Rational Therapy Research Articles

A Case Study of Rational Emotion Therapy to Solve Freshmen Interpersonal Communication Problems

General psychological problems; Rational-emotive therapy; Interpersonal communication

Chronic obstructive pulmonary disease – A neglected and underestimated chronic lung disease in India: A large single-center study in India

ABSTRACT Background: Chronic obstructive pulmonary disease (COPD) is more prevalent chronic respiratory illness with significant morbidity and mortality, underdiagnosed and inadequately treated in India. Our objectives of study were to analyze the disease awareness and knowledge, diagnostic patterns, and treatment trends including rational inhalation treatment in COPD in the rural settings. Materials and Methods: Prospective, observational, questionnaire-based study conducted during July 2013 to January 2020 included 12,000 cases of COPD confirmed by spirometry with chronic respiratory symptoms as cough, sputum production, and shortness of breath. In this study, we assessed disease knowledge, spirometry use, oral or inhalation treatment methods used to all patients before enrollment by applying questionnaire. Statistical analysis was done using the single proportion test. Results: Inhalation treatment use was documented in 58% COPD cases, 31% cases levosalbutamol monotherapy, 18% cases levosalbutamol plus beclometasone, and 9% cases either formoterol plus budesonide or salmeterol plus fluticasone (P < 0.0001). Oral medicines use is documented in 42% COPD cases, 16% cases theophylline, 7% cases salbutamol, and 19% cases oral steroids (P < 0.0001) We have documented that 43% study cases were not accepting the diagnosis and convinced for rational inhalation therapy labeled as “Difficult patients” and 9% patients were taking either formoterol plus budesonide or salmeterol plus fluticasone with or without tiotropium due to cost factor versus 91% are on either oral or other inhalation treatment, labeled as “difficult treatment” and oral medicines were offered in 42% COPD cases by treating doctors over inhalation treatment labeled as “difficult doctor.” We have observed 3% study cases were aware about their illness COPD disease, 54% are not having knowledge about disease, and 43% cases are not accepting the COPD diagnosis (P < 0.0001). Conclusion: COPD is a neglected and underestimated chronic lung disease in India, especially in the rural settings. More awareness is recommended with regard to disease knowledge and rational inhalation treatment and COPD definitely needs frontline place in National Health Mission in coming days to prevent morbidity and mortality.

МИОМА МАТКИ БОЛЬШИХ РАЗМЕРОВ ПОСЛЕ ОСЛОЖНЕННОГО КЕСАРЕВА СЕЧЕНИЯ (КЛИНИЧЕСКИЙ СЛУЧАЙ)

Uterine fibroids is a benign, encapsulated tumor of the female genital area, often found in reproductive age. The pathogenetic mechanism and causes of the development of uterine fibroids are unknown, hence there are questions and disputes on identifying causation. A predisposition of fibroids can serve as chronic inflammatory diseases of the female genital organs, methods of surgical treatment (artificial abortions, cesarean section, biopsy of lining of uterus), dysfunctions of the hypothalamus-pituitary gland-adrenal glands-ovaries, heredity, occupational hazards, extragenital diseases. One of the current issues of modern obstetric and gynecological care is the increasing frequency of cesarean section. Caesarean section is one of the most important risk factors for infection, which causes adverse long-term complications for a woman’s health. Research purpose : to highlight with an example of clinical case how a complicated caesarean section provoked the occurrence of complicated large uterine fibroids in a woman of the reproductive period. The presented material describes a clinical case of a patient who underwent surgical treatment in the gynecological department with a diagnosis of “Multiple uterine fibroids. Tumor growth. Hypermenstrual syndrome. Posthemorrhagic anemia”. The presented clinical case emphasizes the need for a qualified approach to operative delivery, the technique of performing a caesarean section and postoperative management. Conclusion . Treatment of patients with uterine fibroids should be carried out in full, including observation and monitoring for early detection of this pathology, as well as timely preoperative preparation with surgical treatment such as myomectomy and metroplasty. In the early and late postoperative period, measures after caesarean section should be comprehensive and include timely detection of infectious complications, rational antibiotic therapy.

