Traditional Treatment Group Research Articles

High‐dose cyclophosphamide versus monthly intravenous cyclophosphamide for systemic lupus erythematosus: A prospective randomized trial

Monthly intravenous (IV) cyclophosphamide for 6 months has been the standard induction regimen for lupus nephritis, followed by a maintenance regimen of quarterly infusions for 2 years. We undertook this study to compare the efficacy and safety of the standard regimen versus a high-dose IV cyclophosphamide regimen. We performed a prospective randomized trial comparing monthly IV cyclophosphamide at 750 mg/m(2) body surface area for 6 months followed by quarterly IV cyclophosphamide for 2 years (traditional treatment) against high-dose IV cyclophosphamide (50 mg/kg daily for 4 days) (high-dose treatment). Entry criteria included renal lupus, neurologic lupus, or other organ system involvement with moderate-to-severe activity. Fifty-one patients were randomized; 3 withdrew before treatment and 1 committed suicide after 2 months of high-dose treatment. Twenty-two had renal lupus, 14 had neurologic lupus, and 11 had other organ involvement. The outcome measure was the Responder Index for Lupus Erythematosus (complete response, partial response, no change, or worsening). At 6 months (the end of induction), 11 of 21 patients (52%) in the high-dose treatment group had a complete response compared with 9 of 26 patients (35%) in the traditional treatment group (P = 0.13). At the final visit (30 months), 10 of 21 patients (48%) in the high-dose treatment group had a complete response compared with 13 of 20 patients (65%) who continued with traditional treatment (P = 0.13). Six patients crossed over from traditional treatment to high-dose treatment because of lack of response, and 3 of those patients became complete responders. There was not strong evidence that monthly IV cyclophosphamide and high-dose IV cyclophosphamide differed in complete or in any (complete or partial) response to induction or maintenance therapy. However, nonresponders to monthly IV cyclophosphamide can sometimes be rescued with high-dose IV cyclophosphamide.

Epidural Application of Ozone in the Treatment of Herpes Zoster Neuralgia

Objective To evaluate the effect of epidural ozone in the treatment of herpes zoster neuralgia. Methods 80 patients with acute herpes zoster neuralgia were randomly divided into 2 groups, respectively,using the traditional treatment group( C group)and epidural ozone treatment group( E group), and recorded VAS before and after treatment. Results Comparing the results of the two groups, after treatment, the VAS of B group decreased significantly. Conclusion Application of epidural ozone is an effective method in treatment of herpes zoster neuralgia. Key words: Epidural; Ozone; Herpes zoster neuralgia

Application of Ozone in the treatment of herpes zoster

Objeetlve To evaluate the effect of ozone in the treatment of herpes zoster.Methods 80 patients with acute herpes zoster neuralgia were randomly divided into 2 groups,respectively,using the traditional treatment group(A group) and ozone treatment group(B group),and recorded VAS before and after treatment.Results Comparing the results of the two groups,after treatment,the VAS of B group decreased significantly.Conclusion Application of ozone is an effective method in treatment of herpes zoster neuralgia. Key words: Ozone; Herpes zoster neuralgia

Beyond Generic Support: Incidence and Impact of Invalidation in Peer Services for Clients With Severe Mental Illness

Beyond Generic Support: Incidence and Impact of Invalidation in Peer Services for Clients With Severe Mental Illness

Variations of TNF-α and IL-8 in bronchoalveolar lavage fluid in neonates with meconium aspiration syndrome

Objective To study the role of TNF-α and IL-8 in neonates with meconium aspiration syndrome(MAS). Methods Forty-seven neonates with MAS were randomly assigned into the treatment group(n=22) and the control group(n=25) and received traditional treatment and Curosurf therapy,respectively.Another 21 full-term newborns were chosen as control.The levels of TNF-α and IL-8 in serum and bronchoalveolar lavage fluid (BALF) were measured after 24 days of treatment. Results Serum levels of TNF-α and IL-8 in neonates with MAS were significantly higher than the control group[(25.97±6.72)ng/L vs(11.94±2.83)ng/L;(18.82±4.89)ng/L vs(10.38±2.28)ng/L;P<0.01,respectively].The levels of TNF-α and IL-8 in BALF were[(66.46±12.67)ng/L and(31.17±5.67)ng/L]significantly higher than those of the serum(P<0.01,respectively).Compared with the traditional treatment group,levels of TNF-α and IL-8 in BALF at 24 h after Curosurf therapy were lower[(44.38±9.10)ng/L vs(36.97±5.88)ng/L and(26.46±5.01)ng/Lvs(21.06±3.99)ng/L,P＜0.01,respectively]Conclusions TNF-α and IL-8 may play an important role in the development of MAS.Curosurf could protect the lungs from injury by reducing the TNF-α and IL-8 levels in neonated with MAS. Key words: Meconium aspiration; Bronchoalveolar lavage fluid; Tumer necrosis factor-alpha; Interleukin-8; Pulmonary surfactants

