The Impact of War on the Marriage: Development of a Therapy Group for Spouses of Veterans With PTSD

Objectives 1) To assess the impact of multi-drug leprosy therapy on the development of nasal deformities and nasal airway patency. 2) Evaluate the nasal morphology and nasal patency in leprosy patients treated with the multidrug therapy in comparison with patients treated with 1 drug therapy and a group of healthy volunteers. Methods In an overall group of 84 patients studied, 38 were treated with a therapy based on a single drug, and 22 were treated with multi-drug therapy, while 24 subjects formed a control group. We used anterior rhinoscopy to analised the morphology of the nose. We meassured the nasal inspiratory and expiratory resistance of the right and left nostrils and total nasal inspiratory and expiratory resistance at a transnasal pressure of 150 Pa. by using active anterior rhinomanometry. The statistical analysis was carried out using the Varianza analisys. Results The nasal structures in the 1-drug therapy group underwent bone and cartilaginous resorption with an increase in nasal resistances. We found significant statistical differences between the resistance values obtained in this group and the control group (p<0,05). In the multidrug therapy group, the morphology of the nose remains as in healthy patients. No significant statistical differences were found between the resistance values obtained in the multidrug therapy patients and the control group (P>0,05). Conclusions The multidrug therapy prevents developing nasal deformities and maintains a normal nasal airflow.

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Goal-directed Fluid Therapy Does Not Reduce Primary Postoperative Ileus after Elective Laparoscopic Colorectal Surgery

Anesthesiology ◽

10.1097/aln.0000000000001663 ◽

2017 ◽

Vol 127 (1) ◽

pp. 36-49 ◽

Cited By ~ 36

Author(s):

Juan C. Gómez-Izquierdo ◽

Alessandro Trainito ◽

David Mirzakandov ◽

Barry L. Stein ◽

Sender Liberman ◽

...

Keyword(s):

Colorectal Surgery ◽

Fluid Therapy ◽

Postoperative Ileus ◽

Enhanced Recovery ◽

Laparoscopic Colorectal Surgery ◽

Enhanced Recovery After Surgery ◽

Therapy Group ◽

Control Group ◽

Goal Directed Fluid Therapy ◽

The Impact

Abstract Background Inadequate perioperative fluid therapy impairs gastrointestinal function. Studies primarily evaluating the impact of goal-directed fluid therapy on primary postoperative ileus are missing. The objective of this study was to determine whether goal-directed fluid therapy reduces the incidence of primary postoperative ileus after laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program. Methods Randomized patient and assessor-blind controlled trial conducted in adult patients undergoing laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program. Patients were assigned randomly to receive intraoperative goal-directed fluid therapy (goal-directed fluid therapy group) or fluid therapy based on traditional principles (control group). Primary postoperative ileus was the primary outcome. Results One hundred twenty-eight patients were included and analyzed (goal-directed fluid therapy group: n = 64; control group: n = 64). The incidence of primary postoperative ileus was 22% in the goal-directed fluid therapy and 22% in the control group (relative risk, 1; 95% CI, 0.5 to 1.9; P = 1.00). Intraoperatively, patients in the goal-directed fluid therapy group received less intravenous fluids (mainly less crystalloids) but a greater volume of colloids. The increase of stroke volume and cardiac output was more pronounced and sustained in the goal-directed fluid therapy group. Length of hospital stay, 30-day postoperative morbidity, and mortality were not different. Conclusions Intraoperative goal-directed fluid therapy compared with fluid therapy based on traditional principles does not reduce primary postoperative ileus in patients undergoing laparoscopic colorectal surgery in the context of an Enhanced Recovery After Surgery program. Its previously demonstrated benefits might have been offset by advancements in perioperative care.

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Evolution of Laparoscopic Surgery for Colorectal Cancer: The Impact of the Clinical Outcomes of Surgical Therapy Group Trial

The American Surgeon ◽

10.1177/000313481608200825 ◽

2016 ◽

Vol 82 (8) ◽

pp. 685-691 ◽

Cited By ~ 4

Author(s):

Michelle Julien ◽

James Dove ◽

Kevin Quindlen ◽

Kristen Halm ◽

Mohsen Shabahang ◽

...

