching(solution-focused, problem-focused) were developed according to the previous researches. Seventy-two subjects were randomly divided into two groups, receiving the miracle questions in solution-focused brief therapy(The miracle question group, thirty-six subjects) or problem-focused coaching intervention(problem-focused group, thirty-six subjects). Exception memories number and positive and negative emotion level were evaluated between the two groups. Results The subjects receiving the miracle question group write more exception memories (3.67±2.07) than problem-focused group (1.61±1.18) (t=5.178, P 0.05). Conclusion The miracle questions in solution-focused brief therapy can trigger the subjects to exceptional memories .This suggests that in practical application, questions order has impact on the effect of consultation. Before asking exception question, miracle questions should be asked in the use of solution-focused intervention. Key words: Solution-focused brief therapy; College students; Miracle questions; Exception questions; Emotional stage; Cross-sectional studies

Novel IL-6-secreting γδT cells increased in patients with atherosclerotic cerebral infarction.

Mounting evidence has suggested that inflammation associated with interleukin (IL)‑6 and T‑helper (Th)17 cells, has a role in the development of atherosclerotic cerebral infarction (ACI). However, it remains unclear which population of cells determines the levels of IL‑6, and the role of IL‑6‑secreting cells in inducing Th17 cell production. In the present study, IL‑6 levels were determined in patients with ACI, by ELISA. The percentage of CD3+T, CD4+T, CD8+T, CD11c+ dendritic cells and γδT cells were determined by flow cytometry, and the correlation between cytokine IL‑6 and γδT cells was determined by statistical analysis. An in vitro culture assay was used to determine whether γδT cells secreted high levels of IL‑6, and induced production of Th17 cells. The patients with ACI had significantly higher levels of IL‑6 and γδT cells. Furthermore, γδT cells were associated with the secretion of a high level of IL‑6 in patients with ACI. These results indicate that γδT cells are novel IL‑6‑secreting cells, which from then on were known as γδT6 cells. In addition, the novel γδT6 cells induced Th17‑cell production, and this induction was dependent on IL‑6. Novel γδT6 cells increased the induction of Th17‑cell production in patients with ACI. The results of the present study suggest that novel γδT6 cells may be a target for strategic therapies of ACI.

MS14, a Marine Herbal Medicine, an Immunosuppressive Drug in Experimental Autoimmune Encephalomyelitis.

Background:Cytokines are secreted signaling proteins which play essential roles in immune responses during experimental autoimmune encephalomyelitis (EAE), a demyelinating model that mimics many features of multiple sclerosis (MS). Interleukin 6 (IL-6) is a multifunctional cytokine produced by different cells, mediating inflammatory reactions and immune-mediated processes. Several studies have described immunosuppressive potentials of several herbal medicines. MS14 as an Iranian marine herbal medicine has anti-inflammatory and immunomodulatory activities.Objectives:The present study investigated the immunosuppressive potential of MS14 as an herbal drug as well as the IL-6 level in EAE model. We hope it will be a new approach for neurologic diseases and autoimmune originated diseases therapy.Patients and Methods:The present experimental study was a collaboration between Department of Anatomical Sciences of Tabriz University of Medical Sciences and Shefa Neuroscience Research Center of Tehran. We used 30 C57BL/6 mice. The animals were immunized with myelin oligodendrocyte glycoprotein (MOG) to induce EAE and treated with MS14-containing (30%) diets. Subjects were selected by simple random sampling and then they were randomly allocated to two groups. EAE symptoms were assessed using the standard 10–point EAE scoring system from the seventh to the 35th day after immunization. Afterwards, the spleen was removed and its cells were cultured with or without MOG 35-55; then, the IL-6 level was analyzed by ELISA. In addition, histopathological studies were carried out for demyelination lesion evaluation in the spinal cord.Results:MS14 significantly improved clinical symptoms of EAE compared with the control (P < 0.05). It also suppressed proliferative responses of T cells and decreased IL-6 expression (16.93 ± 2.7 vs. 21.4 ± 3.33) (P < 0.05).Conclusions:Our results strongly suggested that IL-6 as a potential molecule could have a role in neuroimmunology and neuroinflammation, which is in congruent with previous studies. Therefore, it can be a clear target in strategic therapies and support effective properties of phytotherapy in EAE and MS treatment.

«One Heart, Many Hands» – Reflections on diversity, relationships, and expanding conversations. Opening plenary at the Conference on Solution Focused Brief Therapy, Toronto 8–9th of November 2013

«One Heart, Many Hands» – Reflections on diversity, relationships, and expanding conversations. Opening plenary at the Conference on Solution Focused Brief Therapy, Toronto 8–9th of November 2013

In Search of Molecular Mechanisms in Endometriosis

In Search of Molecular Mechanisms in Endometriosis

Gold nanoparticle based X-ray contrast agent for tumor imaging in mice and dog: a potential nano-platform for computer tomography theranostics.