Curative effect of infected bed-sore treated by the combination of oxidation potential water and visible light healing equipment

Objective To explore the therapeutic effect of visible light healing equipment and oxidation potential water in the treatment of infected bed-sore. Methods 64 cases of infected bed-sore were randomly divided into 3 groups, with 23 cases in the new treatment group, 21 in the traditional treatment group and 20 in the control group. The new treatment group received local decompression, debridement with oxidation potential water and exposure of visible light for 20min, 10 times a day. The traditional treatment group received local decompression, debridement with Ns and besmeared burn cream for 3 times a day. The control group received only local decompression and debridement with NS, and turned the body over and massaged every two hours. The healing time and the result of every therapy were recorded, and then were statistically analyzed. Results The curative effect, the efficient rate and the healing time between the three groups were compared, and their differences had statistical meaning (P < 0. 05). Conclusions The new treatment and the traditional treatment are beth effective methods to heal infected bed-sore, but the therapeutics effect of visible oxidation potential water and light heading equipment is better than that of the traditional treatment. Key words: Bed-sore; Oxidation potential water; Visible light healing equipment; Nursing

Femoral fractures in children, is early interventional treatment beneficial?

A protocol of early intervention (flexible intramedullary nails, early hip spica, and external fixation) was started in 1999 and during a 3-year period there were 25 children who sustained a femoral shaft fracture (early intervention group). These were prospectively reviewed with a minimum follow up of 24 months (Range 24-35 months). A historical control group of 41 children was used. These children were injured between February 1996 and February 1999 and were retrospectively reviewed. They had traditional in patient treatments with either Gallows or Thomas splint traction (traditional treatment group). Over the 6-year period from 1996 to 2002 there were a total of 66 femoral shaft fractures in the study that presented to our hospital. The mean length of hospital stay was 29 nights in the traditional group and 10 nights in the early intervention group. This difference is significant (p<0.001). The malunion rate was slightly higher in the early active group at radiological union but most of these remodelled over the 2 years of follow up. The protocol of early intervention used in our institution, of flexible nails, early hip spica or external fixation depended on the age of the child, and has resulted in a shorter hospital stay for the children. This has benefits for the child, the family and the hospital.

Effect of topiramate and traditional antiepileptic drugs on pituitary-sexual gland axis in adult males with epilepsy*