SYNDROMIC TESTING AND MULTIPLEX RESPIRATORY PANELS: NEW APPROACH TO DETECT VIRAL VS BACTERIAL ETIOLOGY OF RESPIRATORY TRACT INFECTIONS

Global Healthcare problems as antibiotic resistance and viral epidemics demonstrates that we need particularly verify the etiology of respiratory tract infection. Not only viruses from bacteria should be distinguished, but viral pathogens also must be exactly differentiated. To solve this task syndromic testing inclinical microbiology can be used - to test wide list of possible pathogens we use one multiplex panel includes viruses, bacteria and, if need, also fungi. Global experience of such approach demonstrates that the role of viruses is greatly underestimated during lower respiratory tract infections and the therapy with broad-spectrum antibiotics is unfoundedin this case. Published data demonstrates that syndromic approach during respiratory tract infections diagnostics promotes better detection the etiological agents, more efficiency if mixt infections, support of rational antibiotic therapy and better epidemiological outcome.

Rational local wound therapy in children with burn injury

The outcomes of the Optimelle® dressing line use were analyzed. The effectiveness and safety of these therapeutic dressings in patients with thermal injury have been proven. A significant therapeutic effect was shown with the combination use of the proposed dressings, depending on the phase of the wound process and the depth of tissue injury due to hot fluid. Possible complications, particularly allergic reactions and contact dermatitis, were identified. Prevention and adequate local non-surgical therapy of complications are described. Three clinical cases are presented.

理性情绪行为疗法的在竞技运动领域的应用

理性情绪行为疗法的在竞技运动领域的应用

Rational drug therapy in children: An unrealized dream

Rational drug therapy in children: An unrealized dream

Engineered vitamin E-tethered non-immunogenic facial lipopeptide for developing improved siRNA based combination therapy against metastatic breast cancer.

RNA interference based therapeutic gene silencing is an emerging platform for managing highly metastatic breast cancer. Cytosolic delivery of functional siRNA remains the key obstacle for efficient RNAi therapy. To overcome the challenges of siRNA delivery, we have engineered a vitamin E-tethered, short, optimum protease stabilized facial lipopeptide based non-immunogenic, biocompatible siRNA transporter to facilitate the clinical translation in future. Our designed lipopeptide has an Arginine-Sarcosine-Arginine segment for providing optimum protease-stability, minimizing adjacent arginine-arginine repulsion and reducing intermolecular aggregation and α-tocopherol as the lipidic moiety for facilitating cellular permeabilization. Interestingly, our designed non-immunogenic siRNA transporter has exhibited significantly better long term transfection efficiency than HiPerFect and can transfect hard to transfect primary cell line, HUVEC. Our engineered siRNA therapeutics demonstrated high efficacy in managing metastasis against triple negative breast cancer by disrupting the crosstalk of endothelial cells and MDA-MB-231 and reduced stemness and metastatic markers, as evidenced by downregulating critical oncogenic pathways. Our study aimed at silencing Notch1 signalling to achieve "multi-targeted" therapy with a single putative molecular medicine. We have further developed mechanistically rational combination therapy combining Notch1 silencing with a repurposed drug m-TOR inhibitor, metformin, which demonstrated synergistic interaction and enhanced antitumor efficacy against cancer metastasis.

A validated model to predict spread through air space in lung adenocarcinoma.

Spread through air space (STAS) is currently considered to be a significant predictor of a poor outcome of pulmonary adenocarcinoma. Preoperative prediction of STAS is of great importance for treatment planning. The aim of the present study was to establish a nomogram based on computed tomography (CT) features for predicting STAS in lung adenocarcinoma and to assess the prognosis of the patients with STAS. A retrospective cohort study was performed in Wuhan Union Hospital from December 2015 to March 2021. The sample was divided into training and testing cohorts. Clinicopathologic and radiologic variables were recorded. The independent risk factors for STAS were determined by stepwise regression and then incorporated into the nomogram. Receiver operating characteristic (ROC) curves and calibration curves analysed by the Hosmer-Lemeshow test were used to evaluate the performance of the model. Decision curve analysis (DCA) was conducted to determine the clinical value of the nomogram. The Kaplan-Meier method was used for survival analysis and the multivariable Cox proportional hazards regression model was used to identify independent predictors for recurrence-free survival (RFS) and overall survival (OS). The sample included 244 patients who underwent surgical resection for primary lung adenocarcinoma. The training cohort included 199 patients (68 STAS-positive and 131 STAS-negative patients), and the testing cohort included 45 patients (15 STAS-positive and 30 STAS-negative patients). The preoperative CT features associated with STAS were shape, ground-glass opacity (GGO) ratio and spicules. The nomogram including these three factors had good discriminative power, and the areas under the ROC curve were 0.875 and 0.922 for the training and testing data sets, respectively, with well-fitted calibration curves. DCA showed that the nomogram was clinically useful. STAS-positive patients had significantly worse OS and RFS than STAS-negative patients (both P<0.01). OS and RFS at 5-year for STAS-positive patients were 63.1% and 59.5%, respectively. Multivariate analysis showed that age [hazard ratio (HR), 1.1; 95% confidence interval (CI): 1.035-1.169; P=0.002], diameter (HR, 1.06; 95% CI: 1.04-1.11; P=0.03) and surgical margin (HR, 32.8; 95% CI: 6.8-158.3; P<0.001) were independent risk factors for OS. Adjuvant therapy (HR, 7.345; 95% CI: 2.52-21.41; P<0.001), N stage (N2) (HR, 0.239; 95% CI: 0.069-0.828; P=0.02) and surgical margin (HR, 15.6; 95% CI: 5.9-41.1; P<0.001) were found to be independent risk factors for RFS. The outcome of STAS-positive patients was worse. The nomogram incorporating the identified CT features could be applied to facilitate individualized preoperative prediction of STAS and selection of rational therapy.

