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At least 19 recordsLinked to original sources

PubMed1975

A review of psychologically oriented treatment of alcoholism. II. The relative effectiveness of different treatment approaches and the effectiveness of treatment versus no treatment.

A review of 384 studies of psychologically oriented alcoholism treatment showed that differences in treatment methods did not significantly affect long-term outcome. Mean abstinence rates did not differ between treated and untreated alcoholics, but more treated than nontreated alcoholics improved, suggesting that formal treatment at least increases an alcoholic's chances of reducing his drinking problem.

Alcohol Drinking↗

PubMed1992

A comparison of predictors of treatment drop-out of women seeking drug and alcohol treatment in a specialist women's and two traditional mixed-sex treatment services.

The problem of high levels of client drop-out in drug and alcohol treatment is frequently reported in the literature. In the course of conducting an evaluation of a specialist women's treatment service, the inadequacy of the data on women-specific predictors of treatment drop-out was highlighted. Using a retrospective design, the characteristics of 160 women who left treatment less than 5 days after admission were compared to the 160 women who stayed longer than 5 days and were enrolled in the evaluation study. The findings of this study suggested that women who were employed, had a history of sexual assault (especially in adulthood), nominated alcohol as their drug of choice, were not married, older than 25 years of age and had demonstrated a sympathy with the agency's treatment philosophy were less likely to drop-out of treatment. In addition, for lesbian women, women with a history of sexual assault in childhood, and those with dependent children, attendance at a specialist women's service reduced the incidence of treatment drop-out.

Adolescent↗

PubMed1992

Argon laser photocoagulation for the treatment of diabetic macular oedema. Comparative study of efficacy between focal extramacular treatment and focal macular perifoveolar treatment.

In this paper a comparative study of efficacy between focal extramacular and focal macular perifoveolar argon laser photocoagulation for the treatment of diabetic macular oedema is presented. The follow-up period was 12 months and was based on fluorescein angiograms. After focal extramacular treatment, diabetic macular oedema was resorbed in 54.6% of the cases, remained unchanged in 28.4% and deteriorated in 17.0%. After focal macular perifoveolar treatment resorption of diabetic macular oedema was achieved in 73.7% of the cases, remained unchanged in 17.1% and deteriorated in 9.2%. Focal macular perifoveolar treatment gives statistically significantly better clinical results than focal extramacular treatment (p < 0.05).

Adult↗

PubMed1992

A randomized study of long-term out-patient treatment in alcoholics. Psychiatric treatment versus multimodal behavioural therapy, during 1 versus 2 years of treatment.

Seventy-two alcoholic patients (60 men and 12 women) were randomized into four groups who received psychiatric treatment (PT) or multimodal behavioural therapy (MBT), for either 1 or 2 years. PT was based on psychodynamic principles, and MBT is a cognitive-behavioural treatment. The patients accepting treatment had a mean age of 37 +/- 9 years, and they were socially stable. There was no difference in attrition rate (35%) in relation to therapy and length of treatment. The rate of favourable drinking outcome during the third year was similar in all four alternatives, at 40-44%. A favourable drinking outcome was predicted by a better initial psychic status and few psychiatric symptoms at intake. In PT patients a favourable outcome was more strongly related to a better psychic status than in MBT patients (P = 0.58). The mean number of sessions, 23, did not differ in relation to outcome. The main conclusion from this study is that there were only small and inconclusive differences between the therapies of different types and different duration.

Alcoholism↗

PubMed1977

[Treatment of mastitis in dry cows: treatment of all cows vs treatment of infected cows only (author's transl)].

UNLABELLED: Within a herd, three groups have been randomly constituted. -- CONTROL GROUP: No dry cow therapy. -- Total Treatment group: all cows were submitted to dry cow therapy, in their four quarters. -- Limited Treatment group: cows were submitted to dry cow therapy in their four quarters, only if at least one quarter had given a CMT larger than or equal to +++, in the month before drying-off. --The cows were treated either with cloxacillin or with penicillin-streptomycin in 3% monostearate. The number of cows and quarters examinated and treated are given in table 1; the results of treatments are indicated in table 2. No significant differences can be found between Total and Limited Treatment groups; a slight improvement was observed when compared to CONTROL GROUP. Cloxacillin and penicillin-steptomycin gave similar results. The pathogenic and practical signification of these results is discussed.

Animals↗

PubMed1992

Patterns of treatment failure and prognostic factors associated with the treatment of esophageal carcinoma with chemotherapy and radiotherapy either as sole treatment or followed by surgery .

