Rational Therapy Research Articles

Pathogenetic relationship of microbiome and metabolic disorders on the background of hypertension and gout: Potential targets of pharmacotherapy

Cardiometabolic diseases are one of the urgent problems of modern medicine. Currently, much attention is being paid to the study of the common pathogenesis of diabetes mellitus, gout and hypertension. One of the pharmacological targets is the correction of the intestinal microbiome and dysbiosis, as an integral link in the development of systemic inflammation and endotoxinemia, leading to the development of these pathologies. The article presents the results of scientific research devoted to the study of the effect of the intestinal microbiome on the development of cardiometabolic diseases. The main goal of the research is to find a rational pharmacological therapy of intestinal dysbiosis for the treatment of comorbid patients. It has been proved that, together with standard drug therapy, taking into account the pathogenetic features of the development of cardiometabolic diseases, it is advisable to use drugs that affect the intestinal microbiome. The main classical approach is the use of probiotic drugs containing live bacteria. The use of probiotics in combination with probiotic drugs to support the growth of intestinal normoflora has become a promising direction. However, this approach requires a long period of correction of the microflora, which prompted the idea of using postbiotics – signaling molecules – products of the vital activity of the microflora for a more targeted and rapid effect on pathological processes, both in the intestine and on the organ system as a whole. This approach promotes the beginning of the development of synbiotics, a complex of microorganisms, growth factors and metabolites that made it possible to more effectively influence on dysbiotic processes in various pathologies, including dyslipidemia and cardiovascular diseases. Correction of intestinal barrier permeability disorders will help prevent the development of systemic complications associated with chronic pathologies. The article also presents the author’s scheme of the pathogenesis of cardiometabolic diseases, based on the study of current scientific research.

Evaluating the impact of rational emotive behavior therapy on post-traumatic stress in farmers with experiences of natural disaster.

This study was necessary due to the increasing number of cases of natural disasters such as flood, air pollution, erosion, etc in Nigeria, particularly in the Abia state, as well as the accompanying psychological and health issues affecting individuals within families and society as a whole. The study aimed to examine the impact of rational emotive behavior therapy on farmers' post-traumatic stress (PTS) in Abia State, Nigeria. A randomized control trial was conducted in Abia state, with a sample size of 118 farmers with experiences of natural disasters. Two assessments were conducted before the treatment, immediately after the treatment, and 2 months later to evaluate PTS and irrational beliefs among the farmers. The treatment involved a self-developed PTS-focused rational emotive behavior therapy manual, consisting of 12 sessions lasting 60 minutes each, delivered by counseling psychologists trained in rational emotive behavior and family therapies. Data from the pretest, posttest, and follow-up test were analyzed using chi-square, percentage, partial eta squared, and analysis of covariance statistical tools. The results showed no significant gender differences in the socioeconomic status, employment, and debt status of the participants. The rational emotive behavior therapy was effective in reducing PTS caused by the flood among farmers. Gender did not have a significant moderating effect on farmers' experiences with PTS. The study suggested that family health specialists and rational-emotive therapists collaborate with local authorities to provide career counseling services to farmers and establish community-based rational emotive institutes in each state of Nigeria.

Asthmatic status in pediatric practice in patients with mild bronchial asthma

The main principle of the treatment of bronchial asthma is rational basic therapy, with priority appointment of inhaled glucocorticosteroids. The basis of the effectiveness of treatment is determined by the correct choice of the form of drug delivery, training the patient in inhalation skills and constant monitoring of the correct use of the inhaler. The article demonstrates the clinical observation of the formation of asthmatic status in a child with mild bronchial asthma. The deterioration of the condition and severe exacerbation was caused by insufficient intake of basic therapy funds into the respiratory tract due to improper inhalation techniques due to the patient's lack of skills in using an inhaler. At the same time, the patient was not trained and the necessary control over the correctness of the inhalation technique was not carried out at the outpatient stage.