KONSELING KELOMPOK DENGAN MENGGUNAKAN PENDEKATAN RATIONAL EMOTIVE BEHAVIOUR THERAPY DALAM MENGATASI PERILAKU SELF INJURY REMAJA: LITERATURE REVIEW

Self-injury is self-defeating behavior by intentionally hurting oneself to vent the psychological pressure experienced. To overcome this behavior, group counseling is used with a rational emotive behavior therapy approach. This approach is used to help teenagers change irrational thoughts into rational ones which will later be reflected in the form of behavior. This research uses literature study. And according to the studies that have been carried out, the rational emotive behavior therapy approach can overcome self-injury behavior in adolescents.

PENDEKATAN REALITY THERAPY TERHADAP KORBAN TRAUMATIS AKIBAT PASCA BENCANA ALAM: STUDI LIBRARY RESEARCH

Adolescence is a transitional period to build student identity and develop a self-assessment mindset. Adolescent developmental tasks require significant changes in attitudes and behavior patterns. Due to the developmental tasks of adolescence describing the extent of changes that must be made and the problems that arise from the changes themselves, adolescence is often a difficult problem to solve. Lack of confidence in social interaction is one of the obstacles in changing attitudes and behavior. As a result, students who lack confidence in the social environment often do not have friends, are alone, and have difficulty adjusting to their environment. Students who lack self-confidence have more difficulty growing and developing in the activities they participate in at home, at school, and in the community. This writing uses a literature review and literature study by exploring various literature related to self-confidence in social interaction and group counseling approaches to rational emotive behavior therapy. Group counseling utilizes the dynamics of group members in the service process. The stages in the REBT counseling approach are using the ABC theory.

MENINGKATKAN KEPERCAYAAN DIRI SISWA DALAM BERINTERAKSI SOSIAL DENGAN KONSELING KELOMPOK RATIONAL EMOTIVE BEHAVIOR THERAPY: LITERATURE REVIEW

Adolescence is a transitional period to build student identity and develop a self-assessment mindset. Adolescent developmental tasks require significant changes in attitudes and behavior patterns. Due to the developmental tasks of adolescence describing the extent of changes that must be made and the problems that arise from the changes themselves, adolescence is often a difficult problem to solve. Lack of confidence in social interaction is one of the obstacles in changing attitudes and behavior. As a result, students who lack confidence in the social environment often do not have friends, are alone, and have difficulty adjusting to their environment. Students who lack self-confidence have more difficulty growing and developing in the activities they participate in at home, at school, and in the community. This writing uses a literature review and literature study by exploring various literature related to self-confidence in social interaction and group counseling approaches to rational emotive behavior therapy. Group counseling utilizes the dynamics of group members in the service process. The stages in the REBT counseling approach are using the ABC theory.

Analysis of antibacterials for systemic use recommended for the treatment of patients with community-acquired pneumonia in Ukraine according to the modern approach to preventing the development of antimicrobial resistance