PURPOSE: The records of patients with esophageal cancer who were treated with a combined modality therapy were reviewed to determine the effects of simultaneously administered chemotherapy and radiotherapy (RT) at sites of recurrence and the relationship between treatment outcome and clinicopathologic variables. PATIENTS AND METHODS: One hundred seventeen patients were treated with fluorouracil (800 mg/m2) [corrected] and cisplatin (80 mg/m2) combined with either 36 Gy (36 patients) or 54 to 60 Gy (35 patients) of RT as sole therapy. Forty-six patients underwent surgery after they had received chemotherapy and 36 Gy of RT as initial treatment. Patients with either squamous cell cancer (SCC) or adenocarcinoma were included. RESULTS: Complete endoscopic regression after an initial 36 Gy of RT and chemotherapy occurred in more than 50% of patients and in both tumor types. Relief of dysphagia accompanied tumor regression. Forty-two tumors were resected, and 11 showed a complete histologic response. Significant associations were demonstrated between enhanced survival and a diagnosis of SCC, a complete endoscopic response to initial chemotherapy and RT, and a tumor length of less than 5 cm. Multivariate analyses suggested that tumor length and complete endoscopic response were independent prognostic variables. The survival rate of patients treated by resection or radical-dosage RT was not significantly different. CONCLUSIONS: The relief of dysphagia demonstrates the palliative value of chemotherapy and RT in both tumor types. The similar survival rates of patients with SCC or adenocarcinoma treated either surgically or with high-dose combined therapy (54 to 60 Gy) emphasize the need to evaluate the role of surgery and combined treatment in randomized studies.

Adenocarcinoma↗

PubMed2026

Feasibility and effectiveness of the Bergen 4-Day Treatment for obsessive-compulsive disorder in Australia: A pilot comparison with 3-week inpatient obsessive-compulsive disorder treatment.

OBJECTIVES: Obsessive-compulsive disorder is a debilitating and chronic condition that, when untreated or unresponsive to treatment, imposes a significant health and economic burden on individuals and families. This prospective non-randomised inpatient study compared the acceptability and clinical outcomes of the Bergen 4-Day Treatment programme with those of a standard 3-week specialised treatment programme for obsessive-compulsive disorder in Australia. METHOD: Twenty-five participants diagnosed with obsessive-compulsive disorder were non-randomly assigned to Bergen 4-Day Treatment (n = 12) or a 3-week standard (n = 13) inpatient programme. Independent assessments were completed at pre-treatment, 10 days post treatment and at 3-month follow-up. The Yale-Brown Obsessive-Compulsive Scale was rated to assess obsessive-compulsive disorder severity, while secondary measures of depression, anxiety, obsessive beliefs and wellbeing were self-rated by participants. RESULTS: Baseline characteristics of both groups were comparable, with obsessive-compulsive disorder symptom severity within the moderate to severe range. After treatment, obsessive-compulsive disorder symptoms as well as secondary depression and anxiety symptoms were reduced in both treatment groups. Participants receiving Bergen 4-Day Treatment had significantly lower Yale-Brown Obsessive-Compulsive Scale scores at 10 days (M = 13.46) and 3 months (M = 11.84), compared to standard treatment (M = 19.04 and M = 19.15, respectively). Response (91.9%) and remission (45.8%) rates for the Bergen 4-Day Treatment group were significantly higher at both post-treatment timepoints, compared to the standard treatment group. No dropouts occurred in the Bergen 4-Day Treatment group, and participant satisfaction was high. CONCLUSION: The findings of this pilot open-label study suggest that Bergen 4-Day Treatment shows promise as an acceptable, efficient and effective treatment for obsessive-compulsive disorder, warranting further investigation as a scalable alternative for improving access to specialised obsessive-compulsive disorder treatment in Australia.

Humans↗

PubMed1975

Treatment of chronic obsessive-compulsive neurosis by in-vivo exposure. A two-year follow-up and issues in treatment.