Background Some reports indicate that traditional antiepileptic drugs can cause a certain effect on reproductive endocrine system in epileptic patients. However, the effect of topiramate on reproductive endocrine system needs to be further studied. Objective To compare the effects of topiramate and traditional valproic acid and carbamazepine on pituitary-sexual gland axis in adult males with epilepsy. Design Self-contrast and randomly parallel controlled study. Setting Sichuan Academy of Medical Sciences (Department of Neurology, Sichuan Provincial People's Hospital). Participants A total of 54 male epileptic patients aged from 18 to 75 years were selected from Department of Neurology, Sichuan Provincial People's Hospital from January 2004 to June 2006. All patients were diagnosed as epilepsy based on illness history and electroencephalogram (EEG), and types of epilepsy were classified based on the theory of epilepsy and epilepsy syndrome established by International Anti-epilepsy League in 1989 and 2001. The accepted patients and their relatives provided the confirmed consent. Methods ▪ The accepted patients were randomly divided into traditional treatment group [ n =26, mean age of (34±14) years] and topiramate group [ n =28, mean age of (28±17) years]. In addition, based on various kinds of drugs, patients in the traditional treatment group were divided into two subgroups, including carbamazepine group ( n =14) and valproic acid group ( n =12). Patients in both subgroups were respectively treated with carbamazepine (100 mg/table, Shanghai Sanwei Pharmaceutical Factory, batch number: 060705) and valproic acid (200 mg/table, Hunan Xiangzhong Pharmaceutical Co., Ltd., batch number: 061128). Patients in topiramate group were treated with topiramate (25 mg/table, Xi'an Yangsen Pharmaceutical Co., Ltd., batch number: 060215836). Administration: The beginning dosage of topiramate was 25 mg/d, and then increased 25 mg/d per week. The final dosage was 150 mg/d. In addition, the beginning dosage of carbamazepine was 300 mg/d and the beginning dosage of valproic acid was 500 mg/d. All dosages were regulated based on attack frequency. ▪ Effective evaluation: Attack frequency of epilepsy was regarded as apparent effect (decreased 75%-100%), effect (decreased 50%-75%), poor effect (decreased 25%-50%) and no effect (decreased < 25%). ▪ 3 mL blood was collected from fasting patients at 8 o'clock in the morning before administration and at 6 months after administration so as to detect the changes of dihydroxyestrin (E 2), progestogen (P), total testosterone (TT), luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin (PRL). Main outcome measures Comparison of the therapeutic effects between topiramate group and traditional antiepileptic drugs group; changes of sex hormone before and after administration. Results All 54 patients were involved in the final analysis. ▪ Efficacy: Among 26 patients in the traditional treatment group, 14 patients had apparent effect (54%, 14/26), 5 effect (19%, 5/26), 4 poor effect (15%, 4/26), and 3 no effect (12%, 3/26). The totally effective rate was 72% (19/26). Among 28 patients in the topiramate group, 20 patients had apparent effect (72%, 20/28), 4 effect (14%, 4/28), and 4 poor effect (14%, 4/28). The totally effective rate was 86% (24/28). ▪ Level of sex hormone: Level of FSH in the valproic acid group was decreased after treatment as compared with that before treatment [(3.09±1.82), (4.61±1.97) IU/L, P < 0.01]; levels of LH were (5.38±1.89) and (4.97±2.43) IU/L, respectively in the carbamazepine group and topiramate group, which were higher than those before treatment [(3.63±2.16), (3.68±2.09) IU/L, P < 0.05]; level of PRL in the topiramate group was decreased after treatment as compared with that before treatment [(192.17±105.69), (250.07±135.11) mIU/L, P < 0.05]; levels of PRL were lower in the valproic acid group and topiramate group than that in the carbamazepine group after treatment [(186.35±102.66), (192.17±105.69), (289.50±192.43) mIU/L, P < 0.05]. Conclusion Both new and traditional antiepileptic drugs have a certain effect on pituitary-sexual gland axis. In addition, a short-term application (about 6 months) of topiramate can mainly influence on pituitary hormone (LH and PRL). Valproic acid has an obvious effect on FSH and carbamazepine also has a certain effect on LH.

Cleaning of Traumatic Epidural Hematoma by Drilling Combined with Lysis with Urokinase and Drainage

目的 探讨外伤性硬膜外血肿的微创治疗方法及疗效.方法将98例符合条件的外伤性硬膜外血肿患者随机分配到传统手术治疗组和钻孔尿激酶治疗组,比较传统的骨瓣开颅血肿清除术和钻孔尿激酶灌注引流术治疗外伤性硬膜外血肿的治疗结果及疗效.结果钻孔尿激酶灌注引流术手术时间短、术中出血量少、并发症少、病人恢复快、住院时间短,与传统手术治疗组比较差异有显著性.结论钻孔尿激酶灌注引流术治疗外伤性硬膜外血肿是一种安全有效的治疗方法,值得临床推广应用。

