Search results for: lymphocyte therapy.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 200

Search results for: lymphocyte therapy.

200 Two Cases of VACTERL Association in Pregnancy with Lymphocyte Therapy

Authors: Seyed Mazyar Mortazavi, Masod Memari, Hasan Ali Ahmadi, Zhaleh Abed

Abstract:

VACTERL association is a rare disorder with various congenital malformations. The aetiology remains unknown. Combination of at least three congenital anomalies of the following criteria is required for diagnosis: vertebral defects, anal atresia, cardiac anomalies, tracheo-esophageal fistula, renal anomalies, and limb defects. The first case was 1-day old male neonate with multiple congenital anomalies was bore from 28 years old mother. The mother had history of pregnancy with lymphocyte therapy. His anomalies included: defects in thoracic and lumbar vertebral, anal atresia, bilateral hydronephrosis, atrial septal defect, and lower limb abnormality. Other anomalies were cryptorchidism and nasal canal narrowing. The second case was born with 32 weeks gestational age from mother with history of pregnancy with lymphocyte therapy. He had thoracic vertebral defect, cardiac anomalies and renal defect. diagnosis based on clinical finding is VACTERL association. Early diagnosis is very important to investigation and treatment of other coexistence anomalies. VACTERL association in mothers with history of pregnancy with lymphocyte therapy has suggested possibly of relationship between VACTERL association and this method of pregnancy.

Keywords: Anal atresia, tracheo-esophageal fistula, atrial septal defect, lymphocyte therapy.

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199 Leukocytes Count and Lymphocyte Proliferation of Dinitrochlorobenzene Sensitized Rat Supplemented with Fermented Goat Milk

Authors: Nurliyani, Eni Harmayani, Marsetyawan HNE Soesatyo

Abstract:

Goat milk has an hypoallergenic effects, and allergic diseases related to abnormal of intestinal flora. Probiotic microorganisms do exert an activity on the immune system in the skin of the individual.The purpose of this study are to determine the number of leukocyte and lymphocyte proliferation in rat supplemented with fermented goat milk (acidophilus milk and kefir) and sensitized with dinitrochlorobenzene (DNCB). Female Wistar rats 6-8 weeks olds were divided into 3 treatment groups. The first group supplemented goat milk kefir, second group acidophilus goat milk, and third group as control. During 28-day experiment, on day 15 rat sensitized with allergen DNCB on the dorsal of the body, and on day 24 was challenged with DNCB on the ear. Sampling of blood and tissue of intestinal Peyer'patch (PP) were performed on day 14 (before DNCB sensitized) and on day 28 (after DNCB sensitized). The results showed the number of neutrophils in rats supplemented with acidophilus milk was higher (P<0.05) in after DNCB sensitized than before, but the lymphocyte count was lower. The number of monocytes, eosinophils, and basophils before and after DNCB sensitized have the same average for all treatments of milk fermented and control. Fermented goat milk (kefir and acidophilus milk) did not affect on rat PP lymphocyte proliferation culture supernatant, whereas the rat that had been DNCB sensitized showed higher in proliferative response to PHA mitogen (P <0.05) than before sensitized. In conclusion, supplementation of acidophilus goat milk with a dose of 2.0 ml / head / day on DNCB sensitized rat, can increase the number of neutrophils that play a role in innate immunity, however it was not able to increase lymphocyte proliferation that related to adaptive immunity.

Keywords: Leukocytes, Lymphocyte proliferation, Kefir, Acidophilus milk, Dinitrochlorobenzene

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198 Blood Lymphocyte and Neutrophil Response of Cultured Rainbow Trout, Oncorhynchus mykiss, Administered Varying Dosages of an Oral Immunomodulator – ‘Fin-Immune™’

Authors: Duane Barker, John Holliday

Abstract:

In a 10-week (May – August, 2008) Phase I trial, 840, 1+ rainbow trout, Oncorhynchus mykiss, received a commercial oral immunomodulator, Fin Immune™, at four different dosages (0, 10, 20 and 30 mg g-1) to evaluate immune response and growth. The overall objective of was to determine an optimal dosage of this product for rainbow trout that provides enhanced immunity with maximal growth and health. Biweekly blood samples were taken from 10 randomly selected fish in each tank (30 samples per treatment) to evaluate the duration of enhanced immunity conferred by Fin-Immune™. The immunological assessment included serum white blood cell (lymphocyte, neutrophil) densities and blood hematocrit (packed cell volume %). Of these three variables, only lymphocyte density increased significantly among trout fed Fin- Immune™ at 20 and 30 mg g-1 which peaked at week 6. At week 7, all trout were switched to regular feed (lacking Fin-Immune™) and by week 10, lymphocyte levels decreased among all levels but were still greater than at week 0. There was growth impairment at the highest dose of Fin-Immune™ tested (30 mg g-1) which can be associated with a physiological compensatory mechanism due to a dose-specific threshold level. Thus, our main objective of this Phase I study was achieved, the 20 mg g-1 dose of Fin-Immune™ should be the most efficacious (of those we tested) to use for a Phase II disease challenge trial.

Keywords: Blood Lymphocyte, Neutrophil Response of Cultured Rainbow Trout, Oncorhynchus mykiss, Oral Immunomodulator – 'Fin-ImmuneTM'.

