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Multiple Treatments (multiple + treatment)
Selected AbstractsProgramme Evaluation with Multiple TreatmentsJOURNAL OF ECONOMIC SURVEYS, Issue 2 2004Markus Frölich Abstract., This paper reviews the main identification and estimation strategies for microeconometric policy evaluation. Particular emphasis is laid on evaluating policies consisting of multiple programmes, which is of high relevance in practice. For example, active labour market policies may consist of different training programmes, employment programmes and wage subsidies. Similarly, sickness rehabilitation policies often offer different vocational as well as non-vocational rehabilitation measures. First, the main identification strategies (control-for-confounding-variables, difference-in-difference, instrumental-variable, and regression-discontinuity identification) are discussed in the multiple-programme setting. Thereafter, the different nonparametric matching and weighting estimators of the average treatment effects and their properties are examined. [source] Multipass Treatment of Photodamage Using the Pulse Dye LaserDERMATOLOGIC SURGERY, Issue 7 2003Emil A. Tanghetti MD Background. Pulse dye lasers (PDLs) alter structural proteins in scars and photodamaged skin, in addition to their effects on dermal vasculature. The PDL has become an option in the treatment of photodamage. Although improvements to skin texture are generally modest when compared with ablative resurfacing, PDL offers a treatment with few side effects. A number of methods have been proposed in an effort to improve treatment outcomes. These range from single, low-fluence treatment with no purpura to multiple passes and treatment sessions as well as purpuric doses. Objective. To evaluate several of the PDL treatment methods to improve photorejuvenation outcomes while limiting the risk of side effects. Methods. Twenty patients with photodamage were separated into two groups. Each group received a series of four single-pass treatments or four double-pass treatments at 2-week intervals. Treatments were done using a 595-nm PDL (PhotoGenica V-Star) and a 585-nm PDL (PhotoGenica V) at a pulse duration of 0.5 ms and a 10-mm handpiece. Treatment fluences were maintained below the individual's purpuric threshold, ranging from 3 to 4 J/cm2. Photos were taken before treatment and during follow-up. Efficacy of treatment was based on subjective grading of photos and by patient self-reporting. Results. Multiple treatments resulted in improvements to skin tone and texture, including a reduction in the appearance of rhytids and, in particular, improved pigmentary evenness. There was no significant difference between laser or treatment methods. No side effects were noted. Conclusion. PDL treatments provide effective photorejuvenation with minimal risk of side effects. [source] Advances in mechanisms of postsurgical gastroparesis syndrome and its diagnosis and treatmentJOURNAL OF DIGESTIVE DISEASES, Issue 2 2006Ke DONG Postsurgical gastroparesis syndrome (PGS) is a complex disorder characterized by post-prandial nausea and vomiting, and gastric atony in the absence of mechanical gastric outlet obstruction, and is often caused by operation at the upper abdomen, especially by gastric or pancreatic resection, and sometimes also by operation at the lower abdomen, such as gynecological or obstetrical procedures. PGS occurs easily with oral intake of food or change in the form of food after operation. These symptoms can be disabling and often fail to be alleviated by drug therapy, and gastric reoperations usually prove unsuccessful. The cause of PGS has not been identified, nor has its mechanism quite been clarified. PGS after gastrectomy has been reported in many previous studies, with an incidence of approximately 0.4,5.0%. PGS is also a frequent complication of pylorus-preserving pancreatoduodenectomy (PPPD), and the complication occurs in the early postoperative period in 20,50% of patients. PGS caused by pancreatic cancer cryoablation (PCC) has been reported about in 50,70% of patients. Therefore, PGS has a complex etiology and might be caused by multiple factors and mechanisms. The frequency of this complication varies directly with the type and number of gastric operations performed. The loss of gastric parasympathetic control resulting from vagotomy contributes to PGS via several mechanisms. It has been reported that the interstitial cells of Cajal (ICC) may play a role in the pathogenesis of PGS. Recent studies in animal models of diabetes suggest specific molecular changes in the enteric nervous system may result in delayed gastric emptying. The absence of the duodenum, and hence gastric phase III, may be a cause of gastric stasis. It was