Decreasing the Risk of Diabetic Retinopathy in a Study of Case Management

Diabetic retinopathy affects >60% of people with type 2 diabetes during the first 2 decades of the disease and is ameliorated by good glycemic control. This study tested whether intensive diabetes case management could prevent or delay diabetic retinopathy in patients with established type 2 diabetes. This study was part of a randomized, controlled clinical trial of diabetes case management in type 2 diabetes in southern California counties serving low income ethnic minority populations. Subjects were randomized to intervention (diabetes case management) or control (traditional treatment) groups. Subjects with at least two retinal photographs (n = 149) were included in this analysis to assess the effect of intervention on development or progression of diabetic retinopathy. Progression of retinopathy in the intervention group was not significantly less than in the control group (P = 0.226). However, those in the intervention group with no evidence of retinopathy at baseline were less likely to develop diabetic retinal changes (5/48) during a mean follow-up of 23.1 months than those in the control group (10/34, chi(2) = 4.805, P = 0.028). This difference remained significant in a logistic regression model that controlled for potential confounders (odds ratio 5.35 [95% CI 1.14-25.12]). This study shows that a relatively short duration of case management instituted before the onset of clinically identifiable retinopathy significantly diminished the risk of developing retinopathy in patients with type 2 diabetes. The findings also emphasized the retinal disease burden in this population, with development and progression of retinopathy occurring in <2 years.

Evaluating the effectiveness and efficiency of voice therapy using transnasal flexible laryngoscopy: a randomized controlled trial

Transnasal flexible laryngoscopy (TFL) is an examination of laryngeal anatomy and physiology using continuous light. TFL is being used increasingly by voice pathologists in treatment but with little scientific evidence to support it. The purpose of this study was to evaluate the effectiveness and efficiency of TFL as a therapeutic tool. The study used a prospective randomized controlled trial. Fifty dysphonic subjects were recruited and randomly assigned to either a traditional treatment group or a TFL-assisted treatment group. The effectiveness of voice therapy in both treatment groups was measured with a package of voice outcome measures. Subjects in both treatment groups demonstrated statistically significant improvements after voice therapy (perceptual auditory rating of voice quality measurement p < 0.01; instrumental electroglottographic measurement p < 0.01; patient questionnaire measurement p < 0.01). The time taken to complete treatment in both groups was recorded. The average (median) time taken to complete voice therapy in the TFL-assisted treatment group was 2 hours less than in the traditional treatment group ( p < 0.01). Voice therapy with TFL as a therapy tool was effective and more efficient than traditional voice therapy.

Improvement of wound treatment in modified radical mastectomy of breast cancer

To evaluate the efficacy of Dexon continuous intracutaneous sewing (DCIS) and Redon negative pressure absorbing drainage (RNPAD) in modified radical mastectomy of breast cancer. The clinical data of 128 patients treated with DCIS and RNPAD, and 123 cases treated with traditional sewing and negative pressure absorbing ball were analyzed retrospectively. There were 16 cases (12.5%) of seroma formation,1 (0.8%) of skin flay necrosis among 128 cases treated by DCIS and RNPAD, and 47 cases (38%) of seroma formation, 16 (13%) of skin flay necrosis among 123 cases treated by traditional method. The statistically significant difference was found (P <0.001). The average length of post-operation hospital stay in DCIS and RNPAD group was 8.8 days compared with 14.7 days in traditional treatment group. The use of DCIS and TNPAD could decrease the complication rate of breast cancer operation.

Comparison of Low-Intensity Warfarin Therapy With Conventional-Intensity Warfarin Therapy for Long-Term Prevention of Recurrent Venous Thromboembolism

Observations suggest that traditional anticoagulant therapy, maintaining an international normalized ratio (INR) of approximately 2.0 to 3.0, could be more intensive than is necessary for the long-term prevention of recurrent venous thromboembolism. The value of less-intensive warfarin anticoagulation, with a target INR of 1.5 to 1.9, was therefore examined in a randomized, double-blind study enrolling 738 consecutive patients having one or more episodes of venous thromboembolism. All had completed at least 3 months of conventional oral anticoagulant therapy. Participants were assigned to continue on warfarin with a target INR of either 2.0-3.0 or 1.5-1.9 and were followed up for 2.4 years on average. To be eligible, patients must have had confirmed, symptomatic, proximal deep venous thrombosis or pulmonary embolism with no apparent major risk factor. The mean INR was 1.8 for patients assigned to low-intensity treatment and 2.4 in the usual-intensity group. Nine major bleeding episodes occurred in patients on low-intensity treatment, for a rate of 1.1 per 100 person-years. The 8 such episodes in the traditional treatment group represented a rate of 0.9 per 100 person-years. Including minor bleeding episodes, rates were 4.9 and 3.7 per 100 person-years, respectively. There were no fatal or intracranial bleeds in either treatment group. Older patients were more likely to have major bleeding. Venous thromboembolism recurred at rates of 1.9 events per 100 person-years in the low-intensity group and 0.7 per 100 person-years with traditional treatment, a statistically significant difference. Five episodes in the low-intensity group and 3 in the usual-intensity group occurred after warfarin was discontinued. There was 1 death in the low-intensity group caused by pulmonary embolism and 2 such deaths in the conventional treatment group. These findings show that conventional warfarin anticoagulation is more effective than a low-intensity regimen for preventing recurrent venous thromboembolism; the risk is lowered by approximately two thirds. At the same time, low-intensity treatment does not appear to make bleeding less likely.

