Kind Of Therapy Research Articles

Role of pediatricians in the diagnosis and therapy of dyslexia, dysgraphia and dyscalculia

Pediatricians play an important role in the diagnosis and therapy of children with dyslexia, dysgraphia or dyscalculia. These syndromes strongly affect children's school performance. Children with dyslexia, dysgraphia or dyscalculia show a significant underachievement in reading, writing or counting and their failure to meet the school requirements undermines their self confidence and positive self-concept. As a result, children with learning problems often become aggressive, frustrated or play the clown in the classroom. According to the Hungarian law children with any learning difficulties have the right to get special education by their specific symptoms. In the realisation of the law and equity the pediatrician's expertise is essential and has an important role in the therapeutical procedures. However, the pediatrician's role is more complex than writing an opinion. Pediatricians can help by giving a detailed description about these syndromes and explain them how they can help their child, what are the main difficulties during the child's studies, what kind of therapies can be efficient and how they can make their child's school years easier. During the assessment most of the parents ask the following questions: What does dyslexia, dyscalculia or dysgraphia exactly mean? Is it a handicap or a learning difficulty? Could the child live a normal life? With the proper answer and with an inclusive attitude pediatricians can help both the parents and the children to create a liveable lifestyle and make their children's schoolwork more successful. The authors' opinions are to close the medical and the pedagogical view, because without the cooperation of these two scientific fields, the theme affected parents, children and teachers cannot get proper help to find better solution and support for their problems. In the survey the authors intend to give a complex view about the symptoms of these syndromes and try to give useful advice for pediatricians how they can support their patients emphasizing the key role of pediatricians and clinical expertises in the early recognition and therapy.

Treating and preventing relapse of drug abuse by healthcare providers

였던 것으로 보인다. 미국에서도 의료인의 약물 오남용은 체 Drug abuse by healthcare providers is a serious public problem affecting not only the providers themselves but also their families, colleagues, and patients. It is not a new problem, but the medical community has historically been unwilling to accept and publicly acknowledge the problem, particularly a problem of its own members. Therefore, drug abuse by healthcare providers has either gone unnoticed or has been treated punitively, which has led to high prevalence and mortality. In South Korea, drug-abusing healthcare providers are considered criminals rather than patients. However, many studies have reported that punitive action alone is ineffective. This article describes the treatment principles, prognosis, and possibilities of returning to practice for drug-abusing healthcare providers. Early detection of drug abuse is key to subsequent treatment and prognosis. Furthermore, why relapse prevention as well as treatment is significant and which factors intensify the risk of relapse will be discussed. The use of opioids, coexisting psychiatric illness, and a family history of drug abuse are statistically significant factors. Finally, continuous and close monitoring is effective for relapse prevention, so it is considered another kind of therapy. An organized system for treating drug abuse is currently lacking in South Korea, not only for the general population but also for healthcare providers. In the future, a systematic approach and management by the medical community is necessary to resolve drug abuse by healthcare providers.