The goal of our study was to demonstrate the utility of nanocrystalline gold as an X-ray contrast agent for imaging tumor in living subjects. Even though significant progress has been achieved in this area by researchers, clinical translation remains challenging. Here, we investigated biocompatible gum Arabic stabilized gold nanocrystals (GA-AuNPs) as X-ray contrast agent in tumor bearing mice and dog. Single intratumoral injections of GA-AuNP resulted in X-ray contrast change of -26 HU in the tumor region after 1 hour post-injection period. Subsequently, five intratumoral injections were performed in the mice. The change in CT number in tumor region is not progressive; rather it reaches a saturation point after fourth injection. These data suggested that accumulation of GA-AuNP reaches a threshold limit within a short time period (5 h), and is retained in the tumor tissue for the rest of the period of investigation. A pilot study was conducted in a client-owned dog presented with collision tumor of thyroid carcinoma and osteosarcoma. In this study, GA-AuNP was injected intratumorally in dog and a contrast enhancement of 12 deltaHU was observed. The CT images of both mice and dog clearly demonstrated that GA-AuNP was effectively distributed and retained throughout the tumor site. The CT data obtained by the present study would provide the crucial dosimetry information for strategic therapy planning using this construct. Both mice and dog did not show any clinical changes, thereby confirming that GA-AuNP did not induce toxicity and can be explored for future clinical applications.

A Brief Strategic Therapy Protocol for Binge Eating Disorder

BackgroundObesity and being overweight are often associated with Binge Eating Disorder (BED). Cognitive-Behavioral Therapy (CBT) has shown solid results in reducing binge eating, but it does not traditionally encourage weight loss. Since Brief Strategic Therapy (BST) has shown to be effective in treating obese people suffering from Binge Eating Disorder (BED), our objective is to compare the BST protocol as an alternative and/or integrative treatment to the traditional Cognitive-Behavioral Therapy, for inpatient and telephone-based outpatient treatment. MethodA two arm randomized controlled clinical trial including 6, 12 and 18 months post-treatment follow up is proposed. 60 participants meeting criteria for obesity and BED will be recruited from a single clinical center (Saint Joseph Hospital - Istituto Auxologico Italiano IRCCS) and randomly allocated in the CBT or BST group. The primary end point is the global change of patients’ progress score (Outcome Questionnaire - OQ 45.2), while the secondary outcome measures are patients’ weekly binge episodes and weight loss. Data will be collected before and after hospitalization (after 1 month) as well as at 6, 12 and 18 months from the end of the in-hospital treatment. Data at follow-up time points will be collected through tele- sessions. ConclusionThe present study represents the first randomized controlled trial aimed at comparing the effectiveness of BST with the gold standard CBT. These findings will advance current knowledge in both treatment for BED and telecommunication providing distant clinical healthcare.

What Gregory Bateson's thought brought about Japanese brief therapy

What Gregory Bateson's thought brought about Japanese brief therapy

Antibiotic susceptibility of Brachyspira hyodysenteriae isolates from Czech swine farms: a 10-year follow-up study

Brachyspira hyodysenteriaeis the causative agent of swine dysentery. Loss of clinical efficacy of some antimicrobial agents authorized for treating swine dysentery was observed on certain Czech pig farms. The aim of the present study was to evaluate the antimicrobial sensitivity of six antibiotics using a set of 202 randomly selectedB. hyodysenteriaeisolates obtained from farms in the Czech Republic between years 1997 and 2006. Minimum inhibitory concentration of antibiotics tylosin, lincomycin, tylvalosin, chlortetracyclin, tiamulin and valnemulin were tested, using an agar dilution method. All antibiotics tested showed an increase in minimal inhibitory concentrations. Continual decrease in susceptibility of B. hyodysenteriaeisolates to tiamulin and valnemulin was observed. MultiresistantB. hyodysenteriaewere isolated more frequently in the past years. Only a careful use of antibiotics can ensure their efficacy, especially in case of pleuromutilins, in the strategic therapy of swine dysentery. This rare study demonstrates the minimal inhibitory concentration changes of selected antidysenterics among Czech isolates ofBrachyspira hyodysenteriaeduring a ten-year period.