Brief Communication: Mini-Treatment Groups for Children

This brief communication deals with a relatively unknown model of child group treatment involving only two (or occasionally three) homogeneous or heterogeneous youths. Termed “duo therapy” by some, or “peer pair psychotherapy” by others, this method has been successfully employed with children who were unsuitable for the traditional eight-member treatment groups. While in some instances, such mini-groups were used with fearful and withdrawn youngsters, in others, they were found helpful in preparing unduly impulsive ones, for membership in larger groups. This model has also been recommended for short-term diagnostic or reparative interventions in cases of severe sibling rivalry.

Retention of Clients in Service Under Two Models of Home Health Care for HIV/AIDS

ABSTRACT Objective: To determine if a Transprofessional, care-management approach (experimental group) produces different patterns of retention in home treatment as compared to a Traditional treatment approach (control group). The care-management approach utilizes an interdisciplinary mix of allied health professionals who adhere to a service delivery protocol based on active medical, surgical treatment (curative services) as well as on pain, symptoms, and emotional care (palliative services). Initially, the Transprofessional Model should lead to a greater retention rate in the program as patients bond to blended care managers, but in later stages clients needing hospice should be moved off-services resulting in lower retention rates in the medical-surgical home care venue. Data Sources and Study Setting: Data were collected from 549 AIDS patients admitted for medical/surgical home-care services to the Visiting Nurse Association of Los Angeles (VNA-LA). Demographic and disease-specific data were collected from admitting records; service-utilization data were collected from the VNA-LA's computerized data system. Study Design: Upon admission for home-care services, patients were randomly assigned to an experimental (Transprofessional) or control (Traditional) treatment group. Service levels were comparable. Primary Finding: In the earliest stages, Transprofessional patients tend to be more likely to stay in treatment, probably due to the greater bonding to the program. After about one year, the Transprofessional patients are more likely to leave the program as they are transitioned into hospice care. Conclusions: An integrated model of service delivery, which is based on interdisciplinary care-management and blended modalities of service, provides a quality of life enhancing and a cost-effective method in the provision of home-care services for terminally ill AIDS patients.

Evaluation of the Transprofessional Model of Home Health Care for HIV/AIDS

SUMMARY Objective: To determine if a Transprofessional care-management approach (experimental group) produces savings in service delivery dollars when compared to a Traditional treatment approach (control group). The care-management approach utilizes an interdisciplinary mix of allied health professionals who adhere to a service delivery protocol based on active, medical, surgical treatment (curative services) as well as on pain, symptoms, and emotional care (palliative services). Data Sources and Study Setting: Data were collected from 549 AIDS patients admitted for medical/surgical home-care services to the Visiting Nurse Association of Los Angeles (VNA-LA). Demographic and disease-specific data were collected from admitting records; service-utilization data were collected from the VNA-LA's computerized data system. Study Design: Upon admission for home-care services, patients were randomly assigned to an experimental (Transprofessional) or control (Traditional) treatment group. Service levels were comparable. Principle Findings: Post-test measures indicate an 8 percent reduction in labor delivery costs for an average experimental patient's entire episode of home-care versus for an average control patient's. Conclusions: An integrated model of service delivery, which is based on interdisciplinary, care-management and blended modalities of service, provides a cost-effective method in the provision of home-care services for terminally ill AIDS patients.