结直肠癌根治术后复发的再手术治疗

目的：本文通过对结直肠癌根治术后复发转移患者的最佳治疗方式的探讨，为临床选择合理治疗方案提供理论依据。方法：回顾性分析132例结直肠癌根治术后复发转移患者的临床资料，就其中不同的处理方式对预后的影响进行分析比较。结果：本组患者确诊复发后接受再手术治疗61例(46.2%)，保守治疗71例(53.8%)。再手术治疗患者的中位生存时间25.0月，3年、5年生存率分别为39.0%、26.7%，保守治疗患者的中位生存时间12.0月，3年、5年生存率分别为8.3%、0%，差异有统计学意义(2 = 19.690，P = 0.000)。再手术治疗患者中，再次根治性手术29例，其中位生存时间45个月，3年、5年生存率分别为53.6%、47.7%，姑息性手术32例，中位生存时间仅16.0月，3年、5年生存率分别为27.5%、10.7%，差异亦具有统计学意义(2 = 6.489，P = 0.011)。结论：结直肠癌根治术后复发转移的患者应积极争取再手术治疗，有助于延长生存期。 Objective: Investigating the most effective treatment for patients with relapsed colorectal cancer after radical resection and providing clinical evidence in choosing appropriate treatment protocol. Methods: One hundred and thirty-two patients with colorectal cancer developed recurrence after curative surgery with complete clinical and fol- low-up data were retrospectively analyzed and compared with in respect of different kinds of therapies and correspond- ing prognosis. Results: Of all the 132 patients confirmed relapsing, reoperation was performed on 61 patients (46.2%, reoperation group), and conservative treatment on 71 patients (53.8%, conservation group). Survival analysis revealed that the reoperation group acquired a 25.0-month of median survival time, and its 3-year and 5-year survival rates were 39.0% and 26.7%, respectively. The results of the reoperation group were much better than those of the conservation group, with which the indexes were 12.0 months, 8.3% and 0%, respectively (2 = 19.690, P = 0.000). In the reopera-tion group, 29 patients received radical resection, and they acquired a 45.0-month of median survival time, and its 3-year and 5-year survival rate were 53.6% and 47.7%, respectively. The other 32 patients received palliative surgery and acquired a 16.0-month of median survival time, and its 3-year and 5-year survival rate were 27.5% and 10.7%, re-spectively. The difference was significant (2 = 6.489, P = 0.011). Conclusion: Reoperation, especially radical surgery, is suggested for colorectal cancer patients developed recurrences after radical resection in that it is helpful to prolong the survival time of these patients.

In Practice: Music: a therapy for all?

Organizations like Making Music are calling for more music programmes to be set up, to not only be used as treatment for a wide range of conditions but as a part of everyday lifeMusic therapy, the use and act of making music to alleviate physical and mental symptoms, is becoming increasingly important for the wellbeing of both individuals and communities. With the cost of conventional treatments becoming ever harder to sustain, this kind of therapy could be a cost effective way of ensuring the wellbeing of individuals.Music therapy combines both art and science in the interest of wellbeing, and can be used to alleviate physical and mental symptoms, both disease specific like in the case of Alzheimer's disease and more general symptoms such as stress. Indeed the idea of using music as a healing aid is not a new one. Native Americans used drums in healing ceremonies and even doctors back in the time of Hippocrates were known to play music to patients suffering from mental symptoms. However with recent awareness campaigns by various organizations on silent or non-physical health conditions, research into the use of alternative therapies has become more common, and results so far indicate positive outcomes.When we listen to music many different parts of the brain are affected, which can lter or enhance our emotions. It is suggested that many benefits can be gained from adopting music as a form of therapy, including: improved memory and focus; decreased incidences of depression; increased levels of energy and selfesteem; and also help in improving a person's state of wellbeing and happiness.The use of music therapy is most popular in the treatment of conditions such as depression, Alzheimer's, Parkinson's and adolescent mood disorders. However it is perhaps in the case of Alzheimer's disease where music therapy can be particularly effective. Studies show that in many patients suffering from Alzheimer's, there are massive improvements to social behaviours with responses such as face recognition much improved. In one particular study by Sylvain Clement et al., which looked at both the short and long term effects that music therapy has on patients suffering from Alzheimer's, findings suggested that music had a greater effect in the long term on the patients' wellbeing than other tested activities, such as cooking.2One popular type of music therapy is melodic intonation therapy, which has been used by Harvard Professor Gottfried Schlaug to help stroke patients recover speech capability through singing. His work showed that throughout therapy, new brain connections are made and patients can begin to use their 'singing centre' instead of their damaged 'speech centre' in the brain to communicate. 3 As music therapy can help to improve mood and emotions, it is possible that it could also be used in combination with conventional treatments to help stroke victims in their recovery. …

Treatment efficacy of (153)Sm-EDTMP for painful bone metastasis.

