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Biomedical subjects

B Freund

Publications and source records attributed to B Freund.

At least 19 recordsLinked to original sources
PubMed2002

Comparison of two treatments for traumatic stress: a community-based study of EMDR and prolonged exposure.

This pilot study compared the efficacy of two treatments for postraumatic stress disorder (PTSD): Eye Movement Desensitization and Reprocessing (EMDR) and Prolonged Exposure (PE). Data were analyzed for 22 patients from a university-based clinic serving the outside community (predominantly rape and crime victims) who completed at least one active session of treatment after three preparatory sessions. Results showed both approaches produced a significant reduction in PTSD and depression symptoms, which were maintained at three-month follow-up. Successful treatment was faster with EMDR as a larger number of people (7 of 10) had a 70% reduction in PTSD symptoms after three active sessions compared to 2 of 12 with PE. EMDR appeared to be better tolerated as the dropout rate was significantly lower in those randomized to EMDR versus PE (0 of 10 vs. 3 of 10). However all patients who remained in treatment with PE had a reduction in PTSD scores. Finally, Subjective Units of Distress (SUDS) ratings decreased significantly during the initial session of EMDR, but changed little during PE. Postsession SUDS were significantly lower for EMDR than for PE. Suggestions for future research are discussed.

Cognitive Behavioral Therapy↗
PubMed2000

Botulinum toxin: new treatment for temporomandibular disorders.

BACKGROUND: Temporomandibular disorders (TMDs) affect the face and jaws, and cause chronic pain and dysfunction in many people. As in other conditions involving the musculoskeletal system, controlling the myogenous component is an integral part of treatment. In this study, we evaluated subjective and objective responses to treatment with botulinum toxin A (BTX-A) in a group of 46 patients with TMDs. METHODS: 46 subjects with TMD were enrolled in this uncontrolled study and treated with BTX-A 150U. Both masseter muscles were injected with 50 U each and both temporalis muscles with 25 U each under electromyographic guidance. Subjects were assessed at two-week intervals for eight weeks. Outcome measures included subjective assessment of pain by visual analogue scale (VAS), measurement of mean maximum voluntary contraction (MVC), interincisal oral opening, tenderness to palpation, and a functional index based on multiple VAS. Medians of the data were taken for each outcome measure at each time point and subjected to Duncan's multiple range test. RESULTS: There were significant (P<0.05) differences in all median outcome measures between the pre-treatment assessment and the four follow-up assessments except for MVC. Although MVC was significantly reduced midway through the study, it had returned to pretreatment values by the final two assessments. All other outcome measures remained significantly different from the pretreatment findings. Paired correlation of variables including age, sex, diagnosis, depression index, and time of onset showed no significant differences. CONCLUSIONS: BTX-A injections produced significant improvements in pain, function, mouth opening, and tenderness to palpation. MVC initially diminished then returned to the initial values. Although the study was uncontrolled, the results strongly suggest that BTX-A reduces severity of symptoms and improves functional abilities for patients with TMD and that these extend beyond its muscle-relaxing effects.

Adolescent↗
PubMed2000

Systematic review of the treatment and prognosis of the odontogenic keratocyst.

OBJECTIVES: To clarify the natural history of the odontogenic keratocyst (OKC) and to evaluate treatments with respect to the likelihood of recurrence. STUDY DESIGN: A systematic review of the literature was completed pertaining to the treatment and prognosis of the OKC. Each investigation was evaluated based on 4 inclusion criteria. Each study that met the 4 inclusion criteria was then evaluated based on 8 standards. RESULTS: Of 2290 citations reviewed pertaining to the OKC, 14 investigations were found to meet the 4 inclusion criteria. Resection was found to have the lowest recurrence rate (0%) but the highest morbidity rate. Simple enucleation was reported to have a recurrence rate of 17% to 56%. Simple enucleation combined with adjunctive therapy, such as the application of Carnoy's solution or decompression before enucleation, was reported to have recurrence rates of 1% to 8.7%. CONCLUSIONS: Although the existing literature consists of retrospective consecutive case series, it appears that resection or enucleation with adjunctive therapy is associated with recurrence rates that are lower than those associated with enucleation alone.

Acetic Acid↗
PubMed2000

Silicone block interposition for traumatic bone loss.