Psychotherapeutic burnout interventions-an umbrella review

Although burnout is not an F‑Diagnosis in the ICD-11, many people are suffering from it. This has many economic and health-related consequences, because burnout is closely tied to an inability to work and significant secondary illnesses. This article provides an umbrella review of therapy approaches for burnout that have already been used and evaluated and shows in which areas there are promising, but still little researched, therapeutic support options for those affected. A systematic literature search of studies was carried out in PubMed and Google Scholar between 2010 and 2024. The search terms were "burnout," "therapy," and "intervention" combined with "systematic review" and "meta-analysis." Overall, 10systematic reviews or meta-analyses met the inclusion criteria. In fivesystematic reviews or meta-analyses, the therapy approaches focused on a specific professional group (nurses, doctors, and teachers); the others related to students or various groups of people. In sevenstudies, the effects of mindfulness-based stress reduction on burnout were shown. The effects of cognitive behavioral therapy (CBT) were shown in fourstudies. Acceptance and commitment-therapy (ACT) as well as rational emotive therapy (RET) also proved to be effective. It still needs to be researched whether established thinking and behavioral patterns can be changed through the therapies discussed. The professional context should be given more attention. Some resource-oriented approaches like optimism, a sense of control, self-efficacy, and self-acceptance seem promising in the treatment of burnout.

Acute respiratory viral infections: Consensus on rational therapy

There are diseases for which people turn to specific specialists, but there are also a number of ones that are treated by doctors of different specialties. Therapists, infectious disease specialists, otolaryngologists, and pulmonologists diagnose and treat acute respiratory viral infections. But the same specialists often have to deal with the outcomes of an acute process – postnasal drip and post-infectious cough, which decreases the quality of life and exhaust patients. However, in case when the correct diagnosis is made, there are treatment regimens that allow to achieve quick relieve subjective and objective symptoms, as well as clinical cure of the disease escaping the use of antibacterial therapy. The efficient therapy agreement of the otolaryngologist and pulmonologist is that for various causes of cough, herbal medicine is the best choice.

Potential Nephroprotective Effect of uPA against Ischemia/Reperfusion-Induced Acute Kidney Injury in αMUPA Mice and HEK-293 Cells.

Background/Objectives: The incidence of acute kidney injury (AKI) has been steadily increasing. Despite its high prevalence, there is no pathogenetically rational therapy for AKI. This deficiency stems from the poor understanding of the pathogenesis of AKI. Renal ischemia/hypoxia is one of the leading causes of clinical AKI. This study investigates whether αMUPA mice, overexpressing the urokinase plasminogen activator (uPA) gene are protected against ischemic AKI, thus unraveling a potential renal damage treatment target. Methods: We utilized an in vivo model of I/R-induced AKI in αMUPA mice and in vitro experiments of uPA-treated HEK-293 cells. We evaluated renal injury markers, histological changes, mRNA expression of inflammatory, apoptotic, and autophagy markers, as compared with wild-type animals. Results: the αMUPA mice exhibited less renal injury post-AKI, as was evident by lower SCr, BUN, and renal NGAL and KIM-1 along attenuated adverse histological alterations. Notably, the αMUPA mice exhibited decreased levels pro-inflammatory, fibrotic, apoptotic, and autophagy markers like TGF-β, IL-6, STAT3, IKB, MAPK, Caspase-3, and LC3. By contrast, ACE-2, p-eNOS, and PGC1α were higher in the kidneys of the αMUPA mice. In vitro results of the uPA-treated HEK-293 cells mirrored the in vivo findings. Conclusions: These results indicate that uPA modulates key pathways involved in AKI, offering potential therapeutic targets for mitigating renal damage.