Introduction:Involvement of the skeleton can cause an excruciating pain in two-thirds of terminal patients with a history of malignancy. Due to several limitations of other therapies, such as analgesics, bisphosphonates, chemotherapy, hormonal therapy and external beam radiotherapy; bone-seeking radiopharmaceuticals have an important role in palliation of pain from bone metastases. Although these kinds of therapies have many advantages including the ability to treat multiple sites of tumoral involvement simultaneously, no significant confliction with other treatments, ease of administration and the potential to be used repetitively; in Iran using of this modality is not widely practiced. In this study we evaluated the clinical usefulness of Sm-153 lexidronamfor pain management of bone metastases.Methods:28 patients (14 males and 14 females) aged 38-77 years with a history of painful bone metastases caused by different cancers, not responding to conventional treatments were included in the study. All patients had a recent whole body bone scan indicating multiple bone metastases. 1 mCi/Kg Sm-153 lexidronam was injected intravenously to the patients. Whole body scintigraphy was done 3 or 18 hours post injection. Pain relief and quality of life have been evaluated by analog pain scale and Karnofsky index every week, respectively. Also, all patients were evaluated for hematological toxicity every two weeks. Active follow ups were performed.Results:43% of patients showed the presence of the flare phenomenon during the first three days after Sm injection with a mean duration of 2.2 days. The pain relief began between 2 and 16 days post injection and the duration of pain palliation was in the range of 4 to 32 weeks (mean±SD=15.22±7.8). 64.3% of patients showed complete relief of pain and 21.4% achieved partial response to therapy. (Over all response to therapy was 85.7%). The lowest amount of peripheral blood cells was detected in the fourth week for RBCs and in the 6th week for WBCs and PLTs. No one experienced hematological toxicity induced problems.Conclusion:Sm-153 lexidronam is an effective treatment for painful bone metastases. The complication rate is low and the quality of life of the patients after treatment would be significantly improved.

Decayed, Missing, and Filled Teeth Index and Periodontal Health in Osteoporotic Patients Affected by BRONJ: An Observational Study.

The aim of this paper is to describe the incidence of decayed, missing, and filled teeth (DMFT) and periodontal disease in 32 osteoporotic patients affected by bisphosphonate-related osteonecrosis of the jaw (BRONJ). Moreover, an investigation between the obtained data and 20 patients treated with bisphosphonate drugs and with no evidence of ONJ has been performed. Osteonecrosis of the jaws is a rare complication in a subset of patients receiving bisphosphonate drugs. Based on a growing number of case reports and institutional reviews, this kind of therapy can cause exposed and necrotic bone specifically in the jawbones. From April 2009 to June 2012, 32 osteoporotic patients treated with oral or intravenous (I.V.) bisphosphonates have been recorded. The patients' oral health has been compared with 20 bisphosphonates patients with no ONJ. The incidence of decayed, missing, and filled teeth (DMFT) and periodontal disease was recorded in all patients and student's t-test was applied for comparing the two investigated groups data. Data demonstrated how the poor dental hygiene and periodontal disease of the BRONJ patients' are connected with the occurrence of jawbone necrosis.

Magic in the Russian Marketplace: Creating Trust

Focussing on a commercial magic specialist (mag) well-known in Petersburg today, the article examines the strategies adopted by her and others to gain the confidence of their clientele. It opens by examining the levels of social trust in Russia, arguing that distrust and feelings of defenselessness encourage a sizeable proportion of Russians with the traditional view that problems are externally generated, to think of turning for help to magic practitioners. With magic services derided in the media and condemned by the Church, the magic specialist NPP must counter this negative image as well as promote her services above those of her competitors. Whereas in 2006 she relied on press advertising and recommendation by satisfied customers, in 2012 her main promotional tool is her website. The article examines the specific ways in which she tackles the creation of a trustworthy image. Since magic services offer a kind of therapy, another aspect examined in detail is the relationship with psychology and psychotherapy. It is suggested that from the early 1990s to around 2005 magic specialists sought to hijack psychotherapy, but that more recently links have been played down as magic practitioners define their potential clientele more clearly. The article offers reasons for this, and speculates on future developments.