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197 The Evaluation of Complete Blood Cell Count-Based Inflammatory Markers in Pediatric Obesity and Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is defined as a severe chronic disease characterized by a low-grade inflammatory state. Therefore, inflammatory markers gained utmost importance during the evaluation of obesity and metabolic syndrome (MetS), a disease characterized by central obesity, elevated blood pressure, increased fasting blood glucose and elevated triglycerides or reduced high density lipoprotein cholesterol (HDL-C) values. Some inflammatory markers based upon complete blood cell count (CBC) are available. In this study, it was questioned which inflammatory marker was the best to evaluate the differences between various obesity groups. 514 pediatric individuals were recruited. 132 children with MetS, 155 morbid obese (MO), 90 obese (OB), 38 overweight (OW) and 99 children with normal BMI (N-BMI) were included into the scope of this study. Obesity groups were constituted using age- and sex-dependent body mass index (BMI) percentiles tabulated by World Health Organization. MetS components were determined to be able to specify children with MetS. CBC were determined using automated hematology analyzer. HDL-C analysis was performed. Using CBC parameters and HDL-C values, ratio markers of inflammation, which cover neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), monocyte-to-HDL-C ratio (MHR) were calculated. Statistical analyses were performed. The statistical significance degree was considered as p < 0.05. There was no statistically significant difference among the groups in terms of platelet count, neutrophil count, lymphocyte count, monocyte count, and NLR. PLR differed significantly between OW and N-BMI as well as MetS. Monocyte-to HDL-C value exhibited statistical significance between MetS and N-BMI, OB, and MO groups. HDL-C value differed between MetS and N-BMI, OW, OB, MO groups. MHR was the ratio, which exhibits the best performance among the other CBC-based inflammatory markers. On the other hand, when MHR was compared to HDL-C only, it was suggested that HDL-C has given much more valuable information. Therefore, this parameter still keeps its value from the diagnostic point of view. Our results suggest that MHR can be an inflammatory marker during the evaluation of pediatric MetS, but the predictive value of this parameter was not superior to HDL-C during the evaluation of obesity.

Keywords: Children, complete blood cell count, high density lipoprotein cholesterol, metabolic syndrome, obesity.

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196 Analysis of Sonogram Images of Thyroid Gland Based on Wavelet Transform

Authors: M. Bastanfard, B. Jalaeian, S. Jafari

Abstract:

Sonogram images of normal and lymphocyte thyroid tissues have considerable overlap which makes it difficult to interpret and distinguish. Classification from sonogram images of thyroid gland is tackled in semiautomatic way. While making manual diagnosis from images, some relevant information need not to be recognized by human visual system. Quantitative image analysis could be helpful to manual diagnostic process so far done by physician. Two classes are considered: normal tissue and chronic lymphocyte thyroid (Hashimoto's Thyroid). Data structure is analyzed using K-nearest-neighbors classification. This paper is mentioned that unlike the wavelet sub bands' energy, histograms and Haralick features are not appropriate to distinguish between normal tissue and Hashimoto's thyroid.

Keywords: Sonogram, thyroid, Haralick feature, wavelet.

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195 What Do Young People Seeking Professional Help Want and Expect From Therapy?

Authors: Clare Watsford, Debra Rickwood

Abstract:

Client expectations and preferences about therapy represent an important area of investigation as research shows they are linked to engagement in therapy and therapy outcomes. Studies examining young people-s expectations and preferences of therapy remain a neglected area of research. The present study explored what expectations and preferences young people seeking professional help held regarding: their role as a client, their therapist-s role, their therapeutic outcomes, and the processes of therapy. Gender and age differences were also examined. Participants included 188 young people aged 12-25 who completed a survey while attending their initial session at a youth mental health service. Data were analysed using quantitative methods. Results found the young people held significantly more pessimistic expectations around therapy when compared to what they had wanted therapy to be like. Few age and gender differences were found. Results highlight the importance of a collaborative therapy approach when working with young people.

Keywords: Client expectations, mental health services, preferences, young people

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194 The Effectiveness of Metaphor Therapy on Depression among Female Students

Authors: Marzieh Talebzadeh Shoushtari

Abstract:

The present study aimed to determine the effectiveness of Metaphor therapy on depression among female students. The sample included 60 female students with depression symptoms selected by simple sampling and randomly divided into two equal groups (experimental and control groups). Beck Depression Inventory was used to measure the variables. This was an experimental study with a pre-test/post-test design with control group. Eight metaphor therapy sessions were held for the experimental group. A post-test was administered to both groups. Data were analyzed using multivariate analysis of covariance (MANCOVA). Results showed that the Metaphor therapy decreased depression in the experimental group compared to the control group.

Keywords: Metaphor therapy, depression, female, students.

