Moderate Degree Of Improvement Research Articles

The Placebo Response in Double-Blind Randomised Trials Evaluating Regenerative Therapies for Parkinson's Disease: A Systematic Review and Meta-Analysis.

In the field of stem cell technologies, exciting advances are taking place leading to translational research to develop cell-based therapies which may replace dopamine releasing neurons lost in patients with Parkinson's disease (PD). A major influence on trial design has been the assumption that the use of sham operated comparator groups is required in the implementation of randomised double-blind trials to evaluate the placebo response and effects associated with the surgical implantation of cells. The aim of the present review is to identify the improvements in motor functioning and striatal dopamine release in patients with PD who have undergone sham surgery. Of the nine published trials, there was at the designated endpoints, a pooled average improvement of 4.3 units, with 95% confidence interval of 3.1 to 5.6 on the motor subscale of the Unified Parkinson's Disease Scale in the 'OFF' state. This effect size indicates a moderate degree of improvement in the motor functioning of the patients in the sham surgical arms of the trials. Four of the nine trials reported the results of 18F-Fluorodopa PET scans, indicating no improvements of dopaminergic nigrostriatal neurones following sham surgery. Therefore, while the initial randomised trials relying on the use of sham operated controls were justified on methodological grounds, we suggest that the analysis of the evidence generated by the completed and published trials indicates that placebo controlled trials are not necessary to advance and evaluate the safety and efficacy of emerging regenerative therapies for PD.

Efficacy of focused radiofrequency with ultrasound in body contouring: A study of 64 patients.

Energy-based devices are increasingly used for noninvasive body contouring. Our aim was to investigate the clinical efficacy of combined radiofrequency and ultrasound device for reduction in body circumference in various body parts. The aim of our study was to investigate the clinical efficacy of combined focused radiofrequency and ultrasound device for reduction in body circumference in various body parts. We aimed to report objective measurements in terms of circumference reduction and patient satisfaction scores. We retrospectively analyzed data of 64 patients who were treated with focused radiofrequency and ultrasound device during August 2017-December 2019. All patients had received 4 sessions at one-week interval. Body circumference measurements were done before treatment and one month after the last session. Patients were also asked to score their satisfaction with the result of treatment on a scale of 1 to 5. Abdomen was treated in 40 patients, thighs in 18 patients, and arms in 7 patients. One patient had received treatments to both abdomen and thighs. Circumference measurements in all body parts differed significantly between baseline and one month after the 4th session. Patients were satisfied with the result of treatment (score: 4.48±0.66). No adverse events were noted. Focused radiofrequency and ultrasound combination is a safe and effective treatment modality for body contouring. Patients should be informed about moderate degrees of improvement.

Hepatic ameliorative role of vitamin B17 against Ehrlich ascites carcinoma-induced liver toxicity.

Vitamin B17 (VB17), also known as amygdalin and laetrile, is a type of carbohydrate occurring naturally in many plants, such as apricot kernels which have obtained a great interest in cancer therapy. This study aimed to investigate the hepatic protective potential of VB17 against Ehrlich ascites carcinoma (EAC)-bearing mice-induced liver injury, DNA damage, apoptotic P53, and PCNA alterations. A total of 100 female mice were divided into 5 groups (1st group, control group; 2nd group, VB17 group; 3rd group, EAC group; 4th group, pre-treated EAC with VB17; 5th group, co-treated EAC with VB17). Results showed that the presence of VB17 in pre-treated and co-treated groups lead to decreased DNA damage, microsomal protein, NADPH cytochrome c reductase, alpha-fetoprotein (AFP), AST, ALT, and ALP while showed increased cytochrome b5, cytochrome P450 amidopyrine N-demethylase, and aniline 4-hydroxylase compared with the EAC group. Many histopathological changes were observed in liver sections in EAC as moderate fibrosis and marked diffuse necrosis of hepatic tissue, marked inflammatory cells, and congested blood sinusoids. On the other hand, there was a moderate degree of improvement in hepatocytes in liver sections in pre-treated VB17+EAC, while a mild degree of improvement in hepatocytes, moderate cellular infiltrations, and moderate cytoplasmic vacuolization of hepatocytes in liver sections in co-treated EAC+VB17. In addition, there was a depletion in hepatic P53 and PCNA protein expression compared with the EAC group. It could be concluded that VB17 has a potential hepatoprotective effect against EAC cell-induced liver toxicity.

The association between cognitive coping strategies and treatment outcomes in smokers with PTSD.

Numerous researchers have suggested that certain coping styles (e.g., maladaptive cognitive coping strategies) interfere with recovery from traumatic experiences and contribute to the onset/maintenance of posttraumatic stress disorder (PTSD). Further, given that individuals with PTSD have a high rate of smoking (e.g., Mahaffey et al., 2016) and that maladaptive coping strategies in general are associated with lower smoking quit rates, it is possible that use of maladaptive cognitive coping strategies are particularly problematic for the recovery of smokers with PTSD. The present study examined whether specific cognitive coping strategies are associated with poorer outcome among smokers with PTSD following an integrated treatment for both disorders. Patients with chronic PTSD and nicotine dependence (N = 142) received up to 12 sessions of smoking cessation counseling combined with varenicline or integrated prolonged exposure therapy and cessation counseling combined with varenicline. We hypothesized that greater maladaptive, and lower adaptive, cognitive coping strategies at baseline would moderate degree of improvement in smoking and PTSD outcomes through to follow-up. Multilevel modeling revealed that neither maladaptive nor adaptive cognitive coping strategies moderated smoking abstinence outcomes over the course of the study (ps ≥ .271). However, greater use of catastrophizing and lower use of positive reappraisal at baseline were associated with less improvement in the hyperarousal PTSD symptom cluster over the course of the study (ps ≤ .01). These findings suggest that maladaptive cognitive coping strategies are not necessarily a contraindication for overall outcomes in integrated PTSD and smoking treatment, although they may influence improvement in hyperarousal symptoms. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Use of Amitriptyline Cream in the Management of Entry Dyspareunia Due to Provoked Vestibulodynia