Twenty patients with chronic obsessive-compulsive rituals were treated in a partially controlled design by in-vivo (real life) exposure with self-imposed response prevention. Treatment included 4-12 weeks as in-patients, and lasted a mean of 23 sessions. All patients were followed-up for at least two years. No patients dropped out during the trial, though one refused domiciliary treatment after discharge. Significant improvement in compulsions was found after three weeks of real-life exposure, and continued during follow-up. At two years follow-up 14 patients were much improved, one improved and 5 unchanged; in a third year of follow-up the improved patient became symptom-free after further exposure treatment. Improvement after three weeks exposure predicted good outcome at 6 and 12 months follow-up. Muscular relaxation treatment had no significant effect on rituals. Modelling of exposure conferred no advantage over exposure alone for the group as a whole, though it may help selected patients. The role of response prevention is unknown. Patients' commitment to treatment facilitates exposure. Domiciliary treatment with involvement of family members in therapy seems crucial in some cases. Pilot group treatment of patients and families together suggests that this may be a useful adjuvant to individual treatment by increasing motivation and aiding follow-up. Compulsive slowness presents special treatment problems but can be improved by a prompting and pacing approach. The course of rituals was often independent of that of agoraphobia, marital problems and depression where these had initially coexisted with rituals. Depressive episodes were common before, during and after treatment, and required tricyclic medication. The trial sample was predominantly female but was otherwise typical of patients with compulsive rituals. Of the 125 obsessive-compulsives seen in the first author's unit over four years 96 per cent were offered behavioural or anti-depressant treatment. One quarter refused behavioural treatment after it was offered. Real-life exposure with self-imposed response prevention is usually an effective procedure for lasting reduction of chronic compulsive rituals in well motivated patients.

Adult↗

PubMed1978

The effect of prior treatment on treatment success.

The characteristics of clients discharged from federally funded treatment facilities reporting to CODAP are analyzed in terms of several variables. These are the reasons for discharge (treatment completed, transfer or referral, or treatment not completed), the primary drug of abuse at admission (opiates and nonopiates), and the number of prior treatment experiences. Two independent replications using data for two consecutive quarters produced the same results, finding that the likelihood of completing treatment decreases as the number of prior treatment experiences increases. This relationship was found to apply to both opiate and nonopiate users. Although large differences exist in completion rates between opiate and nonopiate users without prior treatment experience, only small differences exist between opiate and nonopiate users who have had prior treatment. The largest difference in treatment outcome occurs between those with no prior treatment and those who have been treated before. Having one or more prior treatment experiences does not seem to have a major impact on the probability of completing treatment.

Heroin Dependence↗

PubMed1978

Illicit drug use and return to treatment: follow-up study of treatment admissions to DARP during 1969-1971.

The present study was based on follow-up data on 1,409 persons interviewed 4 to 6 years after admission to drug treatments in the Drug Abuse Reporting Program (DARP). The admissions to DARP occurred in 1969-1971, and for most persons the follow-up data included 3 or more years after termination of DARP treatment. The focus of this study was on illicit drug use of former DARP clients, taking into account if and when they reentered drug treatment after termination of DARP treatment. The results showed that a significant drop in opioid and nonopioid (but not marijuana) drug use generally occurred upon entry into other, post-DARP treatments, and that these beneficial effects of treatment tended to continue beyond the end of treatment. Overall, 42% of the sample had no further drug treatment during the first 3 years after DARP, and almost half (42%) of this group used no opioid or nonopioid drugs at all during this time. Comparisons between DARP treatment groups also indicated that therapeutic community clients had the lowest rate of return to post-DARP treatments.

Follow-Up Studies↗

PubMed1992

Prospective randomized controlled trial of sequential treatment with corticoids and alpha-interferon versus treatment with interferon alone in patients with chronic active hepatitis B.

OBJECTIVES: A randomized controlled trial was conducted to prospectively compare the efficacy of sequential treatment with corticoids and alpha-interferon versus treatment with interferon (IFN) alone in patients with chronic hepatitis B. METHODS: Sixty patients with chronic active hepatitis B and positive serum HBV-DNA were randomized into two treatment groups (n = 20, respectively) and one control group (no treatment; n = 20). In one treatment group, patients received first an oral corticoid (2 weeks 40 mg/day and further 2 weeks 20 mg/die prednisolone); thereafter interferon-alpha (Intron A, Essex) was given as three subcutaneous injections of 2 million units per week for 3 months. In patients in whom therapy did not eliminate HBe-Ag and HBV-DNA two months after its end, a similar sequential treatment was given with the same corticoid dose but a higher IFN dose of 5 MU. In the other treatment group patients were given three subcutaneous injections of 5 MU IFN per week for 4 months. The sequential corticoid/IFN treatment at a dose of 3 x 2 MU IFN resulted in seroconversion of HBe-Ag in only 4 of 20 patients (20%). Of the remaining 16 patients 14 subjects received a repetitive corticoid/IFN therapy with the same corticoid dose but with a 3 x 5 MU dose of IFN. RESULTS: With the higher IFN dose, 6 of 14 patients had a seroconversion of HBe-Ag. Therapy with 3 x 5 MU IFN without prior corticoids resulted in a seroconversion in 8 of 20 patients (40%). Calculated for both doses, the sequential corticoid/IFN therapy eliminated HBe-Ag and HBV-DNA in 10/20 patients (50%); therapy with IFN alone was almost as effective (40% seroconversion) (p > 0.05 for comparison of seroconversion rates by chi 2-test). Seroconversion of HBe-Ag and elimination of HBV-DNA occurred in parallel and were associated with a decrease of serum transaminases and a regression of inflammatory activity on rebiopsy. In the control group there was no spontaneous seroconversion of HBs-Ag, HBe-Ag or HBV-DNA. CONCLUSIONS: The present results show that in many patients who failed to respond to a sequential therapy with corticoids and 2 MU IFN, the higher IFN dose of 5 MU effectively eliminated HBe-Ag and HBV-DNA. Sequential corticoid/IFN therapy and therapy with IFN alone eliminated HBe-Ag and HBV-DNA in a similar percentage of patients. Further statistical analysis showed that, in particular, patients with low transaminases benefit from prior corticoid treatment. In all groups, patients with low serum HBV-DNA and a short history of infection had the best treatment results.