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193 Links between Inflammation and Insulin Resistance in Children with Morbid Obesity and Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is a clinical state associated with low-grade inflammation. It is also a major risk factor for insulin resistance (IR). In its advanced stages, metabolic syndrome (MetS), a much more complicated disease which may lead to life-threatening problems, may develop. Obesity-mediated IR seems to correlate with the inflammation. Human studies performed particularly on pediatric population are scarce. The aim of this study is to detect possible associations between inflammation and IR in terms of some related ratios. 549 children were grouped according to their age- and sex-based body mass index (BMI) percentile tables of WHO. MetS components were determined. Informed consent and approval from the Ethics Committee for Clinical Investigations were obtained. The principles of the Declaration of Helsinki were followed. The exclusion criteria were infection, inflammation, chronic diseases and those under drug treatment. Anthropometric measurements were obtained. Complete blood cell, fasting blood glucose, insulin, and C-reactive protein (CRP) analyses were performed. Homeostasis model assessment of insulin resistance (HOMA-IR), systemic immune inflammation (SII) index, tense index, alanine aminotransferase to aspartate aminotransferase ratio (ALT/AST), neutrophils to lymphocyte (NLR), platelet to lymphocyte, and lymphocyte to monocyte ratios were calculated. Data were evaluated by statistical analyses. The degree for statistical significance was 0.05. Statistically significant differences were found among the BMI values of the groups (p < 0.001). Strong correlations were detected between the BMI and waist circumference (WC) values in all groups. Tense index values were also correlated with both BMI and WC values in all groups except overweight (OW) children. SII index values of children with normal BMI were significantly different from the values obtained in OW, obese, morbid obese and MetS groups. Among all the other lymphocyte ratios, NLR exhibited a similar profile. Both HOMA-IR and ALT/AST values displayed an increasing profile from N towards MetS3 group. BMI and WC values were correlated with HOMA-IR and ALT/AST. Both in morbid obese and MetS groups, significant correlations between CRP versus SII index as well as HOMA-IR versus ALT/AST were found. ALT/AST and HOMA-IR values were correlated with NLR in morbid obese group and with SII index in MetS group, (p < 0.05), respectively. In conclusion, these findings showed that some parameters may exhibit informative differences between the early and late stages of obesity. Important associations among HOMA-IR, ALT/AST, NLR and SII index have come to light in the morbid obese and MetS groups. This study introduced the SII index and NLR as important inflammatory markers for the discrimination of normal and obese children. Interesting links were observed between inflammation and IR in morbid obese children and those with MetS, both being late stages of obesity.

Keywords: Children, inflammation, insulin resistance, metabolic syndrome, obesity.

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192 Loss of P16/INK4A Protein Expression is a Common Abnormality in Hodgkin's Lymphoma

Authors: Fawzi Irshaid, Fatiha Dilmi, Khaled Tarawneh, Raji Hadeth, Adnan Jaran, Ahad Al-Khatib

Abstract:

P16/INK4A is tumor suppressor protein that plays a critical role in cell cycle regulation. Loss of P16 protein expression has been implicated in pathogenesis of many cancers, including lymphoma. Therefore, we sought to investigate if loss of P16 protein expression is associated with lymphoma and/or any specific lymphoma subtypes (Hodgkin-s lymphoma (HL) and nonHodgkin-s lymphoma (NHL)). Fifty-five lymphoma cases consisted of 30 cases of HL and 25 cases of NHL, with an age range of 3 to 78 years, were examined for loss of P16 by immunohistochemical technique using a specific antibody reacting against P16. In total, P16 loss was seen in 33% of all lymphoma cases. P16 loss was identified in 47.7% of HL cases. In contrast, only 16% of NHL showed loss of P16. Loss of P16 was seen in 67% of HL patients with 50 years of age or older, whereas P16 loss was found in only 42% of HL patients with less than 50 years of age. P16 loss in HL is somewhat higher in male (55%) than in female (30%). In subtypes of HL, P16 loss was found exclusively in all cases of lymphocyte depletion, lymphocyte predominance and unclassified cases, whereas P16 loss was seen in 39% of mixed cellularity and 29% of nodular sclerosis cases. In low grade NHL patients, P16 loss was seen in approximately one-third of cases, whereas no or very rare of P16 loss was found in intermediate and high grade cases. P16 loss did not show any correlation with age or gender of NHL patients. In conclusion, the high rate of P16 loss seen in our study suggests that loss of P16 expression plays a critical role in the pathogenesis of lymphoma, particularly with HL.

Keywords: B-cells, immunostaining, P16 protein, Reed-Sternberg cells, tumors.

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191 Pilot Trial of Evidence-Based Integrative Group Therapy to Improve Executive Functioning among Adults: Implications for Community Mental Health and Training Clinics

Authors: B. Parchem, M. Watanabe, D. Modrakovic, L. Mathew, A. Franklin, M. Cao, R. E. Broudy

Abstract:

Objective: Executive functioning (EF) deficits underlie several mental health diagnoses including ADHD, anxiety, and depression. Community mental health clinics face extensive waitlists for services with many referrals involving EF deficits. A pilot trial of a four-week group therapy was developed using key components from Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness with an aim to improve EF skills and offer low-fee services. Method: Eight adults (M = 34.5) waiting for services at a community clinic were enrolled in a four-week group therapy at an in-house training clinic for doctoral trainees. Baseline EF, pre-/post-intervention ADHD and distress symptoms, group satisfaction, and curriculum helpfulness were assessed. Results: Downward trends in ADHD and distress symptoms pre/post-intervention were not significant. Favorable responses on group satisfaction and helpfulness suggest clinical utility. Conclusion: Preliminary pilot data from a brief group therapy to improve EF may be an efficacious, acceptable, and feasible intervention for adults waiting for services at community mental health and training clinics where there are high demands and limits to services and staffs.