Variation of Urate Transport in the Nephrons in Subtypes of Hyperuricemia

Background: Hyperuricemia cases (HU) can be classified into four subgroups by combining the two main causes of hyperuricemia, i.e. urate underexcretion and overproduction. These subgroups are as follows: underexcretion-type cases (UE); overproduction-type cases (OP); combined-type cases, and normal-type cases. Since urinary urate excretion (Uua) and urate clearance differ significantly between UE and OP, urate transport in the nephrons and the intratubular urate contents might also differ. Such differences might help clarify the pathophysiology of urate underexcretion in subgroups of hyperuricemia, and thus reveal its underlying mechanisms. Methods: Urate transport coefficients in each subtype of HU were determined employing the previously reported benzbromarone-loading urate clearance tests. The subtype cases of HU were plotted on a graph of urate transport coefficients versus Uua as coordinates. The characteristic features in the distribution of subtype cases on graphs were analyzed in relation to Uua. Results: The mean (±standard error) tubular secretion rate (TSR) in the UE (48.7 ± 1.7 ml/min) was significantly lower and the postsecretory urate reabsorption rate (R₂) in the UE (0.904 ± 0.004) was significantly higher than those in the normal controls (78.0 ± 2.1 ml/min and 0.877 ± 0.003) or the OP (61.1 ± 3.2 ml/min and 0.861 ± 0.009). Decrements of TSR and increments of R₂ in the UE were largest in the subtypes of the HU, in terms of case numbers and the deviation rate of the group. Conversely, decrements of TSR and increments of R₂ were smallest in the OP. A significant correlation was identified between TSR and Uua (r = 0.345, p < 0.0001), and a significant negative correlation was also found between R₂ and Uua (r = -0.393, p < 0.0001). Conclusion: In the UE, hyperuricemia is induced mainly by urate underexcretion, which results from the combination of two main causes in urate transporters of the nephron: significantly lower TSR and significantly higher R₂. Neither of these was observed in OP. Differences in urate transporters in subtypes of the HU might be important not only for understanding the pathophysiology and mechanisms of urate underexcretion and hyperuricemia, but also for providing a strategic therapy for hyperuricemia.

Training psychiatric nurses in solution-focused brief therapy: an evaluation of the training programme

Training psychiatric nurses in solution-focused brief therapy: an evaluation of the training programme

Brief Dynamic Therapy by Long-Term Therapists: An Easy Enhancement

Brief Dynamic Therapy by Long-Term Therapists: An Easy Enhancement

Expression of peroxiredoxins I and IV in multiple myeloma: association with immunoglobulin accumulation

B cell malignancies are classified according to the postulated differentiation stage of the originating cell. During differentiation, structural and molecular changes occur to support massive processing of immunoglobulin in the endoplasmic reticulum (ER) of plasma cells at the final stage. When overloaded, the ER generates unfolded proteins and hydrogen peroxide (H2O2), which may cause cell death. Peroxiredoxins (Prxs) I and IV belong to a family of proteins able to catalyze peroxide detoxification. Here, we investigated a potential association of these enzymes with immunoglobulin production in B cell neoplasms. Our results demonstrated that the expression of Prx IV was induced as cells became competent to synthesize immunoglobulin light chains, as observed by immunohistochemistry in tissue sections of B cell neoplasms and also by qPCR and Western blotting analyses in malignant B cell lines. Prx I was frequently highly expressed, indicating additional regulatory processes besides ER activity. Results obtained exclusively with myeloma cells have shown that expression of Prxs I and IV, both at mRNA and protein levels, was associated with light chain secretion quantified by ELISA. We suggest that Prxs I and IV may provide survival advantages for terminally differentiated neoplastic B cells by the elimination of H2O2 and, in the case of Prx IV, by the conversion of this toxic in a functional agent driving oxidative protein folding in the ER. In this sense, multiple myeloma and lymphomas demonstrated to synthesize immunoglobulin chains may benefit from strategic therapies targeting the adaptive pathway to ER stress, including inhibition of Prxs I and IV activity.

When the Bough Breaks: Rethinking Treatment Strategies for Perinatal Depression

Awareness of depression among OB-GYN physicians has increased with the result that more than 13% of pregnant women in the United States receive prescriptions for antidepressant medications. But the safety and effectiveness of these compounds has been exaggerated while the effectiveness of psychotherapy has been overlooked and distorted and various medical guidelines for treatment of perinatal depression have been downplayed or ignored. This article addresses the common fears and misconceptions surrounding treatment of depression during pregnancy and after childbirth. The effectiveness of strategic cognitive-behavioral therapy enhanced with hypnosis offers excellent results without the risks associated with these medications. Targets for focused intervention are identified and discussed.

Perspective of strategic plasma therapy for prognostic improvement of patients with ovarian cancer

ABSTRACTEpithelial ovarian carcinoma (EOC) is the leading cause of cancer-related death in women in Western countries. Once patients experience recurrence, complete cure is almost impossible. We elucidated the effect of nonequilibrium atmospheric pressure plasma on the growth of EOC, particularly in plasma-activated medium (PAM). Furthermore, we examined the role of reactive oxygen species (ROS) or their scavengers in chronic antineoplastic-resistant EOC cells. As a result, we showed PAM induced the antitumor effect of EOC cells in vitro and in vivo, even in chemoresistant cells. To apply the plasma treatment for advanced or recurrent EOC, we suggest adopting indirect plasma therapy instead of direct plasma considering intraperitoneal administration in the future. However, there are several problems under investigation, including intracellular mechanism of antitumor effect by PAM and adverse event in vivo.