Adolescent↗

PubMed1992

A comparison of the cost-effectiveness of day treatment and residential treatment for children with severe behaviour problems.

This study compares the cost of treating 23 children admitted to a residential treatment unit in a psychiatric hospital and 23 children admitted to the same unit after it was converted to a day treatment program, through a retrospective chart review. The two groups were similar in age, gender, diagnosis, severity of pathology, family functioning and support, the number of subjects who dropped-out, and treatment outcome. The average length of stay on the unit dropped from 19.6 to 6.1 months, and the average cost of treatment per child decreased from $61,412 to $9,213 (Canadian dollars, adjusted for inflation). The sharp decrease in treatment time with day treatment may be the result of close links with community schools and maintaining the child in the family and community. The cost savings can be attributed to the shorter hospital stays and the lower operating costs of day treatment. Implications of these findings will be discussed with respect to health care policy including the need to raise awareness of day treatment as a cost-effective alternative to residential hospital treatment.

Adolescent↗

PubMed1992

Radiation therapy of stage I breast cancer: analysis of treatment technique accuracy using three-dimensional treatment planning tools.

This paper presents the routine implementation of a method for use of three-dimensional (3-D) treatment planning for breast cancer patients with node negative disease, treated with breast conserving surgery. The patients were positioned on a device which fitted a CT aperture with a diameter of 70 cm. A patient reference system was defined by the mamillary plane and the sternum midline. Eight to twelve CT images per patient were taken. The target volume was defined in several CT slices. The treatment planning was made with a 3-D treatment planning system; the treatment technique was isocentric with tangential fields. The patient position was the same at the CT scanner and during the treatment. Four to six portal films per field per patient were routinely taken. The reproducibility of the set-up was investigated on 20 consecutive patients: the treatment-to-treatment variation results were related to the margin of the target. The comparison between treatment planning and portal films gave information about the isocenter displacement. No large discrepancy between measurements on simulator film and on portal films was found. Based on the presented results the described treatment technique has been introduced as part of a routine clinical practice at our institution.

Breast Neoplasms↗

PubMed1992

[Clinical studies on the treatment of Campylobacter enteritis--emergence of quinolone-resistant Campylobacter jejuni after treatment with new quinolones].

In recent years, new quinolones such as ofloxacin (OFLX) and tosufloxacin (TFLX) have been frequently used in the treatment of bacterial enteritis caused by unknown organisms. The agent of first choice for the treatment of Campylobacter enteritis is one of the macrolides, but new quinolones are often administered accidentally to adult patients with Campylobacter enteritis. We have detected quinolone-resistant strains of Campylobacter jejuni (C. jejuni) after the treatment of some patients with new quinolones, and accordingly we reviewed the treatment of Campylobacter enteritis. We experienced 178 adult patients with Campylobacter enteritis from January 1989 to November 1991 at our hospital. From them, we selected 52 patients (32 males and 20 females) in whom stool culture were performed both before and after treatment. The initially administered antimicrobial agent was a macrolide (rokitamycin, RKM) in 6 cases, a new quinolone in 22 cases, and kanamycin (KM) in 24 cases. The new quinolone used was OFLX in 17 cases, TFLX in 3 cases, and norfloxacin (NFLX) in 2 cases. Fifty-one of the 52 C. jejuni strains isolated before treatment were susceptible to OFLX and erythromycin (EM) according to antimicrobial disc susceptibility tests. C. jejuni was eradicated in all patients treated with RKM or KM. However, treatment failed to achieve bacteriological cure in 8/22 (36.4%) patients given new quinolones. In these patients, the strains of C. jejuni isolated before treatment were susceptible to OFLX, but the strains isolated after treatment were all resistant to OFLX according to disc susceptibility tests.(ABSTRACT TRUNCATED AT 250 WORDS)

4-Quinolones↗

PubMed1992

Predicting feasibility of day treatment for unselected patients referred for inpatient psychiatric treatment: results of a randomized trial.

