Different Types Of Therapy Research Articles

The relationship between regional variations in blood flow and histology in a transplanted rat fibrosarcoma

The regional distribution of blood flow to the LBDS1 fibrosarcoma, transplanted into the subcutaneous site in rats, was investigated using the readily diffusible compound 14C-iodo-antipyrine (14C-IAP). Quantitative autoradiography was used to establish absolute values of specific blood flow F for 100 X 100 X 20 microns adjacent tissue volumes of the unperturbed tumour. Mean blood flow to whole tumours was found to decrease with increase in tumour size. This relationship was abolished if blood flow was only measured in sections cut from the periphery of the tumours. Detailed analysis of a sub-group of tumours showed that blood flow to individual tumours was heterogeneous. The range of blood flow was large, indicating that mean blood flow to a whole tumour is a poor reflection of the blood perfusion pattern of that tumour. Necrotic tumour regions were usually very poorly perfused. With the exception of the smallest tumours studied, blood flow was lower in the centre of tumours than in the periphery. Necrosis also tended to develop centrally. However, the peripheral to central gradient of blood flow was apparent even when densely cellular, viable tumour regions and necrotic regions were analysed separately. The decrease in blood flow with tumour size was also apparent in densely cellular, viable tumour regions when analysed separately. Qualitative comparison of tumour histology and regional blood flow showed that there were areas of very low blood flow associated with viable tumour regions. Less common were areas of rather high blood flow associated with necrotic tumour regions. A complicated relationship exists between tumour histology and blood flow. The quantitative autoradiography technique is suitable for investigating the most poorly perfused and the most well perfused viable fractions of animal tumours which may limit the efficacy of different types of therapy.

Object Relations Theory, Buddhism, and the Self

WHAT IS THIS STRANGE ENTITY known as the which is the object of investigation of most current psychoanalytic thinking? Object relations theory, ego, and self-psychology all suggest different concepts of the self, its development, and the developmental arrests leading to adult personality disorders. Each school presents different treatment modalities based on diagnostic and developmental considerations, as well as differing ideas about what cures in therapy. Other, non-analytic, therapies often avoid developmental issues, but have implicit or explicit models of the embedded somewhere in their theories. This same has also been a focal point of nearly 5,000 years of Eastern metaphysical and religious investigation. The Eastern effort emphasizes phenomenological investigations of the as present experience, followed by interpretations of that experience based on traditional metaphysical systems. The self's personal history and infantile origins are ignored. The Eastern approach lacks a clinical tradition as we know it, and self is often used to denote non-personal, special states of consciousness ordinarily regarded as mystical in the West. The Hindu has two levels: Jiva, or the individual soul, and Atman, its universal and spiritual aspect, the experience of which is found in enlightenment. Buddha denied that either existed, and maintained that the experience of Emptiness was the ultimate phenomenological substratum of both the and the world. Buddhism attempts a radical resolution to all psychological illnesses by ending their source, the self, and expanding consciousness towards an identification with all of reality. Efforts have been made to integrate these fundamentally different concepts of and their derivative therapies,' without a great deal of popular acceptance. Current transpersonal syntheses employ the notion of invariant stages of progressive ego development and suggest using different types of therapies for different levels of developmental arrest. This differs from psychoanalytic thinking only in the assumption of developmental stages far beyond the Oedipal stage (see table on pages 65-66). I will argue that an alternative synthesis, combining Eastern

Conditions for Psychotherapy with Schizophrenics Preliminary Lessons from the Danish Nips Project

Proposals for psychotherapy for schizophrenic patients (in the Danish part of the Nordic NIPS project) need a clarification of the conditions offered by the therapy. These conditions pertain to two different types of therapy: a ward-affiliated therapy and a private practice psychotherapy. Particular psychotherapies can then be described in accordance with patterns from each of the two types. The selected patterns are as follows: expressed desire for therapy; contract or free choice of therapist; payment; setting or mental space for therapy; duration of therapy; and frequency of sessions. It is argued that these external criteria can be used to delimit goals for therapy and to outline internal psychic transformations occurring during therapy.

The psychological treatment of tinnitus: An experimental evaluation

Disabling tinnitus in 27 patients was treated in an experimental setting with two different types of therapy aiming at the development of coping behaviour. One was focused on behavioural control procedures, while the other aimed at more cognitive control methods such as distraction. The results of the two forms of therapy were compared with each other and with observations of the untreated control subjects. Assessments of subjective loudness, discomfort from tinnitus and controllability were made on analogue scales and at a questionnaire follow-up. Psychoacoustic measures such as personal loudness units (PLU) were used in connection with these self-recordings and for evaluation of treatment effects. The results confirmed favourable reports on behavioural methods in tinnitus. However, no differences were found between therapies. The results are discussed in the light of the coping and adaptation theory.

Research on the results of psychotherapy: a summary of evidence.