Evaluating the Impact of a Rebt-Based Suicide Prevention Program for Individuals with Alcohol Use Disorders

The purpose of this study was to evaluate the effectiveness of a suicide prevention program based on Rational Emotive Behavior Therapy (REBT) for individuals with Alcohol Use Disorder. Theoretical Framework: The study is grounded in the Rational Emotive Behavior Therapy (REBT) framework, which aims to reduce irrational beliefs, one of the root causes of emotional disturbances, including depression and suicidal ideation. Methods: A nonequivalent quasi-experimental design was employed, involving participants from two Addiction Management Integrated Support Centers in K Province, South Korea. Forty-eight individuals were divided into two groups: 24 in the experimental group and 24 in the control group, each assigned to a different center. The experimental group underwent 10 REBT sessions over 5 weeks, in addition to standard interventions. The control group received only the usual interventions. Outcome variables measured included irrational beliefs, depression, suicidal ideation, and problem-solving ability. Data were collected at baseline and again five weeks after the program ended. Statistical analyses were conducted using chi-square, Fisher's exact test, and independent t-tests. Results: Prior to the intervention, no significant differences in demographic characteristics or baseline outcome variables were observed between the two groups. After the intervention, the experimental group exhibited a significant reduction in irrational beliefs (t=2.36, p=.023), depression (t=3.80, p<.001), and suicidal ideation (t=4.59, p<.001) compared to the control group. Additionally, the experimental group demonstrated a significant improvement in problem-solving ability (t=4.59, p<.001). Discussion/Implications: The study demonstrates that the REBT-based suicide prevention program was effective in reducing irrational beliefs, depression, and suicidal ideation, while also enhancing problem-solving ability in individuals with Alcohol Use Disorder. These results underscore the potential benefits of integrating cognitive-behavioral approaches like REBT into suicide prevention programs for this population. Originality/Value: This research contributes to the limited literature on suicide prevention programs tailored for individuals with Alcohol Use Disorder and offers valuable insights into the applicability of REBT in community-based mental health interventions. The findings suggest the importance of developing structured therapeutic programs that address both cognitive distortions and emotional well-being to prevent suicide in vulnerable populations.

Exploration of drug therapy related problems in a general medicine ward of a tertiary care hospital of Eastern Nepal

BackgroundInpatients are at higher risk of Drug Therapy Related Problems (DTRPs), and early identification and management of these DTRPs is crucial for optimal treatment outcomes and ensuring rational drug therapy. ObjectiveThis study aims to assess DTRPs in a general medicine ward of a tertiary care hospital in eastern Nepal. MethodsA three-month prospective observational study was conducted on inpatients admitted to the general medicine ward of the hospital. Pharmacists routinely performed patient drug therapy reviews, by which suspected DTRPs were identified and recorded as per the Pharmaceutical Care Network Europe Association (PCNE) v.9.1 guidelines. Binary logistic regression analysis was used to determine the influence of predictor variables on the occurrence of DTRPs. ResultsA total of 301 inpatients were enrolled, out of which 233 (77.4%) had one or more DTRPs. Altogether, 528 DTRPs with an average of 2.27 ± 0.92 DTRPs per patient were identified. The primary causes of the DTRPs were drug selection (40.47%), treatment duration (16.71%), dispensing (15.75%), and dose selection (13.12%). Antimicrobials were involved in 55.18% of the DTRPs. DTRPs were more prevalent in elderly, comorbid patients, patients with longer hospital stay days, and polypharmacy, which was statistically significant (p<0.05). Furthermore, multivariate binary logistic regression analysis showed that geriatric patients had a higher risk of experiencing DTRPs, with an adjusted odds ratio of 1.832 (1.021-3.286) at p-value < 0.05. ConclusionDTRPs are frequently prevalent in hospital wards, emphasizing the crucial role of clinical pharmacists in identifying, resolving, and preventing DTRPs in inpatient settings for optimal treatment outcomes.

The effectiveness of rational emotive behavior therapy and acceptance and commitment therapy on oxidative stress in patients with hypertension

The effectiveness of rational emotive behavior therapy and acceptance and commitment therapy on oxidative stress in patients with hypertension

Clinical Decision Support Systems to Identify Drug-Related Problems in Diabetes Mellitus Patients: A Systematic Review