OBJECTIVE: Because previous studies of day treatment as an alternative to inpatient treatment had major disadvantages or methodological shortcomings, the authors conducted a randomized controlled trial to estimate and predict the extent to which day treatment is feasible for unselected patients referred for inpatient treatment. METHOD: Of 160 patients, 57 were randomly assigned to the control condition and 103 were assigned to the experimental condition. Control patients received standard clinical care. In the experimental condition, day treatment was attempted as soon as the patient's condition permitted. The average number of nights per week that experimental patients spent away from the hospital was compared to the average number of nights away for patients under standard care. RESULTS: Day treatment was satisfactory for 40% of the experimental patients but was completely infeasible for another 40%. The level of surveillance needed in the first week, physical illness, number of previous admissions, depressive symptoms, and treatment by qualified psychiatrists versus registrars were variables predictive of these differences. CONCLUSIONS: In this unselected group of patients, no absolute contraindications against day treatment were found. This suggests that the selection criteria applied in nearly all other controlled studies on the subject were unwarranted. The approach used in this study facilitated treatment in the least restrictive environment possible.

Adolescent↗

PubMed1979

Alcohol and drug abuse treatment: perceived effectiveness of inpatient combined treatment programs.

The present study did not address directly the comparative superiority of treatment approaches for combined versus separate treatment. It reflects, instead, the perceptions of staff and clients from the programs visited, the available literature, information gathered in the search for combined programs, and program processes and outcomes. The primary hypothesis generated by the study proposed that, given a receptive treatment staff, it is probable that combined treatment has the flexibility to provide treatment to both drug and alcohol abusers that is at least as effective and probably more efficient than separate treatment. Until empirical evidence that clearly delineates problems associated with combined treatment is obtaned, it was suggested that the selection of a combined or separate treatment paradigm is best determined by the needs of the community and the attitudes of the treatment staff.

Alcoholism↗

PubMed1992

The effect of treatment time and treatment interruption on tumour control following radical radiotherapy of laryngeal cancer.

A significant effect of overall treatment time on local control was found in a retrospective review of 1012 radically irradiated squamous cell carcinomas of the larynx. The actuarial local relapse free rate (LRFR) at 5 years for the whole group was 59%. The effect of treatment time on local control was modelled to the linear-quadratic equation. Using logistic regression analysis treatment time and dose were significant (p = 0.008 and p = 0.04, respectively). When the analysis was adjusted for the influence of stage and laryngeal subsite treatment time remained a significant prognostic factor (p = 0.02). The derived value of gamma/alpha was 0.7 Gy/day and when adjusted for stage and sub-site 0.8 Gy/day. This equates to a dose increment to maintain iso-effective local control of 0.64 Gy/day and 0.73 Gy/day respectively for daily fractions of 2.5 Gy and an assumed alpha/beta for tumour of 25 Gy. To provide an estimate of the clinical impact of treatment interruptions not compensated for by dose escalation a Cox regression was performed. Significant variables were T stage, N stage, sex, total dose and total length of treatment interruption. Using the proportional hazard model it was calculated that each day of treatment interruption resulted in an increase in the hazard of local relapse by 4.8% (p = 0.006). Based on our data it was calculated that this would result in a decrease in local control of 1.4% for each day of uncompensated treatment interruption.

Canada↗

PubMed1992

An oral health survey of Head Start children in Alaska: oral health status, treatment needs, and cost of treatment.

The purpose of this study was to obtain information on the oral health status, treatment needs, and cost of treatment for Head Start children in Alaska. Twenty communities, representing five regions within the state, were selected for participation. The study consisted of three distinct parts: a caries status exam, a sociodemographic questionnaire, and a treatment needs examination. A total of 544 children between three and five years old were examined. The mean dmft and dmfs scores were 3.91 and 8.73, respectively. When stratified by race, the Alaska Native children had significantly higher mean dmft and dmfs scores. When stratified by community of residence, those children residing in the rural communities had higher rates of dental caries than the urban children. Forty-five percent of the total sample was in need of dental restorative treatment, excluding examinations, radiographs, and preventive services. The proportion of rural children needing care was much higher than the urban children (59% vs 27%). On average, each urban child needed treatment on 0.7 teeth, while each rural child needed treatment on 2.8 teeth. When all treatment factors including sedation and transportation costs are considered, the potential cost of treatment for the 1,475 children enrolled in the Alaska Head Start programs was $601,624.

Age Factors↗