Keywords: Executive functioning, cognitive-behavioral therapy, dialectical behavior therapy, mindfulness, adult group therapy.

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190 Neutrophil-to-Lymphocyte Ratio: A Predictor of Cardiometabolic Complications in Morbid Obese Girls

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is a low-grade inflammatory state. Childhood obesity is a multisystem disease, which is associated with a number of complications as well as potentially negative consequences. Gender is an important universal risk factor for many diseases. Hematological indices differ significantly by gender. This should be considered during the evaluation of obese children. The aim of this study is to detect hematologic indices that differ by gender in morbid obese (MO) children. A total of 134 MO children took part in this study. The parents filled an informed consent form and the approval from the Ethics Committee of Namik Kemal University was obtained. Subjects were divided into two groups based on their genders (64 females aged 10.2±3.1 years and 70 males aged 9.8±2.2 years; p ≥ 0.05). Waist-to-hip as well as head-to-neck ratios and body mass index (BMI) values were calculated. The children, whose WHO BMI-for age and sex percentile values were > 99 percentile, were defined as MO. Hematological parameters [haemoglobin, hematocrit, erythrocyte count, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red blood cell distribution width, leukocyte count, neutrophil %, lymphocyte %, monocyte %, eosinophil %, basophil %, platelet count, platelet distribution width, mean platelet volume] were determined by the automatic hematology analyzer. SPSS was used for statistical analyses. P ≤ 0.05 was the degree for statistical significance. The groups included children having mean±SD value of BMI as 26.9±3.4 kg/m2 for males and 27.7±4.4 kg/m2 for females (p ≥ 0.05). There was no significant difference between ages of females and males (p ≥ 0.05). Males had significantly increased waist-to-hip ratios (0.95±0.08 vs 0.91±0.08; p=0.005) and mean corpuscular hemoglobin concentration values (33.6±0.92 vs 33.1±0.83; p=0.001) compared to those of females. Significantly elevated neutrophil (4.69±1.59 vs 4.02±1.42; p=0.011) and neutrophil-to-lymphocyte ratios (1.70±0.71 vs 1.39±0.48; p=0.004) were detected in females. There was no statistically significant difference between groups in terms of C-reactive protein values (p ≥ 0.05). Adipose tissue plays important roles during the development of obesity and associated diseases such as metabolic syndrom and cardiovascular diseases (CVDs). These diseases may cause changes in complete blood cell count parameters. These alterations are even more important during childhood. Significant gender effects on the changes of neutrophils, one of the white blood cell subsets, were observed. The findings of the study demonstrate the importance of considering gender in clinical studies. The males and females may have distinct leukocyte-trafficking profiles in inflammation. Female children had more circulating neutrophils, which may be the indicator of an increased risk of CVDs, than male children within this age range during the late stage of obesity. In recent years, females represent about half of deaths from CVDs; therefore, our findings may be the indicator of the increasing tendency of this risk in females starting from childhood.

Keywords: Children, gender, morbid obesity, neutrophil-to-lymphocyte ratio.

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189 Cognitive Behaviour Therapy to Treat Social Anxiety Disorder: A Psychology Case

Authors: Yasmin Binti Othman Mydin, Mohd. Fadzillah Abdul Razak

Abstract:

Rational Emotive Behaviour Therapy is the first cognitive behavior therapy which was introduced by Albert Ellis. This is a systematic and structured psychotherapy which is effective in treating various psychological problems. A patient, 25 years old male, experienced intense fear and situational panic attack to return to his faculty and to face his class-mates after a long absence (2 years). This social anxiety disorder was a major factor that impeded the progress of his study. He was treated with the use of behavioural technique such as relaxation breathing technique and cognitive techniques such as imagery, cognitive restructuring, rationalization technique and systematic desensitization. The patient reported positive improvement in the anxiety disorder, able to progress well in studies and lead a better quality of life as a student.

Keywords: Anxiety, behaviour, cognitive, therapy

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188 A Heat-Inducible Transgene Expression System for Gene Therapy

Authors: Masaki Yamaguchi, Akira Ito, Noriaki Okamoto, Yoshinori Kawabe, Masamichi Kamihira

Abstract:

Heat-inducible gene expression vectors are useful for hyperthermia-induced cancer gene therapy, because the combination of hyperthermia and gene therapy can considerably improve the therapeutic effects. In the present study, we developed an enhanced heat-inducible transgene expression system in which a heat-shock protein (HSP) promoter and tetracycline-responsive transactivator were combined. When the transactivator plasmid containing the tetracycline-responsive transactivator gene was co-transfected with the reporter gene expression plasmid, a high level of heat-induced gene expression was observed compared with that using the HSP promoter without the transactivator. In vitro evaluation of the therapeutic effect using HeLa cells showed that heat-induced therapeutic gene expression caused cell death in a high percentage of these cells, indicating that this strategy is promising for cancer gene therapy.