BACKGROUND. According to a 2019 epidemiological study, antibiotic resistance (AR) caused about 1.27 million deaths worldwide, with lower respiratory tract infections (particularly pneumonia) dominating the global disease burden caused by resistant microorganisms.&#x0D; OBJECTIVE. To determine the compliance of antibiotics (J01), which are recommended by the guidelines of the National Academy of Medical Sciences of Ukraine for the empiric therapy of community-acquired pneumonia (CAP) in adults, with World Health Organization (WHO) recommendations based on the prevention of the development of AR.&#x0D; MATERIALS AND METHODS. Objects – antibiotics (J01) recommended by the guideline and their belonging to the access, watch and reserve groups according to the WHO AWaRe classification of antibiotics. Methods: system overview, analytical, comparison and generalization.&#x0D; RESULTS AND DISCUSSION. In the guidelines for empiric therapy of CAP in adults, antibiotics of 7 groups are recommended, from which 36 international non-proprietary names (INNs) were selected and analyzed. Of these, 7 INNs belong to the access group, of which only 4 antibiotics (amoxicillin, amoxicillin / clavulanic acid, gentamicin, doxycycline) are recommended by WHO experts for empiric treatment of CAP in adults; 26 INNs belong to the watch group, but only 3 antibiotics (cefotaxime, ceftriaxone, clarithromycin) according to the WHO database are recommended as empiric therapy for the severe CAP in adults. Ceftaroline, according to the WHO AWaRe antibiotic classification, belongs to the reserve group and should be used to fight multiresistant microorganisms. No antibiotic of the reserve group is recommended by WHO for empiric therapy of CAP.&#x0D; CONCLUSIONS. The results of the analysis can be used in updating the recommendations for rational empiric antibiotic therapy of CAP, taking into account the mechanisms of resistance to the development and spread of AR.

Critical Analysis of Rational Emotive Behavior Therapy Approaches: Ethics and Values in Counseling

This article will begin with an overview of REBT theory before moving on to a discussion of the ethics governing the field of psychology. This paper will try to answer the question whether Ellis's (1955) REBT theory can be used independently during therapy sessions, or whether it requires a combination of ethics and values to provide the best service to clients or not. Ethical considerations must be applied to the application of theory to improve it and make it more useful in therapy sessions, therefore it is important to determine how well theory can function on its own while still meeting the needs of its clients.

인지⋅정서⋅행동치료(REBT)에 기반한 심리극 집단상담 프로그램이 청소년의 부정적 자동적 사고, 역기능적 태도 및 우울에 미치는 효과

Objectives The goal of this study is to investigate the effect of REBT-based psychodrama group counselling on depression in adolescents. Methods For the purpose of this study, 182 middle-school teenagers in Jeollakbuk-do were divided into an experimental group and a control group of 91 subjects each, and a total of 10 sessions of REBT-based psychodrama group counselling were conducted. With a focus on authenticating the efficacy of this therapy method, a pre-post-test on depression, negative automatic thoughts and dysfunctional attitude was conducted on the adolescents. Results In order to evaluate the effects of program participants on negative automatic thoughts, dysfunctional attitudes, and depression, mean and standard deviation were calculated to conduct pre-test and post-test on the experimental group (n=91) and control group (n=91), and covariate analysis (ANCOVA) was conducted to evaluate the effect of the program. A t-test was conducted to analyze the differences in variables between the experimental group and the control group, and a two-way mixed ANOVA was conducted to examine the effects of psychodrama group counseling program based on Rational Emotive Behavior Therapy on negative automatic thoughts, dysfunctional attitude, and depression changes. Conclusions Following the use of statistical methods, the result of this study revealed a significant decrease in depression, negative automatic thoughts, and dysfunctional attitude in the experimental group in which REBT- based psychodrama group counselling was conducted, in comparison to the control group. Also, on the topic of expediting the argument on irrational beliefs, with psychodrama as the central theme, the application of REBT-based counselling has been suggested. Based on this, proposals and suggestions for follow-up studies on an integrated approach to REBT and psychodrama have been put forward.

Heart failure as a complication of myocardial infarction: rational therapy. Case report

Heart failure (HF) is still a frequent complication of myocardial infarction. Timely identification of subjects at risk for HF development and early initiation of guideline-directed HF therapy in these patients, can decrease the HF burden. This article aims at summarizing clinical data on established pharmacological therapies in treating post-MI patients with left ventricular systolic dysfunction and signs and symptoms of HF.

Development, Validity, and Reliability of the Rational Emotive Behavioral Therapy Counseling Module (REBTGCM) for Adolescent Smokers

Development, Validity, and Reliability of the Rational Emotive Behavioral Therapy Counseling Module (REBTGCM) for Adolescent Smokers