thought that PGS after PPPD might be attributable, at least in part, to delayed recovery of gastric phase III, due to lowered concentrations of plasma motilin after resection of the duodenum. The damage to ICC might play a role in the pathogenesis of PGS after PCC, for which multiple factors are possibly responsible, including ischemic and neural injury to the antropyloric muscle and the duodenum after freezing of the pancreatoduodenal regions or reduction of circulating levels of motilin. As the treatment of gastroparesis is far from ideal, non-conventional approaches and non-standard medications might be of use. Multiple treatments are better than single treatment. This article reviews almost all the papers related to PGS from various journals published in English and Chinese in recent years in order to facilitate a better understanding of PGS. [source] Treatment of basal cell carcinomas in patients with nevoid basal cell carcinoma syndromeJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2009S Van Der Geer Abstract Background, Nevoid basal cell carcinoma syndrome (NBCCS) is characterized by the development of multiple basal cell carcinomas (BCCs). A major problem for these patients is the enormous amount of BCCs which can invade in the deep underlying structures, especially in the face. Different treatment modalities are used in these patients; surgical excision, Mohs micrographic surgery, cryotherapy, photodynamic therapy, ablative laser therapy and topical 5% imiquimod. There is no evidence based advice how to treat a NBCCS patient. Objective, To give a review of the literature about the possible treatment modalities for the multiple BCCs in NBCCS patients. Results, Literature consists mainly of case reports; no evidence based advice how to treat a NBCCS patient exists. Multiple treatments are available (surgical and non-surgical), and a lot of them can be combined. Treatment in a megasession is an option to diminish the medical and social inconvenience for the patient. Conflicts of interest None declared [source] Women with co-occurring substance use and mental disorders (COD) in the criminal justice system: a research reviewBEHAVIORAL SCIENCES & THE LAW, Issue 4 2004JoAnn Y. Sacks Ph.D. Associated with the dramatic increase in the numbers of women entering the criminal justice system is the recognition of the prominent role of co-occurring substance use and mental disorders (COD) in the lives of female offenders. This article reviews current research examining the prevalence and range of COD among female offenders, the variety of psychosocial problems faced by the female offender with COD, and the multiple treatment needs of women with COD who are under criminal justice supervision. Women with COD can enter the criminal justice system at several different points and, because both substance use and mental disorders carry significant risk of relapse, effective treatment approaches must address both disorders. The paper concludes with a discussion of several important treatment issues and provides suggestions regarding an agenda for future treatment and research. Copyright © 2004 John Wiley & Sons, Ltd. [source] An Adaptive Hierarchical Test Procedure for Selecting Safe and Efficient TreatmentsBIOMETRICAL JOURNAL, Issue 4 2006Franz König Abstract We consider the situation where during a multiple treatment (dose) control comparison high doses are truncated because of lack of safety and low doses are truncated because of lack of efficacy, e.g., by decisions of a data safety monitoring committee in multiple interim looks. We investigate the properties of a hierarchical test procedure for the efficacy outcome in the set of doses carried on until the end of the trial, starting with the highest selected dose group to be compared with the placebo at the full level ,. Left truncation, i.e., dropping doses in a sequence starting with the lowest dose, does not inflate the type I error rate. It is shown that right truncation does not inflate the type I error if efficacy and toxicity are positively related and dose selection is based on monotone functions of the safety data. A positive relation is given e.g. in the case where the efficacy and toxicity data are normally distributed with a positive pairwise correlation. A positive relation also applies if the probability for an adverse event is increasing with a normally distributed efficacy outcome. The properties of such truncation procedures are investigated by simulations. There is a conflict between achieving a small number of unsafely treated patients and a high power to detect safe and efficient doses. We also investigated a procedure to increase power where a reallocation of the sample size to the truncated treatments and the control remaining at the following