Keywords: Inducible gene expression, Gene therapy, Hyperthermia, Heat shock protein, Tetracycline transactivator.

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187 The Impact of Solution-Focused Brief Therapy on the Improvement of the Psychological Wellbeing of Family Supervisor Women

Authors: Kaveh Qaderi Bagajan, Osman Khanahmadi, Ziba Mamaghani Chaharborj, Majid Chenaparchi

Abstract:

The purpose of this study is to investigate the efficacy of the solution-focused brief therapy on improving the psychological wellbeing of family supervisor woman. This study has been carried out by semi-experimental method and in the form of pre-test, post-test performance on two groups (experimental and control), so that one sample group of 30 individuals was randomly achieved and were randomly divided in two groups of experimental (n=15) and control (n=15). To collect data, Ryff scale psychological wellbeing was used. After conducting pre-test (RSPWB) for two experimental and control groups, Solution-focused brief therapy interference was conducted on the experimental group during five two-hour sessions. Finally, Ryff scale psychological wellbeing was reused for the two groups as post-test and achieved outcomes that were analyzed using covariance. The results indicated that the significant increase of average marks of the experimental group in psychological wellbeing had better function than that of the control group. Finally, solution-focused brief therapy for improving psychological well-being of family supervisor women has a suitable capability and could be used in this way.

Keywords: Solution-Focused Brief Therapy, Short-term Therapy, Family Supervisor Women, Psychological Wellbeing.

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186 Effect of Cold, Warm or Contrast Therapy on Controlling Knee Osteoarthritis Associated Problems

Authors: Amal E. Shehata, Manal E. Fareed

Abstract:

Osteoarthritis (OA) is the most prevalent and far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint. Patients suffering from osteoarthritis often complain of dull ache pain on movement. Physical agents can fight the painful process when correctly indicated and used such as heat or cold therapy Aim. This study was carried out to: Compare the effect of cold, warm and contrast therapy on controlling knee osteoarthritis associated problems. Setting: The study was carried out in orthopedic outpatient clinics of Menoufia University and teaching Hospitals, Egypt. Sample: A convenient sample of 60 adult patients with unilateral knee osteoarthritis. Tools: three tools were utilized to collect the data. Tool I : An interviewing questionnaire. It comprised of three parts covering  sociodemographic data, medical data and adverse effects of the treatment protocol. Tool II : Knee Injury and Osteoarthritis Outcome Score (KOOS) It consists of five main parts. Tool II1 : 0-10 Numeric pain rating scale. Results: reveled that the total knee symptoms score was decreased from moderate symptoms pre intervention to mild symptoms after warm and contrast method of therapy, but the contrast therapy had significant effect in reducing the knee symptoms and pain than the other symptoms. Conclusions: all of the three methods of therapy resulted in improvement in all knee symptoms and pain but the most appropriate protocol of treatment to relive symptoms and pain was contrast therapy.

Keywords: Knee Osteoarthritis, Cold, Warm and Contrast Therapy.

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185 The Efficacy of Self-Administered Danger Ideation Reduction Therapy for a 50-year Old Woman with a 20 Year History of Obsessive- Compulsive Disorder: A Case Study

Authors: Mairwen K. Jones, Lynne Harris, Lisa D. Vaccaro

Abstract:

Obsessive-Compulsive Disorder (OCD) is a common and disabling condition. Therapist-delivered treatments that use exposure and response prevention have been found to be very effective in treating OCD, although they are costly and associated with high rates of attrition. Effective treatments that can be made widely available without the need for therapist contact are urgently needed. This case study represents the first published investigation of a self-administered cognitive treatment for OCD in a 50-year old female with a 20 year history of OCD. The treatment evaluation occurred over 27 weeks, including 12 weeks of self-administration of the Danger Ideation Reduction Therapy (DIRT) program. Decreases of between 23% to 33% on measures from pre-treatment to follow-up were observed. Bearing in mind the methodological limitations associated with a case study, we conclude that the results reported here are encouraging and indicate that further research effort evaluating the effectiveness of self-administered DIRT is warranted.

Keywords: Anxiety Treatment, Cognitive Therapy, Danger Ideation Reduction Therapy, Obsessive–Compulsive Disorder, Self- Administered Danger Ideation Reduction Therapy.

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184 The Effects of Mirror Therapy on Clinical Improvement in Hemiplegic Lower Extremity Rehabilitation in Subjects with Chronic Stroke

Authors: Hassan M. Abo Salem, Xiaolin Huang

Abstract:

Background: The effectiveness of mirror therapy (MT) has been investigated in acute hemiplegia. The present study examines whether MT, given during chronic stroke, was more effective in promoting motor recovery of the lower extremity and walking speed than standard rehabilitation alone. Methods: The study enrolled 30 patients with chronic stroke. Fifteen patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received mirror therapy for 4 weeks, 5 days a week. Main measures: Passive ankle joint dorsiflexion range of motion, gait speed, Brunnstrom stages of motor recovery, plantar flexor muscle tone by Modified Ashworth Scale. Results: No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation, mirror therapy improved Ankle ROM, Brunnstrom stages and waking speed (p < 0.05). However, there were no significant differences between two groups on MAS (P > 0.05).Conclusion: Mirror therapy combined with a conventional stroke rehabilitation program enhances lowerextremity motor recovery and walking speed in chronic stroke patients.