In situations where bone is lost secondary to trauma, the use of a hand-carved silicone block provides good results. When bone grafting is undertaken, a well-defined membrane will have enveloped the implant. Incising the membrane allows easy block removal, and after freshening the bone ends, a cavity awaits the bone graft. This technique offers simplicity and adequate stability for therapy, and secondary bone grafting is facilitated by the created space.

Adolescent↗
PubMed1999

Systemic findings associated with central serous chorioretinopathy.

PURPOSE: To determine systemic factors associated with central serous chorioretinopathy. METHODS: In a retrospective study, 230 consecutive patients with central serous chorioretinopathy examined in a referral setting were compared with a historical gender-matched and age-matched control group of 230 patients with ocular findings who were examined in the same referral setting. RESULTS: The median age of the patients was 49.8 years, and of the control subjects, 50.0 years. The male-female ratio for both groups was 2.7:1. Patients with central serous chorioretinopathy were more likely to use psychopharmacologic medications (odds ratio = 2.6; 95% confidence interval = 1.30 to 5.19; P = .0049) and corticosteroids (odds ratio = 3.17; 95% confidence interval = 1.30 to 7.70; P = .0067) and were more likely to have hypertension (odds ratio = 2.25; 95% confidence interval = 1.39 to 3.63; P = .0008) than were the control subjects. CONCLUSIONS: This study identified psychopharmacologic medication use, corticosteroid use, and hypertension as factors associated with central serous chorioretinopathy. These findings reinforce the concept that stress and adaptations to stress play a role in this disorder. The findings of possible associations between central serous chorioretinopathy and both hypertension and corticosteroid usage suggest that these modifiable factors may influence morbidity of central serous chorioretinopathy.

Adult↗
PubMed1999

The use of botulinum toxin for the treatment of temporomandibular disorders: preliminary findings.

PURPOSE: The aim of this study was to evaluate the response of patients with temporomandibular disorders to Botulinum toxin A (BTX-A) therapy. METHODS: The 15 subjects enrolled in this uncontrolled study were diagnostically categorized and treated with 150 units of BTX-A. Both masseter muscles received 50 units each under eletromyographic (EMG) guidance. Similarly, both temporalis muscles were injected with 25 units each. Subjects were assessed at 2-week intervals for 8 weeks. Outcome measures included subjective pain by visual analog scale (VAS), measurement of bite force, interincisal opening, tenderness to palpation, and a functional index based on multiple VAS. RESULTS: All mean outcome measures, with the exception of bite force, showed a significant (P = .05) difference between the preinjection assessment and the four follow-up assessments. No side effects were reported. CONCLUSIONS: BTX-A injections produced a statistically significant improvement in four of five measured outcomes, specifically pain, function, mouth opening, and tenderness. No statistically significant changes were found in mean maximum voluntary contraction or in paired correlation of factors such as age, sex, diagnosis, depression index, or time of onset.

Administration, Cutaneous↗
PubMed1999

Zanamivir: a review of clinical safety.

Preclinical and clinical studies have clearly demonstrated that zanamivir, a potent and highly selective inhibitor of the influenza A and B virus neuraminidase, has an impressive safety profile. This report describes the safety and tolerability findings from the clinical studies completed up to the 17 July 1998 involving over 6000 adult and adolescent patients from North America, Europe and the Southern Hemisphere. Serious adverse events from an ongoing Japanese clinical programme are also reported. Zanamivir was administered in various dose forms and frequencies and was found to have a comparable safety profile with placebo when given for both the treatment and prophylaxis of influenza-like illness. These findings were independent of age and underlying medical condition. 4152 patients received zanamivir and the most commonly reported adverse events were consistent with the signs and symptoms of influenza-like illness. Most of the adverse events were mild and did not result in patient withdrawal from the studies. Less than 1% of zanamivir and placebo recipients reported a serious adverse event. In addition, 490 healthy volunteers received zanamivir in clinical pharmacology studies. It was well tolerated and the incidence of adverse events was similar in zanamivir and placebo recipients. In addition, no clinically significant laboratory abnormalities were detected. Results from in vitro and in vivo animal studies suggest that zanamivir has low acute toxicity and no significant systemic toxicity or respiratory tract irritancy at plasma exposures more than 100-fold higher than those anticipated following clinical use. Neither genotoxic nor reproductive types of toxicity have been observed in toxicology studies at doses equal to 17 to 197 times the current therapeutic dose (20 mg/day). The characteristics of the molecule and the low systemic exposure indicate a very low potential for drug interactions with the inhaled route. Furthermore, repeated 600mg intravenous doses were well tolerated in healthy volunteers. The observed safety profile of zanamivir compares favourably with currently available agents with anti-influenza virus activity, such as rimantadine and amantadine, as well as GS4104, a neuraminidase inhibitor currently in phase III development. This may be attributed to the low systemic bioavailability of zanamivir, which is given by oral inhalation, direct to the primary site of viral replication. The potential advantages of this include a reduced risk of drug-drug interactions, other nontarget organ toxicities (e.g. brain) and drug clearance issues from both kidney and liver. Therefore, the safety profile of zanamivir supports its use in the management of influenza.