The authors present a basic overview of recent research on the outcome of psychotherapy, considering different types of therapy and different diagnostic categories separately. In some studies psychotherapy was more efficacious than spontaneous remission or placebo effects, especially in cases of anxiety and in nonpsychotic depression. As an adjunct to drugs and/or ECT, psychotherapy was effective in lowering the relapse rate of schizophrenic outpatients. Psychotherapy appeared to be more effective when focusing on realistic, relevant issues and when teaching social skills. Family therapy may be the most robust mode in terms of consistent positive results with different problems. Although results continue to be mixed, methodological progress is apparent and optimism for continued progress is warranted.

Reproducibility of treadmill exercise in patients with intermittent claudication

The reproducibility of pain limited exercise time (ET) and heart rate (HR) have been evaluated in repeated treadmill exercise tests in 24 patients with arterial occlusive disease of the lower limbs and intermittent claudication. The protocol includes a walking speed of 1 m/s and load increments of 10 watt/min and the two tests were separated by 1--14 days. The total ET was systematically increased by about 30 sec (P less than 0.05) at the second exercise test. The reproducibility of ET at the onset of leg pains was 34%, whereas the corresponding value at maximal leg pain was 16%. HR at the termination of the test did not differ systematically between the two tests and the reproducibility of HR was 6.1% and 5.5% at the onset of pain and maximal pain, respectively. It is concluded that a slight improvement in walking capacity at a second exercise test must be taken into account when evaluating different types of therapy in patients with intermittent claudication and, furthermore, that ET, walking distance or work load, should preferably be evaluated at or near maximal leg pain.

Misfortune and Therapy among the Lisu of Northern Thailand

This article addresses the question, are sick people treated as they are? and proposes an answer in terms of the Lisu theory of misfortune. The author discusses the availability of different types of therapies and presents statistical data on the use of therapies and how they relate to the economic situations of households. He then asks why the theory of misfortune, in particular the notions of disease, diagnosis, and therapy, should take the form it does and develops an analysis in terms of Kuhn 's idea of paradigms.

CESSATION OF THERAPY IN CHILDHOOD LEUKEMIA. A SURVEY OF 160 CASES FROM THE NORDIC COUNTRIES

A report will be given on 160 children from the five Nordic countries who had their antileukemic therapy discontinued prior to November, 1976. Twenty-seven of the 160 cases (17 %) had suffered a relapse before May 1977. Sixty-nine had their therapy stopped in the first ten months of 1976. Thirty-five first line patients treated for more than 3 years, without cessation of therapy, are also included in the report. Different types of therapy have been used. Central nervous system or testicular relapse occurred in 21 of the total 44 cases who relapsed after three years or more of continuous remission, and whether they were on therapy or not. A further follow up on the 160 children and in another 50 cases off therapy will be presented. Cessation of therapy after three years of primary remission is now common in the Nordic countries and have even successfully been performed in a few cases after three or more years of secondary remission.

Cooperative Study of Hospital Frequency and Character of Transient Ischemic Attacks

Information was collected among six participating medical centers on the frequency of performance and the percentage of abnormality of 30 tests performed on patients with complaints suggesting transient ischemic attacks (TIAs). A number of these were commonly performed and commonly exhibited abnormalities. Although the diagnosis of TIA is made by history and physical examination, these tests were of value in aiding the physician to determine possible causes of TIA, to detect risk factors of associated conditions, to rule out alternative diagnoses, and to assess the patient's ability to tolerate different types of therapy. (<i>JAMA</i>239:2001-2003, 1978)

Cooperative study of hospital frequency and character of transient ischemic attacks

Information was collected among six participating medial centers on frequency of performance and the percentage of abnormality of 30 tests performed on patients with complaints suggesting transient ischemic attacks (TIAs). A number of these were commonly performed and commonly exhibited abnormalities. Although the diagnosis of TIA is made by history and physical examination, these tests were of value in aiding the physician to determine possible causes of TIA, to detect risk factors of associated conditions, to rule out alternative diagnoses, and to assess the patient's ability to tolerate different types of therapy.

CESSATION OF THERAPY IN CHILDHOOD LEUKEMIA. A SURVEY OF 155 CASES FROM THE NORDIC COUNTRIES

A report will be given on 155 children from the five Nordic countries who had their antileukemic therapy discontinued prior to November 1976. Twenty-seven (17 %) of the cases had suffered a relapse before Hay 1977. Sixty-seven had their therapy stopped in the first ten months of 1976. Thirty-three first line patients treated for more than 3 years, without cessation of therapy, are also included in the report, seventeen of whom relapsed while still on therapy.All cases have been reported as acute lymphocytic leukemia. Different types of therapy have been used.Central nervous system or testicular relapse occurred in 21 of the total 44 cases who relapsed after three years or more of continuous remission, and whether they were on therapy or not.

Mental health and the future

The application of modelling and technology could improve empirical theories of mental health. Biochemical indices, such as enzymes and catecholamines, may provide precise, pancultural stress standards. These indices will serve as adjuncts to clinical screening and will permit quantitative evaluation of different types of therapy. When used in conjunction with measures of the psychosocial environment, biochemical indicators may discern person-environment fit or mismatch. This technology could be designed for use on a large-scale. A likely outcome will be a greater emphasis on preventive health care: brief courses at home, school, and work are likely to improve the ability to cope with stress.