Keywords: Mirror therapy, stroke, MAS, walking speed.

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183 The Efficacy of Danger Ideation Reduction Therapy for an 86-Year Old Man with a 63-Year History of Obsessive-Compulsive Disorder: A Case Study

Authors: Mairwen K. Jones, Bethany M. Wootton, Lisa D. Vaccaro

Abstract:

While OCD is one of the most commonly occurring psychiatric conditions experienced by older adults, there is a paucity of research conducted into the treatment of older adults with OCD. This case study represents the first published investigation of a cognitive treatment for geriatric OCD. It describes the successful treatment of an 86-year old man with a 63-year history of OCD using Danger Ideation Reduction Therapy (DIRT). The client received 14 individual, 50-minute treatment sessions of DIRT over 13 weeks. Clinician-based Y-BOCS scores reduced 84% from 25 (severe) at pre-treatment, to 4 (subclinical) at 6-month post-treatment follow-up interview, demonstrating the efficacy of DIRT for this client. DIRT may have particular advantages over ERP and pharmacological approaches, however further research is required in older adults with OCD.

Keywords: Cognitive Therapy, Danger Ideation Reduction Therapy, Obsessive-Compulsive Disorder, Older adults, Psychogeriatrics

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182 The Use of Music Therapy to Improve Non-Verbal Communication Skills for Children with Autism

Authors: Maria Vinca Novenia

Abstract:

The number of school-aged children with autism in Indonesia has been increasing each year. Autism is a developmental disorder which can be diagnosed in childhood. One of the symptoms is the lack of communication skills. Music therapy is known as an effective treatment for children with autism. Music elements and structures create a good space for children with autism to express their feelings and communicate their thoughts. School-aged children are expected to be able to communicate non-verbally very well, but children with autism experience the difficulties of communicating non-verbally. The aim of this research is to analyze the significance of music therapy treatment to improve non-verbal communication tools for children with autism. This research informs teachers and parents on how music can be used as a media to communicate with children with autism. The qualitative method is used to analyze this research, while the result is described with the microanalysis technique. The result is measured specifically from the whole experiment, hours of every week, minutes of every session, and second of every moment. The samples taken are four school-aged children with autism in the age range of six to 11 years old. This research is conducted within four months started with observation, interview, literature research, and direct experiment. The result demonstrates that music therapy could be effectively used as a non-verbal communication tool for children with autism, such as changes of body gesture, eye contact, and facial expression.

Keywords: Autism, non-verbal communication, microanalysis, music therapy, school-aged children.

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181 The Effectiveness of Solution-Focused Group Therapy on Improving Depressed Mothers of Child Abuser Families

Authors: Roya Maqami, Kaveh Qaderi Bagajan, Mohammad Mahdi Yousefi, Saeed Moradi

Abstract:

The purpose of this study is to investigate the efficacy of solution-focused group therapy on improving the depressed mothers of child abuser families. This study was carried out in the form of a semi-pilot, pre-test and post-test on two groups (experimental and control). Subjects include all mothers and their children that are the members of Shush and Naser Khosro child home. Beck Depression Inventory and Child Trauma Questionnaire were used to collect data. First, child abuse questionnaire was completed by children, Then Beck Depression Inventory was completed by their mothers that 22 of them were recognized as depressed and randomly divided in two groups of experimental and control. After applying pre-test for both of these groups, the intervention of solution- focused group therapy was performed in five sessions on experimental group. Finally, post-test was applied on both groups and subsequently in a month, follow-up test was performed. T-test, multivariate variance, and repeated measurement analysis of variance were used to analyze the data. According to the findings, it can be concluded that this therapy leads to the improvement of depressed mother's mood. As a result, the intervention of solution-focused group therapy is useful in order to improve the depressing mood of mothers of child abuser families.

Keywords: Child Abuse, Depressed Mothers, Child Abuser Families, Solution-focused Group Therapy.

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180 Acceptance and Commitment Therapy for Work Stress: Variation in Perceived Group Process and Outcomes

Authors: William H. O'Brien, Erin Bannon, M.A., Heather McCarren, Eileen Delaney

Abstract:

Employees commonly encounter unpredictable and unavoidable work related stressors. Exposure to such stressors can evoke negative appraisals and associated adverse mental, physical, and behavioral responses. Because Acceptance and Commitment Therapy (ACT) emphasizes acceptance of unavoidable stressors and diffusion from negative appraisals, it may be particularly beneficial for work stress. Forty-five workers were randomly assigned to an ACT intervention for work stress (n = 21) or a waitlist control group (n = 24). The intervention consisted of two 3-hour sessions spaced one week apart. An examination of group process and outcomes was conducted using the Revised Sessions Rating Scale. Results indicated that the ACT participants reported that they perceived the intervention to be supportive, task focused, and without adverse therapist behaviors (e.g., feelings of being criticized or discounted). Additionally, the second session (values clarification and commitment to action) was perceived to be more supportive and task focused than the first session (mindfulness, defusion). Process ratings were correlated with outcomes. Results indicated that perceptions of therapy supportiveness and task focus were associated with reduced psychological distress and improved perceived physical health.