Animals↗
PubMed1993

Impact of parental terminal cancer on latency-age children.

The underlying psychological and emotional components of distress were examined in 87 children with a parent in the terminal phase of cancer. Common fears, concerns, misperceptions, and behavioral consequences are analyzed, as are more severe psychological and behavioral reactions. Implications for psychoeducational parent-guidance intervention are discussed.

Adaptation, Psychological↗
PubMed1993

Validating nursing diagnoses: an approach to reinforce nursing process with BSN-completion students.

An eight-week medical-surgical clinical rotation was used to expose RN students to the process of validating nursing diagnoses. Although limited in scope, students gathered data from the literature, nurse experts, and clinical observations to support defining characteristics of selected nursing diagnoses. Because of the response from students and agency nurses, a more comprehensive experience, to be offered as a nursing elective, is being planned.

Clinical Nursing Research↗
PubMed1992

Ludwig's angina: a place for steroid therapy in its management?

Ludwig's angina is an uncommon but potentially fatal condition which presents as a hard swelling of the floor of the mouth. It spreads rapidly as a gangrenous process that may cause death through local airway obstruction. Ludwig's angina carried a 54% mortality rate in the preantibiotic era which has now been reduced to approximately 4%. Diagnosis is based on history and clinical observation. Currently described treatment involves protecting the airway and managing the infection with antibiotics and surgical drainage when indicated.

Humans↗
PubMed1989

Sexual history, attitudes and functioning of obsessive-compulsive patients.

An exploratory investigation of sexual history, attitudes and functioning was conducted with 44 obsessive-compulsive outpatients seeking behavioral therapy. Prior to treatment, patients completed a life history questionnaire which requested information about personal and parental attitudes toward sex, current sexual functioning, sexual obsessions, and sexual history. Pretreatment measures of obsessive-compulsive symptomatology revealed a severely obsessional group who were moderately depressed and introverted. Obsessive-compulsives did not appear to differ from normative samples in sexual history or attitudinal variables. One-third of the present sample reported obsessions related to sexual themes. Symptomatology interferred with sexual satisfaction, particularly for those concerned with bodily secretions. Sexual dysfunction, however, was relatively uncommon. Categorizing patients according to the type of obsession (bodily secretion vs. other obsession) or their religious affiliation (Catholic vs. non-Catholic) yielded no differences with respect to sexual history, attitudes and treatment outcome. Some association of early sexual experiences with current sexual dysfunction was observed.

Adult↗
PubMed1983

[A method for the cryopreservation of thrombocytes].

By using dimethylsulfoxide (0.7 mol/l) a technique of cryoconservation of thrombocyte concentrates was elaborated, with own material-technological possibilities being taken into consideration. In comparison to fresh thrombocytes the results of parameters tested in vitro reveal a mean functional ability of 50%. The survival time of cells stored in this way in vivo may be compared with fresh cells. On this basis HLA-typed single-donor pools could be established for clinical application.

Blood Platelets↗
PubMed1982

Enterocolitis complicating chrysotherapy. Case report and review of the literature.

We report a case of a 71-yr old man with seronegative rheumatoid arthritis, who developed severe enterocolitis during gold therapy. Radiological studies, endoscopy and biopsies showed diffuse involvement of the stomach, duodenum and small and large intestines. The clinical course was prolonged and complicated by multiple infections. Of the 10 cases with chrysotherapy-induced enterocolitis reported in the literature, 3 were from Israel. There may be a relationship between the development of enterocolitis following gold therapy, ethnic group and HLA-B8 and DRw3 antigens.

Aged↗