Clinical Decision Support Systems (CDSSs) has been developed for utilization to provide rational therapy to Diabetes Mellitus (DM) patients including preventing Drug-related Problems (DRPs) such as the effect of drug treatment being not optimal, untreated indications and symptoms, unnecessary therapy, and adverse drug reactions. This study aims to summarize the available evidence on the intervention of CDSSs, key outputs, and impact of the user in DM patients. This study was a systematic review using PubMed, Scopus database, and by manually searching the bibliographies of articles that have been found. We included studies reporting on evaluated CDSSs that had been implemented in medication prescription, reducing medication errors, adverse drug events, drug-allergy checking, drug dosing support, and so on. A total of 8 studies were selected among 855 studies. CDSSs are used in hospitals and primary care settings to identify potential drug interactions, correct therapy regimens, monitor therapy, blood glucose documentation, ensure patients receive medication according to the guideline, provide nutritional advice, and schedule physical activity. The usage of CDSSs improves blood glucose levels, detects possible drug interactions, reduces face-to-face consultations, improves documentation, assists in identifying dose, and promotes prescribing in line with the guideline. The use of CDSSs can help to reduce the risk of errors in management therapy.

The Effect of Rational Emotive Behavior Therapy (REBT) Intervention on Reducing Anxiety and Improving the Quality of Self-Coping of Pregnant Women in the Working Area of the Nilam Sari Community Health Center, Bukittinggi City 2015

One indicator of the success of health services is reflected in the decline in maternal mortality. but in reality in Indonesia it is still relatively high. One of the factors that affect the health of pregnant women is excessive anxiety. The result of various studies in the world show, excessive anxiety in pregnancy adversely affect the quality of pregnancy and can lead to complications, mental health development of children. This study aims, know the effect of interventions Rational Emotive Behavior Therapy (REBT) to decrease anxiety and quality of coping pregnant women in the region Puskesmas Nilam Sari Bukittinggi 2015. The method used in this study is Quasy Experiment design non randomized pretest – post test without control with a sample of 16 pregnant women categories moderate to very hight anxiety. Measuring Instruments used quesionnaires Pregnancy Anxiety Scale (PSA), Pregnancy Related Anxiety Scale (PRAS), Revised Ways Of Coping Scale (WCQR), and an Intervention Module designed practicing with psychologist regarding principle of step Rational Emotive Behavior Therapy (REBT). Analysis of data using Friedman test, Wilcoxon and Marginal Homogeneity test.

Psychological Dynamics among Adolescents with Self-Harm Behavior Based on Rational Emotive Behavior Therapy

The objective of this study was to ascertain the psychological underpinnings of self-harm behaviors among adolescents, with a particular emphasis on the tenets of rational emotive behavior therapy (REBT). Additionally, this study aimed to elucidate the various forms of self-harm behaviors and the underlying factors that contribute to these behaviors in adolescents. This research employed a qualitative approach with a phenomenological research design. The research subjects were students at State Senior High School 1 Batu, Indonesia, selected based on certain criteria in accordance with the research needs (purposive sampling). The results demonstrate three key aspects of the psychological dynamics of adolescents with self-harm behavior, namely cognitive, affective, and conative. These were mapped into the ABC model, which comprises three elements, namely activating events, irrational beliefs, and impacts. Forms of self-harm in adolescents include physical (slashing the hand) and non-physical (ignoring health, smoking, taking drugs, and staying up late). The background of adolescents committing self-harm behavior is influenced by both internal factors (dissatisfaction and loneliness) and external factors (family problems and modeling).

The effect of rational therapy on modifying irrational thoughts among university students

The current research aims to identify the effect of the thinking distraction method in reducing existential frustration among university students at the College of Physical Education and Sports Sciences/Al-Qasim Green University. The researcher has dealt with a theoretical framework that includes all the variables of the research, and to achieve the goal of the research, an existential frustration scale was built, using a statistical analysis sample. The number of items in this scale was (200) and after verifying its validity and reliability, the number of items in this scale reached (30) distributed across the scale’s areas. To test the research hypotheses, the researcher chose a sample of (14) male students only, who were intentionally selected from those who obtained the highest scores on the scale. Existential frustration scale: They were divided into two groups (experimental and control) with (7) students in each group. After parity was achieved for the two groups. As well as building the therapeutic program according to the problems posed in the scale according to the method (the thinking-distraction method), one session of the therapeutic program was taken, and after completing the application of the therapeutic program using the group therapy method on the research sample, the results showed that the program was effective in reducing existential frustration among university students.