Keywords: Work stress, Acceptance and Commitment Therapy, therapy process.

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179 Ozone Therapy and Pulsed Electromagnetic Fields Interplay in Controlling Tumor Growth, Symptom and Pain Management: A Case Report

Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

Abstract:

Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: Cancer, complementary and alternative medicine, ozone therapy, palliative care, PEMF Therapy.

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178 TeleMe Speech Booster: Web-Based Speech Therapy and Training Program for Children with Articulation Disorders

Authors: C. Treerattanaphan, P. Boonpramuk, P. Singla

Abstract:

Frequent, continuous speech training has proven to be a necessary part of a successful speech therapy process, but constraints of traveling time and employment dispensation become key obstacles especially for individuals living in remote areas or for dependent children who have working parents. In order to ameliorate speech difficulties with ample guidance from speech therapists, a website has been developed that supports speech therapy and training for people with articulation disorders in the standard Thai language. This web-based program has the ability to record speech training exercises for each speech trainee. The records will be stored in a database for the speech therapist to investigate, evaluate, compare and keep track of all trainees’ progress in detail. Speech trainees can request live discussions via video conference call when needed. Communication through this web-based program facilitates and reduces training time in comparison to walk-in training or appointments. This type of training also allows people with articulation disorders to practice speech lessons whenever or wherever is convenient for them, which can lead to a more regular training processes.

Keywords: Web-Based Remote Training Program, Thai Speech Therapy, Articulation Disorders.

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177 Education and Research in Physical Therapy and Rehabilitation in Libya

Authors: W. Astiata, A. Wasif

Abstract:

In this paper, an overview is made on the educational and research activities in the field of physical medicine and rehabilitation in Libya, including development in rehabilitation science, research, training, occupational therapy, physiotherapy and physiatrist, which are mainly concerned with the patients in Libya[3] [13].

Keywords: Physiotherapy, Rehabilitation, Libya, Graduates, Institutions, Universities, Research, Education, Courses.

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176 The Effects of Extracorporeal Shockwave Therapy on Pain, Function, Range of Motion and Strength in Patients with Plantar Fasciitis

Authors: P. Sanzo

Abstract:

Ten percent of the population will develop plantar fasciitis (PF) during their lifetime. Two million people are treated yearly accounting for 11-15% of visits to medical professionals. Treatment ranges from conservative to surgical intervention. The purpose of this study was to assess the effects of extracorporeal shockwave therapy (ECSWT) on heel pain, function, range of motion (ROM), and strength in patients with PF. One hundred subjects were treated with ECSWT and measures were taken before and three months after treatment. There was significant differences in visual analog scale scores for pain at rest (p=0.0001); after activity (p= 0.0001) and; overall improvement (p=0.0001). There was also significant improvement in Lower Extremity Functional Scale scores (p=0.0001); ankle plantarflexion (p=0.0001), dorsiflexion (p=0.001), and eversion (p=0.017),and first metatarsophalangeal joint flexion (p=0.002) and extension (p=0.003) ROM. ECSWT is an effective treatment improving heel pain, function and ROM in patients with PF.

Keywords: Extracorporeal shockwave therapy, shockwave therapy, plantar fasciitis, heel pain, function, range of motion, strength.

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175 Marital Interactions in Predicting Treatment Outcome in Panic Disorder with Agoraphobia

Authors: Ghassan El-Baalbaki, Claude Bélanger, Michel Perreault, Steffany J. Fredman, Donald H. Baucom

Abstract:

This study had two goals. First, it investigated marital interaction variables as predictors of treatment outcome in panic disorder with agoraphobia (PDA) in sixty-five couples with one spouse suffering from PDA. Second, it analyzed the impact of PDA improvement, following therapy, on marital interaction patterns of both spouses. The partners were observed during a problem-solving task, before and after treatment. Negative behaviors at the outset of therapy, both in the PDA and the NPDA partners, predicted less improvement at post-test. It also appears that improvement in some PDA symptoms following therapy is linked to increase in the dominant behavior of the NPDA spouse and to an improvement in terms of his intrusiveness.

Keywords: Communication and problem-solving skills, Emotional overinvolvement, Marital relationship, Panic disorder withagoraphobia, Treatment outcome.

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174 The Effects of Extracorporeal Shockwave Therapy on Pain, Function, Range of Motion, and Strength in Patients with Insertional Achilles Tendinosis

Authors: P. Sanzo

Abstract:

Increased physical fitness participation has been paralleled by increasedoveruse injuries such as insertional Achilles tendinosis (AT). Treatment has provided inconsistentresults. The use of extracorporeal shockwave therapy (ECSWT) offers a new treatment consideration.The purpose of this study was to assess the effects of ECSWTon pain, function, range of motion (ROM), joint mobility and strength in patients with AT. Thirty subjects were treated with ECSWT and measures were takenbefore and three months after treatment. There was significant differences in visual analog scale (VAS) scores for pain at rest (p=0.002); after activity (p= 0.0001); overall improvement(p=0.0001); Lower Extremity Functional Scale (LEFS) scores (p=0.002); dorsiflexion range of motion (ROM) (p=0.0001); plantarflexion strength (p=0.025); talocrural joint anterior glide (p=0.046); and subtalar joint medial and lateral glide (p=0.025).ECSWT offers a new intervention that may limit the progression of the disorder and the long term healthcare costs associated with AT.

