Iris tears secondary to intraoperative floppy-iris syndrome associated with tamsulosin.
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Adrenergic alpha-1 Receptor Antagonists↗
Biomedical subjects
Andrew Frost
Publications and source records attributed to Andrew Frost.
Neutralizing tumor necrosis factor activity leads to remission in patients with refractory noninfectious posterior uveitis.
OBJECTIVE: To evaluate the efficacy and safety of tumor necrosis factor (TNF) inhibition with the p55 TNF receptor fusion protein (TNFr-Ig) for severe sight-threatening noninfectious posterior segment intraocular inflammation. METHODS: Seventeen patients with refractory noninfectious posterior segment intraocular inflammation received TNFr-Ig by intravenous infusion in this nonrandomized, open-label, pilot study. The primary outcome measure was logMAR visual acuity. Secondary outcome measures were binocular indirect ophthalmoscopy score, cystoid macular edema, adverse effects, and vision-related (visual core module 1) and health-related (36-Item Short-Form Health Survey) quality of life. RESULTS: Within 1 month of TNFr-Ig therapy, 9 patients (53%) achieved at least a 2-line improvement in visual acuity, 8 (57%) of 14 patients with vitreous haze before treatment achieved an improvement in binocular indirect ophthalmoscopy score to 0, and macular edema resolved in 5 (56%) of 9 affected patients. Twelve (71%) of the patients achieved complete cessation of intraocular inflammation following TNFr-Ig therapy. A reduction in concomitant immunosuppression was possible for 11 patients (65%) following TNFr-Ig therapy. However, all but 1 patient required continuing adjuvant therapy during the response to TNFr-Ig, which had a median duration of 3 months. Adverse effects included mild infusion reactions in 3 patients and transient lymphocytopenia in 2 patients. CONCLUSION: Therapy with TNFr-Ig was safe and effective for treating patients with sight-threatening noninfectious posterior segment intraocular inflammation resistant to conventional immunotherapy, but adjuvant immunosuppression and repeat infusions would be required to maintain long-term remission.
Adult↗
Therapeutic engagement styles of child sexual offenders in a group treatment program: a grounded theory study.
It is widely observed that child sexual offenders typically exhibit considerable reluctance to self-disclose at a level that reflects the full reality of their offending. Their successful engagement in relapse prevention-based programs is therefore problematic. This paper describes a study involving men undertaking a prototypical group treatment program, facing the challenge of revealing to others the details of their offense process. A procedure was developed to access their covert responses at the time of this encounter. From a grounded theory analysis, participants were found to employ various strategies to manage situations where self-disclosure was required. Four distinct disclosure management styles emerged: exploratory, oppositional, evasive, and placatory; the latter three of which appear unfavorable to effective engagement in treatment. As well as suggesting ways of influencing disclosure management style, analysis indicated that it might be possible to predict these different orientations during routine assessment.
Adult↗
Reflexivity, reflection, and the change process in offender work.
This study explores the therapeutic engagement experiences of men who have sexually offended against children and who are involved in a prototypical prison-based group treatment programme. The study examined factors relating to the therapeutic engagement of the offender in treatment, and in particular, the impact of the "out-of-group" time between sessions. The findings, although tentative, suggest that between formal therapy sessions, clients of the programme make significant movement either toward or away from engagement in the therapy. The implications of these processes with respect to clinical practice and the development of offender services are discussed.
Adult↗