The Effectiveness of a Rational Emotive Behavior Therapy Group Setting in Reducing Egocentrism in Bullying Perpetrators

The Effectiveness of a Rational Emotive Behavior Therapy Group Setting in Reducing Egocentrism in Bullying Perpetrators

The Development and Validation of the Rational and Irrational Beliefs Scale of Rational Emotive Behaviour Therapy(REBT)

The Development and Validation of the Rational and Irrational Beliefs Scale of Rational Emotive Behaviour Therapy(REBT)

The Effects of Rational Emotive Behavior Therapy, Progressive Muscle Relaxation, Distraction, and Rumination on State Anger Using the Autobiographical Essay Memory Task

ABSTRACT Given the many negative outcomes of anger, including physical aggression and violence, there is a need to improve treatment outcomes. As such, several treatment approaches were evaluated in this study. The autobiographical essay memory task (AEMT) was given to 157 participants on Amazon’s Mturk. Using a four (intervention) by three (state anger) mixed design, participants were randomly assigned to one of four conditions: control group (a distraction task), rumination, self-help Rational Emotive Behavior Therapy (REBT), or progressive muscle relaxation (PMR). All participants were instructed to write an anger-evoking memory for ten minutes. Following this, participants were then asked to partake in their respective intervention. Using the State Anger Scale from the State-Trait Anger Expression-2, state anger was measured at baseline, after writing about the anger-evoking memory, and post-intervention. As expected, there was a significant difference across the three time points, p < .001, η2 = .30. Once the AEMT was completed, participants received an intervention. Participants indicated lower levels of state anger post-intervention compared to post-AEMT, p < .001; however, participants post-intervention still reported higher levels of state anger compared to baseline, p < .001. Using the LSD post-hoc test, participants in the rumination condition reported higher levels of state anger post-intervention compared to participants who engaged in PMR (p < .001), self-help REBT (p = .04), and the control condition (p < .001). There were no significant differences noted between PMR, self-help REBT, and the control conditions post-intervention. The AEMT was an effective tool to evoke state anger in a lab setting. Additionally, self-help REBT, PMR, and distraction are effective tools to decrease state anger.

Counseling for Special Needs Children Experiencing Bullying Through Rational Emotive Behavior Therapy (REBT) Approach

When a family having a child with special needs, the happiness that parents experience is mixed with a variety of other emotions such as shock, self-guilt or partner, to worry about their child's future. ABK needs special attention and service. ABK requires special attention, help, service, and learning methods. Likewise, ABK parents need special support to make it easier for them to adapt, accept, and then educate their ABK optimally. One of the forms of support that is needed is counseling. Counseling for ABKs needs to be done among others so that they do not feel alone and have a support group to make them more resilient in the face of various problems and challenges in life. Especially when ABK suffered bullying, where ABK included those who were vulnerable to bullyed because of their different conditions. Rational Emotive Behavioral Therapy (REBT) provides an overview of how counseling for ABK victims of bullying through the REBT approach can help them in addressing the problems associated with the impact of ABK's Bullying.

Poetry writing can enhance character formation in school students through the application of rational emotive behavior theory

ABSTRACT This study explores the role of poetry writing and the ABC model of Rational Emotive Behavior Therapy (REBT) in promoting character development and moral behavior among students. The study used DAS SF1 and SF2 and assessed poetic talent using a poetry attitude and knowledge test. Forty-eight students were selected using the purposive method from five Convent schools, along with five teachers. Following a two-month intervention of 30 sessions, the researcher conducted interviews to evaluate the method’s efficacy. Content analysis of the integrated poetry writing and REBT program was performed using NVivo, while both quantitative and qualitative data were analyzed using SPSS. The study found significant positive correlations between the integration of REBT and improved behavior, suggesting that incorporating poetry writing into the curriculum can enhance students’ behavior and attitudes.