When Should Rehabilitation Begin after Stroke?

Early rehabilitation is widely regarded as an important feature of effective stroke care. But what is 'early', and what kinds of therapies should, or can, we begin soon after stroke onset? In this commentary, some of the barriers and drivers for early rehabilitation research and practice are explored.

Effectiveness of Sand Tray Short Term Group Therapy with Grieving Youth

Losing a beloved person with whom one is deeply involved is like falling into an abyss of infinity leading to an undesirable feeling which in turn may cause mourning. The grief reactions differ from person to person depending on the circumstances of the occurred calamities, religious, social and cultural beliefs and in general the perceived meaning of the death for the bereaved. Adolescents are one of the vulnerable groups in facing the loss. Belongingness during adolescence is of an essence, as the adolescent seeks to shape ego identity in oneself. The grief process may nullify the personal assumptions regarding the world (spiritual assimilation), relations with others, and personal identity (inner world). Hence, it is indispensable to provide interventions for healing the wounds stemming from the loss. Among various approaches, play therapy is one of the best treatments for grief in the juveniles. Play therapy is the process of making conscious and verbalization of the unconscious and the nonverbal issues. Sand tray therapy is a sort of play therapy which provides people an opportunity to express themselves in a creative and nonverbal way. Currently this kind of therapy is considered as an effective method to work with children and adolescents. However, despite the high rate of mortality in Iran. there is not enough research conducted in this regard. In light of the great significance of cultural differences in the resolution of grief, it is essential to evaluate a variety of theories effective in resolving this process. on the other hand grief will change person‘s inner world, attitude, percept and the outer world. indeed dynamics of individual and social life survivors’ will be changed. Hence in this research will be studied Appraisal of effectiveness of sand tray Short term group therapy with grieving youth. For this purpose 20 person who had lost a close family member in the last two years were selected as the participations in the study through purposive sampling and then randomly placed in a control and an experimental group of 10 person each. first, as a pre- test, participation filled out the Grief Experience Inventory. The experimental group as intervention received 90minute twice in a week sand tray therapy sessions for six weeks. The control group was did not receive any intervention. All the test was again administrated on both groups upon termination of interventions. The data analysis was carried out using descriptive statistic and Mixed ANOVA. Results show that the mean values of experimental group on GEQ-34 and its subscales of search for somatic reaction, guilt feeling, and rejection feeling were reduced significantly on post test. So Sand Tray Short Term Group Therapy seem to be an effective and useful technique in reducing intensity of grief experience among adolescent; this is afforded through providing safe environment for modeling loss coping skills and making emotional catharsis possible.

5thAnnual Symposium on Self-Monitoring of Blood Glucose (SMBG) Applications and Beyond, May 3–5, 2012, Dublin, Ireland

International experts in the fields of diabetes, diabetes technology, endocrinology, and pediatrics gathered for the 5th Annual Symposium on Self-Monitoring of Blood Glucose (SMBG) Applications and Beyond. The aim of this meeting was to continue setting up a global network of experts in this field and provide an international platform for exchange of ideas to improve life for people with diabetes. In line with previous editions, the 2012 meeting comprised a comprehensive scientific program, parallel interactive workshops, pros and cons debates, and a keynote. All these discussions were intended to help identifying gaps and areas where further scientific work and clinical studies are needed.