This study aimed to evaluate the effectiveness of topical amitriptyline 2% in sorbolene (cetomacrogol aqueous) cream in the management of patients with entry dyspareunia caused by provoked vestibulodynia. A prospective study of 150 patients presenting with entry dyspareunia to a private gynecologist (R.P.) was undertaken during a 12-month period. Provoked vestibulodynia was diagnosed by the presence of pinpoint tenderness confined to the vulvar vestibule. Most patients (102) had purely provoked vestibulodynia, whereas 48 had both provoked and unprovoked pain. There were 7 patients with grade 1 dyspareunia (intercourse always painful but only occasionally preventing penetration), 83 patients with grade 2 (intercourse always painful preventing penetration on most occasions), and 60 patients with grade 3 (apareunic). Questionnaires were evaluated before and 3 months after commencement of treatment. No control group using placebo was studied because of the private-practice setting. Duration of symptoms varied from 1 to 30 years, the mean being 4.7 years. There was no response in 66 patients (44%). Of these, 16 patients ceased treatment early because of local skin irritation and hence were regarded as treatment failures. The 84 patients (56%) that responded were divided into 3 groups as follows: (i) 25 with a slight but noticeable improvement; (ii) 44 with a moderate degree of improvement; and (iii) 15 with an excellent response, describing intercourse as comfortable and pain free (10% of the total study group). Most patients in all 3 groups elected to continue application of the cream after completion of the study. The response rate was similar (48%) in the subgroup that also had unprovoked vestibulodynia. There was no difference in the response rate according to parity. The response rate was also similar in patients who had previously taken oral amitriptyline unsuccessfully. In these 44 patients, the overall response rate was 59%. Topical amitriptyline cream should be considered for first-line treatment in the management of patients with provoked vestibulodynia causing entry dyspareunia. The response rate is reasonable (56%), and it eliminates the problems with systemic administration, namely, drowsiness and the difficulty patients have in accepting antidepressant medication for their condition.

Children's expectations and experiences of psychodynamic child psychotherapy

The aim of this study was to explore children's expectations and experiences of psychodynamic child psychotherapy. Semi-structured interviews were conducted using self-rating instruments, drawing materials and a selection of toys. Ten children aged 6–10 years were interviewed prior to and after treatment (mean number of sessions = 99). The main results showed that most of the children, despite their young age, had the ability to give clinically valuable accounts, verbally or non-verbally, of their problems. A majority of the children expressed positive hopes and expectations about their forthcoming therapy as well as regarding the experience of therapy as positive or very positive after termination. Self-ratings of change showed a moderate degree of improvement in their problems. Pre-treatment attitudes were linked with post-treatment self-ratings of improvement. The importance of preparing the child and the family for therapy and of listening to the children's experiences is highlighted.

BRITISH MILITARY INTELLIGENCE IN JAVA AND SUMATRA, 1945–46

In the period immediately after World War II, British-Indian forces occupied the Netherlands East Indies – modern Indonesia. The occupation bridged the gap between the surrender of Japan and the brief resumption of Dutch colonial rule which preceded Indonesian independence. Though intended as a humanitarian intervention, the occupation soon assumed the character of a guerrilla conflict. Indonesian nationalists perceived the occupation force as paving the way for a return of their colonial masters and made strenuous efforts at resistance. This article deals with a single theme of the occupation: intelligence. It charts the inadequate state of intelligence prior to the deployment of the occupation force in the East Indies and the moderate degree of improvement thereafter, setting this in the context of continuing anxieties, resulting in large part from the British colonial experience.

EVALUATION OF THERAPEUTIC FACTORS IN PHARMACOLOGIC SHOCK

1. Seven of 20, or 35 per cent, of a group of chronic schizophrenic patients were benefited by insulin to the point of social recovery or marked improvement, as compared with a 20 per cent spontaneous remission rate in a control group of 30 patients. 2. Coma was found to be essential for the production of improvement, its effectiveness being increased when combined with intensive resocialization activities. 3. Metrazol was only one-half as effective as insulin in chronic schizophrenia, but justified its use because of its greater ease of administration and lesser cost. In chronically disturbed patients its use frequently resulted in moderate degrees of improvement resulting in better ward adjustment. 4. Paranoid schizophrenia responded best to insulin; agitated catatonia to metrazol. 5. Neither the age of the patient nor the degree of hereditary taint could be correlated with the therapeutic responses. 6. In involutional melancholia and manic-depressive psychosis, depressed phase, metrazol treatment appea...