The phenotype of systemic lupus erythematosus as a factor in rational therapy choosing

Systemic lupus erythematosus (SLE) is characterized by a variety of clinical manifestations, which are defined as separate phenotypes of the disease. Despite the universality of immunopathological reactions, which are based on the formation of anti-nuclear antibodies and antibodies to native DNA, the spectrum and severity of immunological disorders in individual phenotypes are different. The role of type I interferons (IFN) in the SLE pathogenesis has now been proven. Hypersecretion of IFN-α and IFN-β leads to the production of antibodies against the components of the cell nucleus through activation of the native and adaptive immunity system. The current treatment strategy provides for achieving remission or low activity with immunosuppressants, including selective ones, such as biological agents. According to the updated international recommendations, anifrolumab, monoclonal antibodies against type I IFN, which has demonstrated high efficacy in the treatment of SLE with skin-mucous and joint lesions., can be used for the treatment of SLE along with rituximab and belimumab. The article presents our own clinical observation on the analysis of the effecacy and safety of anifrolumab in the treatment of a young patient with high-activity SLE and pronounced skin manifestations. It was shown that after the first injections of the drug, there was a rapid dynamics of skin and joint syndrome, the activity of SLE decreased from maximum to minimum according to the SELENA-SLEDAI index. The results obtained confirm the rationale of including anifrolumab in the treatment regimen in cases of insufficient previous therapy.

The effect of psychosocial interventions on anxiety and depression in congenital heart disease population: a systematic review and explorative meta-analysis

Abstract Introduction Patients with congenital heart disease (CHD) face various psychological challenges throughout their clinical journey, mainly attributed to symptoms of anxiety and depression. Approximately 19-43% of adults with CHD experience symptoms of depression and/or anxiety. In this scenario, addressing anxiety and depression through psychological interventions (PIs) becomes crucial. However, no available syntheses of the efficacy of PIs on anxiety and depression in the population with CHD have been performed thus far. Purpose To explore the efficacy of PIs on anxiety and depression within the CHD population. Methods We have conducted a systematic review up to January 2024 in these databases: PubMed, CINAHL, SCOPUS, and EMBASE. The study selection process adhered to specific inclusion criteria: (a) patients of all ages with CHD, (b) randomized controlled trial studies (RCTs), (c) published in English between 2000 and 2023, (d) focusing on PIs targeting anxiety and depression as outcomes. Cohen’s d was calculated to quantify and standardize the effect sizes between groups (treatment group vs. control group, considering an intention-to-treat approach) and within groups (from baseline to the last follow-up) to compute a cumulative effect size (Cohen’s d) per each study that controls potential differences of the outcome scores at the baseline in each study. Random-effect models were applied to pool each primary study's effect size (Stata 18 with the "metan.ado" add-on). Results Out of 558 records identified, only 3 RCTs met the inclusion criteria. These studies, published between 2017 and 2021, predominantly involved adults with CHD. None was conducted in Europe. Three main PIs were tested: Rational Emotive Behaviour Therapy, Mindfulness-based Stress Reduction, and Cognitive-Behaviour Therapy. Instead, the Hamilton Depression Rating Scale and Beck Depression Inventory were utilized, while the Hospital Anxiety and Depression Scale was employed to assess both depression and anxiety. For depression (N_intervention group = 93, N_control group = 85), the overall Cohen’s d was -1.04 [95% CI: -2.00, -0.07; p ≤ 0.001] with a moderate level of heterogeneity among studies (I² = 31.53%; Q(2) = 2.79; p = 0.25) as illustrated in Figure 1. Therefore, the findings indicate a moderate statistically significant effect of PIs in reducing depression up to three months post-intervention. Conversely, for anxiety (N_intervention group = 51, N_control group = 43), the overall Cohen’s d was 0 [95% CI: -0.96 +0.97; p ≤ 0.001] as illustrated in Figure 2. Conclusions This study summarizes the current evidence and brings the need for more attention in performing research employing PIs in adults with CHD. In fact, the paucity of available included RCTs sustains the need for more research. The results of this study highlight that PIs appear to be effective in reducing depression, while the studies performed in this population do not support evidence about anxiety.Figure 1.Figure 2.