Treatment costs of attention deficit hyperactivity disorder in Germany

Attention deficit hyperactivity disorder (ADHD) is one of the most common behavioural disorders among children and adolescents. The number of patients as well as prescriptions to treat this disease has continuously increased over the past few years. The aim of the present study was to analyse the costs for treating ADHD patients from the perspective of a major German health insurance fund. Anonymised administrative claims data were available for the study. All services reimbursed by the health fund for the selected ADHD patients were recorded. Apart from the resource use attributed directly to ADHD, co-morbidities as well as incremental costs were described based on a control group design. A total of 30,264 ADHD patients were diagnosed in 2008. The total costs for these patients were euro 3,888, and the incremental costs were euro 2,902. The largest proportions of incremental costs were due to therapeutic devices and remedies like occupational therapy amounting to euro 1,270. Proportionate costs of euro 263 have been settled for pharmacotherapy with Methylphenidate and Atomoxetine. However, 41% of the patients were not treated with ADHD-related pharmaceuticals. ADHD costs are relevant from health insurance perspective. The expenses for occupational therapy constitute the cost driver. Compared to the findings of studies from the United States and contrarily to the backdrop of public discussions about considerably increased prescriptions of ADHD-specific drugs, the significantly higher additional expenses for occupational therapy services are impressing. This kind of therapy is internationally rather unknown and is therefore not acknowledged as a therapeutic standard.

Extrakorporale Gasaustauschverfahren

In recent years the range of products for extracorporeal lung support has substantially expanded. In principle systems generating high blood flow and thus enabling oxygenation and decarboxylation, corresponding to classical extracorporeal membrane oxygenation (ECMO), can be distinguished from low-flow systems, enabling decarboxylation only. Technical progress and new data have led to a novel insight into the role of ECMO as an invasive, ultimate therapy in refractory life-threatening lung failure towards a broader range of applications even in spontaneously breathing and awake patients. Indications for extracorporeal decarboxylation, initially thought to enable most protective ventilator settings, have been extended to forms of hypercapnic lung failure and towards avoidance of intubation and mechanical ventilation itself in patients with isolated hypercapnia and failure of non-invasive ventilation. It has to be emphasized however, that due to a still sparse amount of literature and potentially deleterious complications associated with extracorporeal lung support, these kinds of therapies should be reserved for specialized and experienced centers.

Traumatic Tympanic Membrane Perforations

To obtain clinical and audiometric findings in traumatic tympanic membrane perforations from a typical patient collective in a Western industrial nation because the appropriate data have an important relevance in medicolegal questions. Retrospective data collection. Germany's largest university clinic for otorhinolaryngology, head and neck surgery. From the medical records of 198 patients with traumatic tympanic membrane perforations, the following data were collected: demographic data, date and mechanism of the trauma, otoscopic findings and collateral injuries, kind of therapy and its results, pure tone audiometry, and statement of tinnitus or vertigo in the course. Most patients were young (mean age, 29.2 yr) and male (62%). Men and women are equally represented in perforations resulting from a physical blow to the ear (44.7% vs 46.7%); a collision was more often the cause in men (23.6% vs 14.7%), whereas an accidental perforation by insertion of a cotton bud was approximately 2 times more common on women (13.8% vs 25.3%). The left ear was more often affected than the right ear (58.5% vs 41.5%). Collateral damage was found in only 1% of the cases. In blows, collisions, barotraumas, and the insertion of sharp objects, the inferior parts of the tympanic membrane were most often affected; the most severe (subtotal) perforations were caused by explosions, weld beads, and insertion of cotton buds. For therapy, myringoplasty had an overall success rate of 88.9%; splinting with silicon foils, 51.6%; and "no therapy," 53.3%. Bone conduction thresholds for the affected ear were higher in low, middle, and high frequencies compared with the contralateral ear by trend, but a statistical difference was only found in the high frequencies. In follow-up examinations, the hearing thresholds in the high frequencies were no longer significantly different. A "c dip" or "fis dip" was found in 18.0% and 9.2%. Tinnitus and vertigo were reported in 30.8 and 8.1%, respectively, but only in 2.0% and 0% during follow-up. High-frequency hearing loss, tinnitus, and vertigo in traumatic tympanic membrane perforations have a good prognosis.