Effects of different types of therapy on the personality as a whole.

Effects of different types of therapy on the personality as a whole.

CONSIDERATIONS ON THE TREATMENT OF PROSTATIC CARCINOMA

A series of 163 cases of cancer if the prostate, observed at the National Cancer Institute of Milan, had an average age of 69.8 years. Stage I included 56 cases (34.4%); stage II 45 cases (27.6%); stage III 62 cases (38%). An analysis of the survival was made according to the different type of therapy adopted. Roentgen therapy did not improve the survival. No difference was observed between the survival of the cases treated with stylbestrol only, with stylbestrol associated with castration, or stylbestrol dipropionate. In the cases in which adrenalectomy was performed, a decrease of urinary 17-ketosteroids was noted, frequently without improvement of the clinical and urological condition. The best results were observed in the group which had castration before estrogen and T.A.C.E. therapy.

PROPOSED CODE OF CLASSIFICATION OF NEOPLASMS

A code for the statistical elaboration of tumors is presented. The code takes into consideration the data concerning the etiology and epidemiology of tumors, but gives the utmost importance to the gathering of the clinical and therapeutic data, and particularly of those suitable to evaluate the results obtained with different types of therapy.

Comparative series in evaluation of cancer therapy; a discussion of some statistical difficulties.

A group of patients with a disease such as cancer of the breast will contain some who would survive five years without any treatment and others who would die within five years despite any treatment. The presence of these has a serious effect on the chance of showing a difference between two methods of treatment. Controlled series in cancer therapy should be carefully chosen, otherwise equivalent results are likely to be obtained and real differences which are present may be obscured. This type of reasoning is applied to McWhirter's proposal that the overall survival rate is the crucial figure in judging methods of treatment for cancer of the breast. If one method of treatment is superior to another for one stage of the disease only, then this difference may be obscured if groups containing all the stages are compared. Yet staging as ordinarily practised is a crude device and tends to give fallacious answers. We suggest co-operation between treatment centres using different types of therapy to obtain detai...

Progress in physical medicine and rehabilitation.

The specialty of physical medicine and rehabilitation has made great strides during the past few years. The different types of therapy included in this field are not new; many of them are perhaps the oldest in the field of the healing art; however, in the past years these methods have been employed empirically or unwisely, often without materially helping the patient. More recently, through the efforts of many physiatrists, these measures have been utilized more effectively and. extensively. The physiatrist, too, has been responsible for arousing greater interest on the part of the profession in the different forms of therapy, whether in the specific agents, in the kinds of therapy included in occupational therapy, or in the use of all the principles now referred to as medical rehabilitation. Most of the best schools have established departments of physical medicine and rehabilitation with physiatrists in charge. This is an

BILIARY TRACT DISEASE IN THE AGED

MEDICAL care for the steadily increasing number of elderly persons becomes a greater problem each year. Definitive treatment is possible for more of the diseases of the aged, but their diminished reserve and decreased life expectancy cannot be disregarded in deciding on a therapeutic approach. A study of the dangers and results of treatment is therefore valuable. Investigation of patients beyond the age of 70 who had been operated on in the past three years at the Denver General Hospital showed that biliary tract disease ranked next to carcinoma of the stomach and colon in mortality and next to repair of hernias in frequency (Table 1). The records of all elderly patients treated for biliary tract disease by operative or nonoperative means were therefore reviewed to evaluate further this disease and its response to different types of therapy. The problems of geriatric surgery have received increasing attention, and the importance

Pruritus Ani

A REVIEW of the voluminous literature on the subject of anal pruritus reveals that nearly as many theories regarding the etiology of this condition have been advanced and methods of treatment advocated as there have been authors. Several conclusions might be taken from this. First, the final answer has not been written, and there may be several etiologic factors involved in many of the patients with this condition. Secondly, because so many preliminary good results have been reported following so many apparently different types of therapy directed primarily toward the perianal region, the treatment of the patient, in addition to . . .

THE MEDICAL TREATMENT OF HYPERTHYROIDISM

THE CONCEPTION that treatment of Graves' disease (1) is primarily surgical, is widespread despite the fact that American as well as European literature contains numerous reports of satisfactory results with non-surgical treatment in selected cases. It is undoubtedly true that since Plummer and Boothby (2, 3, 4) inaugurated routine preoperative iodine preparation, the prognosis of surgical procedures in Graves' disease has been markedly improved. It is also true that a high percentage of cures is obtained by subtotal thyroidectomy, but the results are by no means universal. Because of these operative failures, and because of those cases not amenable to surgery, it is the immediate concern of the internist, from a practical point of view, to continue his search for a satisfactory medical treatment. The mode of action of different types of therapy is still far too speculative to be discussed in this purely clinical paper, but one must admit that it is extremely difficult for patho-physiologists to comprehend...