Keywords: Extracorporeal shockwave therapy, shockwave therapy, Achilles tendinosis, range of motion, strength, joint mobility

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173 Effects of Virtual Reality on the Upper Extremity Spasticity and Motor Function in Patients with Stroke: A Single Blinded Randomized Controlled Trial

Authors: K. Afsahi, M. Soheilifar, S. H. Hosseini, O. S. Esmaeili, R. Kezemi, N. Mehrbod, N. Vahed, T. Hajiahmad, N. N. Ansari

Abstract:

Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of virtual reality (VR) beside conventional rehabilitation versus conventional rehabilitation alone on the spasticity and motor function in stroke patients. Materials and methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were Modified Ashworth scale, Recovery Stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in combination group (P = 0.003). Only wrist extension was varied between groups and was better in combination group. The variables generally had statistically significant difference (P < 0.05). Conclusion: VR plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: Stroke, virtual therapy, efficacy, rehabilitation.

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172 Neurological Manifestations in Patients with HIV Infection in the Era of Combined Antiretroviral Therapy

Authors: Sharan Badiger, Prema T. Akkasaligar, Deepak Kadeli, M. Vishok

Abstract:

Neurological disorders are the most debilitating of manifestations seen in patients infected with HIV. The clinical profile of neurological manifestations in HIV patients has undergone a shift in recent years with opportunistic infections being controlled with combination anti-retroviral therapy and the advent of drugs which have higher central nervous system penetrability. The aim of this paper is to study the clinical, investigation profile and various neurological disorders in HIV patients on anti‐retroviral therapy. Fifty HIV patients with neurological manifestations were studied. A complete neurological examination including neurocognitive functioning using Montreal Cognitive Assessment and HIV Dementia scale were assessed. Apart from relevant investigations, CD4 count, cerebrovascular fluid analysis, computed tomography (CT) and magnetic resonance imaging (MRI) of brain were done whenever required. Neurocognitive disorders formed the largest group with 42% suffering from HIV associated Neurocognitive Disorders. Among them, asymptomatic neurocognitive impairment was seen in 28%; mild neurocognitive disorder in 12%, and 2% had HIV‐associated dementia. Opportunistic infections of the nervous system accounted for 32%, with meningitis being the most common. Four patients had space occupying lesions of central nervous system; four tuberculomas, and one toxoplasmosis. With the advent of highly active retroviral therapy, HIV patients have longer life spans with suppression of viral load leading to decrease in opportunistic infections of the nervous system. Neurocognitive disorders are now the most common neurological dysfunction seen and thus neurocognitive assessment must be done in all patients with HIV.

Keywords: Anti retroviral therapy, cognitive dysfunction, dementia, neurological manifestations, opportunistic infections.

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171 Verifying the Supremacy of Volume Modulated Arc Therapy Over Intensity Modulated Radiation Therapy: Pelvis Malignancies’ Perspective

Authors: M. Umar Farooq, T. Ahmad Afridi, M. Zia-Ul-Islam Arsalan, U. Hussain Haider, S. Ullah

Abstract:

Cancer, a leading fatal disease worldwide, can be treated with various techniques including radiation therapy. It involves the use of ionizing radiation to target cancer cells. On basis of source placement, radiation therapy is of two types i.e., Brachytherapy and External Beam Radiotherapy (EBRT). EBRT has evolved from 2-D conventional therapy to 3-D Conformal radiotherapy (3D-CRT) and then Intensity-Modulated Radiotherapy (IMRT). IMRT improves dose conformity and sparing of organs at risk. Volumetric Modulated Arc Therapy (VMAT) is a modern technique that uses treatment delivery in arcs with rotation of the gantry. In this report, a dosimetry comparison was performed between IMRT and VMAT. This study was conducted in the Radiotherapy Department of the Institute of Nuclear Medicine and Oncology Lahore (INMOL). Ten patients with Prostate Carcinoma were selected for this study to compare the methods. Simulation of these patients was done with help of a CT Simulator. All target volumes and organs were delineated by the oncologists. Then suitable fields/arcs were applied which cover volumes effectively. This was followed by the optimization of plans for both techniques for every patient. Finally, a comparison of evaluating parameters e.g., Conformity Index (CI), Volume Coverage, Homogeneity Index (HI), Organ Doses, and MUs (Monitor Units) was performed. We obtained better results of target conformity indices from VMAT (CI = 1.16) than IMRT (CI = 1.24). VMAT was better in organ sparing too. Also, VMAT shows fewer MUs (733 MUs) as compared to IMRT (2149 MUs). From this study, it is concluded that VMAT is a better treatment technique than IMRT. This technique will enhance treatment efficiency as it takes less time in obtaining the required results. Also, a very less scatter dose will be delivered to the patient.

Keywords: 2-D Conventional Radiotherapy, 3-D Conformal Radiotherapy, Intensity Modulated Radiotherapy, Prostate Carcinoma, Radiotherapy, Volumetric Modulated Arc Therapy.

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