Oxytetracycline-containing bovine serum albumin microspheres for treatment of calves with experimentally induced Pasteurella haemolytica pneumonia

Heat denatured bovine serum albumin microspheres containing oxytetracycline (BSA-OTC MS) were injected into the jugular veins of calves with experimentally induced Pasteurella haemolytica pneumonia. Serum levels of oxytetracycline in the traditional treatment group fell in the expected range (1–10 μg/ml); serum levels of drug in the groups administered BSA-OTC MS were below detection limits of the test (< 0.5 μg/ml). Clinical results using BSA-OTC MS administered daily at 12.5% of normal whole body drug dose, but targeted to the lung by size, yielded equivalent outcomes to a standard OTC intravenous dosing regimen. Clinical results for a single dose of BSA-OTC MS were largely indistinguishable from the negative control group, which received no treatment.

Presidential Cancer

Molecular tumor profiling and next-generation sequencing are being increasingly utilized, but there are limited data on the therapeutic implications and potential benefits of targeted treatments. We aim to characterize gynecologic oncology patients referred for somatic tumor genetic mutation testing and assess survival outcomes, efficacy, and toxicities of those receiving targeted therapy.We conducted a retrospective chart review of gynecologic oncology patients referred for somatic tumor testing by next generation sequencing between 1/1/2012–8/23/2019. The primary objective was to compare overall and progression free survival between those treated with targeted therapy (group 1) versus traditional treatment (group 2).Most patients (70%) had additional treatment options available based on actionable mutations. The median number of somatic mutations identified was 5 (range 0–53). Patients in group 1 had more actionable somatic mutations (median 2 versus 0, p < 0.001). There was no difference in OS (median 64 versus 76 months, p = 0.97) or PFS (median 2 versus 8 months, p = 0.05) between the groups. While fewer patients in group 1 experienced neuropathy (0 versus 5, p = 0.02), grade I/II thrombocytopenia (7 versus 13, p = 0.03), grade III/IV thrombocytopenia (0 versus 4, p = 0.02), and grade III/IV neutropenia (1 versus 9, p = 0.002), all other non-hematologic toxicities were similar in the two groups.Most gynecologic cancer patients have actionable mutations and may benefit from a personalized targeted therapy treatment plan. Next generation sequencing can be used to identify clinically actionable mutations in gynecologic cancers and guide the selection of treatments, thereby expanding treatment options without worsening survival or toxicity.

Reading Stories to Young Children: Effects of Story Structure and Traditional Questioning Strategies on Comprehension

The purpose of the study was to determine if the pre- and postquestioning and discussion portions of the directed reading activity (DRA) could improve comprehension when stories were read to kindergarten children. Questioning and discussion focused on the structure of stories as well as traditional (literal, inferential, and critical) questioning and discussion were investigated. The stories were read to children using the DRA format of pre- and postquestioning and discussion. Story structure treatment groups ( N = 73) received structural questions and discussion; traditional treatment groups ( N = 64) received traditional comprehension questions and discussion; and the combined treatment groups ( N = 57) received a combination of both. The control groups ( N = 60) heard stories with no pre- or postquestions or discussion. The results indicated that the use of the DRA when reading stories to children significantly improved comprehension. Traditional and structural treatment groups each significantly improved performance on traditional and structural questions, respectively. Each treatment also had a small positive effect on children's ability to answer the other type of question. The combined treatment group made the greatest gains. When differences occurred between achievement levels within the treatment groups, it was the high and middle achievers whose scores increased. None of the treatments significantly increased performance of the low achievers.

The use of a token economy to reduce illicit drug use among methadone maintenance clients

The effects of a token economy in modifying the illicit polydrug use of 97 methadone maintenance clients was investigated over a period of two and a half years. Subjects' drug-free urinalysis reports were reinforced with points which could be redeemed to obtain methadone. Each subject's daily dose level varied with the point balance. A multiple baseline analysis showed that when methadone acquisition was in part made contingent upon drug-free urinalyses, illicit drug use declined rapidly. After six months, the token economy group's urines were 14% positive for illicit drugs compared to 39% in the traditional treatment group. As time in treatment increased, illicit drug use further declined. These results suggest a more effective and practical strategy for the treatment of polydrug abusing methadone maintenance clients than has previously been available.