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Reduction Therapy (reduction + therapy)

Distribution by Scientific Domains

Medical Sciences	57%

Selected Abstracts

Role of Dobutamine Stress Echocardiography for Preoperative Cardiac Risk Assessment Before Major Vascular Surgery: A Diagnostic Tool Comes of Age

ECHOCARDIOGRAPHY, Issue 1 2000
DON POLDERMANS M.D.
Background: Cardiac complications are a major cause for perioperative mortality and morbidity Also, the presence and severity of underlying coronary artery disease (CAD) determine long-ten prognosis after successful surgery. Aim: This overview evaluates the additional value ofdobutamir, stress echocardiography (DSE) to common clinical cardiac risk factors and other noninvasii cardiac imaging modalities for perioperative and late cardiac prognosis. Results: DSE provides tl attending physician with preoperative prognostic information for perioperative and long-ten prognosis for cardiac events. It also enables the selection of high risk patients for evaluation i cardiac risk reduction therapies. Conclusions: DSE is a useful tool for preoperative cardiac ris evaluation in addition to common clinical cardiac risk factors. (ECHOCARDIOGRAPHY, Vo ume 17, January 2000) [source]

Maximizing help for dissonant smokers

ADDICTION, Issue 1s1 2000
Michael Kunze
'Consonant' smokers know and accept the risks associated with tobacco consumption, and do not wish to change their smoking, whereas 'dissonant' smokers are tobacco consumers whose attitudes differ from their behaviour. Dissonant smokers have several options: to quit smoking (the optimal solution), reduce their smoking, switch products or brands, or do nothing. To date, nicotine replacement therapy (NRT) is the best-established medical aid to smoking cessation, but several important factors impact on NRT use. As smokers constitute a diverse group there is a need for various different formulations, some of which will suit certain smokers better than others. Smokers should be allowed to select their preferred products in order to increase compliance, and should also be permitted to combine various products if desired. Adequate dosage regimens should be stressed in order to avoid under-dosing, which is common with NRT. It is also essential that the medical system focuses increasingly on the diagnosis and treatment of those smokers who are unable or unwilling to quit smoking. High nicotine dependence correlates with a high risk of pulmonary and cardiovascular disease; because these smokers cannot quit, cessation efforts have little impact on the incidence of tobacco-related diseases in this population. Additional smoking control interventions, such as smoking reduction therapy, are therefore required to treat this group. Our experience in Vienna shows that these smokers can be targeted through approaches that utilize new messages offering alternatives to cessation. [source]

Role of hepatic iron in non-alcoholic steatohepatitis

HEPATOLOGY RESEARCH, Issue 3 2009
Yoshio Sumida
Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of clinical entities ranging from simple steatosis to non-alcoholic steatohepatitis (NASH) with possible evolution to cirrhosis and hepatocellular carcinoma. Iron is considered a putative element that interacts with oxygen radicals in inducing liver damage and fibrosis. The role of hepatic iron in the progression of NASH remains controversial, but in some patients, iron may have a role in the pathogenesis of NASH. Though genetic factors, insulin resistance, dysregulation of iron-regulatory molecules, erythrophagocytosis by Kupffer cells may be responsible for hepatic iron accumulation in NASH, exact mechanisms involved in iron overload remain to be clarified. Iron reduction therapy such as phlebotomy or dietary iron restriction may be promising in patients with NASH/NAFLD to reduce insulin resistance as well as serum transaminase activities. [source]

Partners in treatment: relational psychoanalysis and harm reduction therapy

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2010
Debra Rothschild
Abstract A relational psychoanalytic harm reduction orientation to the treatment of substance misusers is presented and illustrated with a clinical example. Both harm reduction therapy and relational psychoanalysis rely on a two-person model in which the therapist and client are collaborators in the treatment. In both, substance use is seen in the context of the user's internal psychodynamics and external environment, and there is an emphasis on treating the person as a whole individual whose substance use is one aspect of life, rather than focusing on the substance use itself as was often done in the past. Historically, psychoanalysis and substance abuse treatment were so different from each other that their paths rarely crossed. The introduction of harm reduction therapy to substance abuse and the relational orientation in psychoanalysis have brought the fields closer together such that the valuable contributions that each can make to the other can now be appreciated. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66: 1,14, 2010. [source]

Miglustat (Zavesca®) in type 1 Gaucher disease: 5-year results of a post-authorisation safety surveillance programme

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 9 2009
Carla E. M. Hollak MD
Abstract Purpose Miglustat (Zavesca®) is an orally-available substrate reduction therapy (SRT) for treatment of mild-to-moderate type 1 Gaucher disease (GD1) in adult patients unsuitable for enzyme replacement therapy (ERT). Miglustat has not been evaluated in children with GD1, and is not used during pregnancy and breast-feeding. A non-interventional, prospective, web-based safety surveillance programme was initiated at the time of the European launch of miglustat in 2003, and is ongoing. We report the first 5 years of collected data, focusing on neurological manifestations. Methods Data were collected on 122 GD1 patients between March 2003 and April 2008, representing 244 patient-years cumulative miglustat post-authorisation experience. The electronically-captured data collected from participating physicians includes patient demographics, prior and current therapies, baseline disease manifestations and concurrent conditions, disease severity, duration of miglustat exposure, and safety-relevant information. Results Mean (SD) age at baseline was 46.1 (16.5) years. At baseline, bone disease and neurological manifestations were reported in 55.6 and 28.6% of patients, respectively; the latter included peripheral neuropathy (7.2%) and a wide variety of neurological symptoms and signs. In addition, 23.2% had other health conditions relevant to neurological status. During the reporting period, new neurological manifestations were reported in 23 (18.9%) patients, principally tremor. Thirty-five (28.7%) patients discontinued treatment, predominantly for gastrointestinal (GI) disturbances (11.5%), two-thirds of which occurred during the first 6 months. Conclusion The safety profile of miglustat in GD1 patients included in the safety surveillance programme is overall consistent with that reported in the registration and other clinical trials, and no new safety finding was identified. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Gene therapy for lysosomal storage diseases: the lessons and promise of animal models

THE JOURNAL OF GENE MEDICINE, Issue 5 2004
N. Matthew Ellinwood
Abstract There are more than 40 different forms of inherited lysosomal storage diseases (LSDs) known to occur in humans and the aggregate incidence has been estimated to approach 1 in 7000 live births. Most LSDs are associated with high morbidity and mortality and represent a significant burden on patients, their families, and health care providers. Except for symptomatic therapies, many LSDs remain untreatable, and gene therapy is among the only viable treatment options potentially available. Therapies for some LSDs do exist, or are under evaluation, including heterologous bone marrow transplantation (BMT), enzyme replacement therapy (ERT), and substrate reduction therapy (SRT), but these treatment options are associated with significant concerns, including high morbidity and mortality (BMT), limited positive outcomes (BMT), incomplete response to therapy (BMT, ERT, and SRT), life-long therapy (ERT, SRT), and cost (BMT, ERT, SRT). Gene therapy represents a potential alternative therapy, albeit a therapy with its own attendant concerns. Animal models of LSDs play a critical role in evaluating the efficacy and safety of therapy for many of these conditions. Naturally occurring animal homologs of LSDs have been described in the mouse, rat, dog, cat, guinea pig, emu, quail, goat, cattle, sheep, and pig. In this review we discuss those animal models that have been used in gene therapy experiments and those with promise for future evaluations. Copyright © 2004 John Wiley & Sons, Ltd. [source]