stages is performed. (© 2006 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] DE-310, a novel macromolecular carrier system for the camptothecin analog DX-8951f: Potent antitumor activities in various murine tumor modelsCANCER SCIENCE, Issue 2 2004Eiji Kumazawa DE-310 is a novel macromolecular conjugate composed of DX-8951f, a camptothecin analog, and a carboxymethyldextran polyalcohol carrier, which are covalently linked via a peptidyl spacer. In a murine Meth A (fibrosarcoma) solid tumor model, once daily×5 treatments (qd×5) with DX-8951f at the maximum tolerated dose (MTD) were required to shrink the tumor, and DX-8951f (qd×5) at 1/4 MTD was required to inhibit tumor growth. A single treatment (qd×1) with DE-310 at the MTD or 1/4 MTD shrank the tumor, with no body weight loss occurring at 1/4 MTD. Even at 1/16 MTD, DE-310 inhibited tumor growth. In a long-term assay, Meth A solid tumors disappeared in mice treated with DE-310 (qd×1) at the MTD and 1/2 MTD, and all 6 mice remained tumor-free on the 60th day after administration. Repeated injection (4 times) on schedules of every 3 days, 7 days or 14 days demonstrated that multiple treatment with DE-310 produced greater tumor growth delay than a single treatment with DE-310. Against 5 human tumor (colon and lung cancer) xenografts in mice, DE-310 (qd×1) was as effective as DX-8951f administered once every 4 days, 4 times. The life-prolonging activity of DE-310 was assessed in lung (3LL, Lewis lung carcinoma) and liver (M5076, histiocytoma) metastasis models. Against 3LL, DE-310 (qdx1) at the MTD to 1/3 MTD significantly prolonged survival, with an increase in life span (ILS) of 4.8- to 1.6-fold, respectively, over that in untreated control mice. Also, DE-310 (qd×1) significantly prolonged survival in the liver metastasis model of M5076. These results demonstrate that DE-310 is a promising agent for the treatment of cancer. [source] Combined clotrimazole irrigation and depot therapy for canine nasal aspergillosisJOURNAL OF SMALL ANIMAL PRACTICE, Issue 6 2006T. R. Sissener Objectives: To evaluate the effect of short duration 1 per cent clotrimazole flush when combined with 1 per cent clotrimazole cream instilled into the frontal sinuses for the treatment of nasal aspergillosis in 14 dogs. Methods: Fourteen dogs with clinical, radiological, serological and rhinoscopic findings consistent with nasal aspergillosis were treated by frontal sinus trephination and a short, five-minute flushing of 1 per cent topical clotrimazole solution followed by a 1 per cent clotrimazole cream instilled as a depot agent. Results: Twelve of the 14 dogs (86 per cent) responded well to treatment and either had no clinical signs after treatment or had signs consistent with mild rhinitis during a minimum follow-up period of six months. Only one dog required multiple treatments. Treatment was well tolerated by all patients, with minimal complications. Clinical Significance: This treatment compares favourably to previously published data using one-hour topical clotrimazole or enilconazole flushing treatment protocols. The treatment technique significantly reduced treatment time under anaesthesia. [source] Treatment with short-term, high-dose cyclosporin A in children with refractory chronic idiopathic thrombocytopenic purpuraBRITISH JOURNAL OF HAEMATOLOGY, Issue 1 2003Silverio Perrotta Summary. We report on 14 children (seven boys, seven girls) with chronic idiopathic thrombocytopenic purpura (ITP) refractory to multiple treatments, who were given a short-term therapy (range between 6 and 10 weeks) with high doses of cyclosporin A (CyA) (median, 10 mg/kg/d). Six patients experienced adverse events and one developed severe systemic mycosis during therapy. A complete response (CR) was observed in four patients and a partial response (PR) in three patients. Only the four CR patients, who were all girls, had a sustained response. These data suggest that CyA may be effective in some children with chronic symptomatic ITP. [source] Giant dermatofibroma with granular cell changes: side-effect of bee-venom acupuncture?CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 5 2009D.-Y. Rhee Summary Dermatofibroma (DF) is a common benign fibrohistiocytic tumour with a predilection for the legs in middle-aged women. Giant DF, a rare clinical variant of DF, is characterized by its unusually large size. Granular cell change is typical of granular cell tumour, but can be observed in diverse cell lineages. Traumatic factors may be involved in the pathogenesis of giant DF and cellular granularity. We describe a 49-year-old Korean man with a giant DF showing granular cell differentiation, which may have been caused in part by multiple treatments with bee-venom acupuncture. [source] | ||||||||||