Putative Biological Mechanisms of Efficiency of Substrate Reduction Therapies for Mucopolysaccharidoses

Mucopolysaccharidoses (MPS) are inherited metabolic diseases caused by mutations in genes coding for lysosomal enzymes involved in the degradation of glycosaminoglycans (GAGs). Dysfunction of any of these enzymes results in the accumulation of GAGs, which leads to severe clinical symptoms and significantly shortened life span. Several kinds of therapies have been proposed to treat MPS, including bone marrow or stem cell transplantation, enzyme replacement therapy, and gene therapy. Another option is substrate reduction therapy (SRT), in which synthesis of GAGs is inhibited. Recent studies employing in vitro and animal models suggested that this therapy may be efficient in decreasing levels of GAGs in MPS cells, including those bearing two null alleles of the affected gene. Results of behavioral tests in animals as well as some preliminary clinical observations with pediatric patients corroborated the suggestions about possible efficacy of SRT in MPS treatment, including brain functions. Efficient reduction of GAG levels in MPS cells homozygous for null mutations may be intriguing in the commonly accepted scheme of SRT mode of action. In this paper, we propose an explanation of this phenomenon, based on already known facts. Thus, we suggest that SRT may lead to reduction of GAG levels in MPS cells due to inhibition of efficiency of GAG synthesis combined with (a) any readthrough of the stop codon, (b) dilution of already accumulated GAGs due to cell growth followed by cell divisions, and (c) action of endoglycosidases degrading GAGs, e.g., heparanase, in combination with functional GAG-specific hydrolases.

The role of second generation antipsychotics in autism disorder

EG is a 9-year old boy who is brought to clinic for evaluation; he is accompanied by his father who appears distressed. He apologizes for being late to the appointment, but he states that he had a hard time getting EG to leave the house because he would not stop playing with his Yu-gi-oh cards. When dad tried to take the cards away, EG became angry, began to cry loudly, and started to hit himself and his dad. Dad says this is common behavior for the past few years and now that he is getting older they are worried that he could hurt himself or others. He displays these behaviors both at home and at school with his teachers and therapists.

Is there any association between impaired health-related quality of life and non-adherence to medical therapy in inflammatory bowel disease?

Objectives.Inflammatory bowel diseases (IBD) have a huge impact on the patients' lives and require continuous medication and long-term medical follow-up. The Short Form Health Survey (SF-36) is a commonly used questionnaire measuring health-related quality of life (HRQOL). Our aim was to evaluate whether HRQOL influences medication adherence and vice versa in IBD patients, and to find relationships between demographic parameters, therapeutic modalities and non-adherence or HRQOL. Patients and methods.Five hundred ninety-two IBD patients treated at six Hungarian tertiary centers were enrolled. Patients completed the SF-36 questionnaire and a medication adherence report scale during their visits. The associations between demographic parameters, HRQOL, different kinds of therapies and non-adherence were analyzed. Results.The most affected dimension was physical functioning and least affected were the social functions. About 42.7% of the patients revealed their HRQOL to be acceptable. About 74.6% of the patients believed that the prescribed medications actually improved their HRQOL. Diarrhea was the most common and most severe symptom during the course of the disease. Non-adherence was reported in 13.4% of the patients. ‘Forgetting to take the medication' was the main reason for non-adherence in 67.6% of the cases. Medication adherence was significantly higher among nonsmoker patients, and also in the case of immunomodulator therapy. There was no association between the sum of HRQOL and different subscores and non-adherence. Conclusion.Inflammatory bowel disease is associated with low HRQOL, which is not affected by drug therapy. The impaired quality of life in IBD is mainly influenced by the disease itself.