ОСОБЕННОСТИ ТЕЧЕНИЯ ОСТРЫХ ОДОНТОГЕННЫХ ВОСПАЛИТЕЛЬНЫХ ПРОЦЕССОВ ЧЕЛЮСТЕЙ ВДЕТСКОМ ВОЗРАСТЕ

The goal.Studying the clinical course’s features of acute odontogenic inflammatory processes of the jaws in children, describing species composition of pathogens, determination sensitivity to antibiotics of various groups in acute odontogenic inflammatory processes of the jaws in childhood. Materials and methods.The case histories of 900 patients were analyzed, microbiological research methods were carried out (microscopic examination of clinical samples with Gram staining, culture method, determination of the sensitivity of theisolated pathogen to antimicrobial drugs).Results.The most common odontogenic inflammatory processes of the jaws were observed in children aged 4–5 years. In48,85 % of cases in a milk bite and in 67,92 % of cases in a permanent bite, the cause of the development of an odontogenic inflammatory process was complicated caries of the mandibular molars. 56% of children had a general condition. The leading causative agent of the inflammatory process of the jaws was in 65,6 % of cases hemolytic streptococcus. In other cases, Streptococcus Viridans(6,1 %), pneumococci (4,3 %), candida (3 %), Staphylococcus aureus(2,8 %), Moraxella cataralis(1,2 %), etc. were detected in the mixed microflora of purulent exudate. The drugs of choice for empirical antibiotic therapy for odontogenic inflammatory process caused by beta-hemolytic streptococcus group A are vancomycin (antibiotic sensitivity –99 %), fluoroquinolones (antibiotic sensitivity –98 %), beta-lactams (antibiotic sensitivity –91 %). The highest percentage of resistance of this microflora was noted to macrolides (41 %), and to clindamycin (33 %). The rapid spread of the purulent-inflammatory process in the maxillofacial region in acute odontogenic processes in children, the resistant microflora of the odontogenic purulent focus require a competent approach when providing emergency care.Conclusions.The obtained has great practical importance for the choice of rational antibiotic therapy.

Calcitriol increases MBNL1 expression and alleviates myotonic dystrophy phenotypes in HSALR mouse models

BackgroundMyotonic dystrophy type 1 (DM1), one of the most common forms of adult-onset muscular dystrophy, is caused by abnormally expanded CTG repeats in the 3′ untranslated region of the DMPK gene. The CUG repeats transcribed from the expanded CTG repeats sequestrate a splicing factor, MBNL1, causing the clinical symptoms in DM1. Nowadays, only symptomatic treatments are available for DM1, and no rational therapy is available. Recently, upregulation of MBNL1 expression has been found to be one of the promising therapies for DM1.MethodsAll experiments were conducted in the C2C12 myoblasts and HSALR mice, a DM1 mouse model. Real-time PCR and western blot were used to detect the mRNA and protein level, respectively. The rotarod exercise, grip strength and hanging time were used to evaluate the muscle strength of mice.ResultsIn this study, we demonstrated that calcitriol, an active form of vitamin D3, increased MBNL1 in C2C12 mouse myoblasts as well as in HSALR mice model for DM1. In HSALR mice model, calcitriol improved muscle strength, and corrected aberrant splicing in skeletal muscle. Besides, calcitriol reduced the number of central nuclei, and improved muscle histopathology in HSALR mice. In addition, we identified that calcitriol upregulated MBNL1 expression via activating the promoter of Mbnl1 in C2C12 myogenic cells.ConclusionOur study suggests that calcitriol is a potential pharmacological strategy for DM1 that enhances MBNL1 expression.

DIAGNOSTICS OF PREGNANT WOMEN WITH GESTATIONAL DIABETES

Object: Selection of an effective method of delivery for mother and child in pregnant women with gestational diabetes.Purpose of the study: Selecting the optimal method of delivery by studying the outcome of labor for the mother and fetus in women with gestational diabetes.Material and methods: The retrospective group included 67 women who passed through the regional perinatal center, city maternity complex and family clinics No. 5, No. 6 of the city of Bukhara in the periods from 2016 to 2018. The main (prospect) group consisted of 68 women whose pregnancy proceeded against the background of overt or gestational diabetes mellitus (GDM). The control group consisted of 31 women whose pregnancy proceeded physiologically.Results and discussion: As a result of the study, the course of pregnancy and childbirth according to the history of childbirth and own observations revealed that in all (60%) pregnant women with GDM, pregnancy and childbirth proceeded with any complications, like in the mother and the fetus.Сonclusion: Thus, the optimal delivery route is selected taking into account the condition of the fetus and the level of TSH and clay hemoglobin. If pregnancy proceeded against the background of corrected diabetes with the use of the optimal insulin regimen and rational diet therapy, the absence of signs of diabetic fetopathy, then in this category of pregnant women, the delivery through the birth canal is considered the best option. The issue of delivery time is decided individually, taking into account the degree of compensation for diabetes mellitus, cervical maturity, condition and size of the fetus.