Terapias cognitivo-conductuales de tercera generación (TTG): la atención plena / mindfulness

La intención del presente trabajo es reseñar el tratamiento basado en la atención plena,también conocida como Mindfulness, el cual es una de las llamadas terapias cognitivo-conductuales de tercera generación (TTG). Las aportaciones de las TTG se aprecian en las terapias concretas que la constituyen, las cuales tienen como principio terapéutico el abandono de la lucha contra los síntomas y en su lugar la reorientación de la vida.Recientemente las TTG han comenzado a estudiarse en las principales universidades del mundo, así como a ser utilizadas de manera satisfactoria en diversos escenarios clínicos yen diversos países occidentales. Este tipo de terapia también ha comenzado a ser evaluada en Latino América, sin embargo su introducción en el ámbito clínico y académico ha sido más lento, quizá debido a que los principios generales de la atención plena aún no han sido suficientemente difundidos. Este trabajo recapitula las bases de las TTG y expone los principales preceptos budistas en los que se encuentra fundada la atención plena, siendo su objetivo principal el describir esta aproximación terapéutica y recapitular el estado actual de las investigaciones desarrolladas hasta el momento.

Psychotherapeutic follow up of out patients with traumatic brain injury: Preliminary results of an individual neurosystemic approach

Psychotherapy for affective/behaviour disorders after traumatic brain injury (TBI) remains complex and controversial. The neuro-systemic approach aims at broadening the scope in order to look at behaviour impairments in context of both patient's cognitive impairments and family dysfunctioning. To report a preliminary report of a neuro-systemic psychotherapy for patients with TBI. All patients with affective/behaviour disorders referred to the same physician experienced in the neuro-systemic approach were consecutively included from 2003 to 2007. We performed a retrospective analysis of an at least 1-year psychotherapy regarding the evolution of the following symptoms: depressive mood, anxiety, bipolar impairment, psychosis, hostility, apathy, loss of control, and addictive behaviours as defined by the DSM IV. Results were considered very good when all impairments resolved, good when at least one symptom resolved, medium when at least one symptom improved, and bad when no improvement occurred, or the patient stopped the therapy by himself. Forty-seven patients, 35 men and 12 women, with a mean age of 33.4 years, were included. Most suffered a severe TBI (mean Glasgow coma score: 6.4) 11 years on average before the inclusion. At the date of the study, 11 patients (23%) had a poor outcome, 23 (48%) suffered Moderate disability and 13 (27%) had a Good recovery on the GOS scale. All therapy sessions were performed by the same physician, with 10 sessions on average during 13.5 months. Results were classified very good in six cases (13%), good in 18 others (38%), medium in 10 patients (21%) and bad in 13 cases (27%). We observed a significant improvement of affective disorders, namely anxiety (P<0.001) depressive mood (P<0.001) and hostility (P<0.01). However, bipolar symptomatology, apathy, loss of control and addictive disorders did not improve. From our best knowledge, this is the first clinical report of neuro-systemic psychotherapy for affective/behaviour disturbances in TBI patients. This kind of therapy was shown to be feasible, with a high rate of compliance (72%). Psycho-affective disorders and hostility were shown to be more sensitive to therapy than other behaviour impairments. These preliminary findings have to be confirmed by prospective trials on broader samples of patients.

P-0127 Study on 34 Cases with Primary Malignant Gastric Lymphoma

ABSTRACT Introduction Primary malignant gastrointestinal lymphoma accounts for 1-4% of malignant gastrointestinal tumors and approx. 10% of all malignant lymphomas, while primary malignant gastric lymphoma accounts for the highest percentage (65%) of primary malignant gastrointestinal lymphomas. Herein, we report the results of our study on 34 patients with primary malignant gastric lymphoma. Methods In the case that gastric malignant lymphoma was diagnosed in our hospital by 1988 from 2010, we find 34 cases of primary gastric malignant lymphoma. So we reviewed and reported about age, gender, kind of therapy, clinical income and prognosis. Results The male/female ratio was 22:13, and the median age was 60 years old. They were diagnosed based on endoscopic examination (31 patients), resected specimen (2), and no clear data (1). The tissue type was indolent lymphoma (8 patients), aggressive lymphoma (21), and unclear (5), and the number of cases with DLBCL was the highest. As the clinical disease stage, Lugano international disease stage classification I was confirmed in 16 patients, II in 9, IIE in 1, IV in 4, and unclear in 4. For the treatment, single surgical treatment was provided to 4 patients, surgery+chemotherapy to 15, single chemotherapy to 9, surgery+chemotherapy+radiotherapy to 1, chemotherapy+radiotherapy to 1, sterile filtration to 1, and 3 were untreated. As for the therapeutic effect, CR was confirmed in 23 patients, PR in 2, NC/PD in 6, and unclear in 3. Conclusion For malignant gastrointestinal lymphoma, surgery has traditionally been performed as the first-line treatment in the limited stage, and thus surgical treatment was performed for many of the subjects of our study who were diagnosed in the 1980s to 90s. In recent years, however, favorable prognoses have been observed because of the increasing usefulness of chemotherapy, radiotherapy, and sterile filtration for MALT lymphoma, and the general selection of gastric conservation therapy. The benefits of surgical treatment include decreased tumor amount by resection of local and regional lymph nodes, and more accurate diagnosis of the disease stage. However, we consider that the disadvantages of the majority of the recent therapies can be avoided by performing endoscopic examination and improving diagnostic imaging.

Abstract 3582: Genetic polymorphisms in NAT2 gene influence overall survival in bladder cancer patients

Abstract Aromatic amines are involved in the etiology of bladder cancer and these compounds are acetylated by N-acetyltransferase 1 (NAT1) and 2 (NAT2). Epidemiological studies have shown that the slow NAT2 acetylator phenotype is associated with increased risk of bladder cancer. Although several studies have shown an association between bladder cancer risk and SNPs in NAT2, the impact on survival has not been established. Because SNPs are innate characteristics of individuals, we hypothesize that their presence could have an effect even after tumor resection and, thus, be useful as prognostic markers. In order to investigate this possibility, we examined 5 SNPs in NAT2 gene (rs1041983, rs1801280, rs1799931, rs1495741, rs12545528) and investigated their impact on overall survival (OS). The study population comprised the cohort of new histologically confirmed cases of bladder cancers treated in the urology departments of the S. Giovanni Battista Hospital in Turin. Vital status ascertainment was carried out through linkage with the local town offices. Blood samples and questionnaires of 331 subjects were collected before therapy. White blood cell DNA was purified from stored blood samples. Polymorphic sites were genotyped by 5′Nuclease assay (TaqMan) with fluorogenic Minor Groove Binder probes. Subjects’ phenotype was estimated using a standard approach based on the combination of two polymorphisms: rs1041983 and rs1801280; we also estimated phenotype from SNP rs1495741 (Garcia-Closas et al. 2011). For each SNP we calculated crude and adjusted (by age, stage, grading and therapy) Hazard Ratios (HR) and the corresponding 95% Confidence Interval (95% CI) using the Cox proportional-hazard regression model for the co-dominant and per-allele model. Stratified analyses by kind of therapy and tumour type were also performed. We computed the phase of the haplotype using PHASE 2.1: for each haplotype we computed HR, comparing subjects carrying 2, 1 or 0 copies of the same haplotype. The rs1799931 and the rs1801280 variant alleles, which lead to reduced N-acetyltransferase activity and/or reduced protein stability, were significantly associated with a decreased OS (HR: 4.54; 95% CI: 1,78-11,61 and HR: 1.43; 95% CI: 1,04-1,96 adjusted per allele model, respectively); in contrast variant alleles of SNPs which do not seem to modify the protein activity (rs12545528 non-coding and rs1041983 silent) were significantly associated with an increased OS (HR: 0.68; 95% CI: 0,49-0,96 and HR: 0.58; 95% CI: 0,40-0,85 per allele model, respectively). Similar observations were made when the cases were stratified into papillary and non-papillary tumours or stratified by kind of therapy. Haplotype analysis confirmed the results described above not providing any other indication. In conclusion, NAT2 rs1799931 and rs1801280 functional SNPs can be considered as potential prognostic factors for the survival of patients with bladder cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3582. doi:1538-7445.AM2012-3582