Keyword(s):

Colorectal Cancer ◽

Clinical Outcomes ◽

Surgical Therapy ◽

Early Stage ◽

Therapy Group ◽

Oncologic Outcomes ◽

Tumor Stages ◽

The Cost ◽

The Impact ◽

Colorectal Resections

The Clinical Outcomes of Surgical Therapy Group (COST) Trial established laparoscopic procedures offer short-term benefits while preserving the same oncologic outcomes in colorectal cancer (CRC) patients compared with open procedures. The aim of this study was to evaluate the trend of laparoscopic resection for CRC before and after the publication of the COST Trial. Retrospective study of surgically treated CRC patients was conducted from January 2000 to December 2009. Surveillance, Epidemiology, and End Results Program and Medicare. Between 2000 and 2009, 147,388 patients underwent resection for CRC, 9,901 resections were performed laparoscopically. In 2000, 1.0 per cent of colorectal resections were performed laparoscopically. There was a dramatic increase in laparoscopic resections in 2009 to 30.4 per cent. During this time period, rates of laparoscopic resections increased for all tumor stages. Right colectomies and early stage tumors had the most significant rise from 3.1 per cent (2004) to 38.7 per cent (2009) and 4.41 per cent (2004) to 39.17 per cent (2009), respectively; whereas, rectal and later stage tumors resection rates were more modest from 2.1 per cent (2004) to 13.2 per cent (2009) and 1.41 per cent (2004) to 17.10 per cent (2009), respectively. This study demonstrates the COST Trial had a significant impact on utilization of laparoscopic colorectal resection for CRC. Although laparoscopic colorectal resections have been accepted for all types of CRCs, more difficult procedures are being adopted at slower rates.

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How the Post-Fracture Rehabilitation Choice Affects Brain Function in Older People?

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000495937 ◽

2019 ◽

Vol 9 (1) ◽

pp. 34-43

Author(s):

Noriko Mitsuboshi ◽

Minoru Kouzuki ◽

Shigeru Mochida ◽

Kanehito Morimoto ◽

Katsuya Urakami

Keyword(s):

Spectral Analysis ◽

Brain Function ◽

Therapy Group ◽

Power Spectral Analysis ◽

Antioxidant Potential ◽

Coherence Analysis ◽

Power Spectral ◽

Panel Type ◽

Potential Methods ◽

The Impact

Background: We investigated how the type of rehabilitation affects brain function and antioxidant potential. Methods: Twenty-eight patients hospitalized for fall-related fractures were assigned to either a physical therapy group or an occupational therapy group. Cognition was assessed using the Touch Panel-type Dementia Assessment Scale (TDAS) and oxidative stress with serum pentosidine levels. Spectral analysis and coherence analysis were also performed. Results: Changes in TDAS scores and serum pentosidine levels did not differ significantly between the 2 therapies. Power spectral analysis revealed a significant intergroup difference in δ waves. Coherence analysis showed significant intergroup differences in the activities of δ waves and β waves. Conclusions: Cognitive function and antioxidant potential did not differ between the 2 types of rehabilitation. However, the impact on cerebral neuronal activity may have differed.

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The impact of medical clowns exposure over postoperative pain and anxiety in children and caregivers: An Israeli experience

Pediatric Reports ◽

10.4081/pr.2019.8165 ◽

2019 ◽

Vol 11 (3) ◽

Cited By ~ 1

Author(s):

Nitza Newman ◽

Slava Kogan ◽

Moshe Stavsky ◽

Shay Pintov ◽

Yotam Lior

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Therapy Group ◽

Postoperative Pain Management ◽

Serum Cortisol ◽

Pain Reduction ◽

Parental Distress ◽

Post Surgery ◽

Emotional Outcomes ◽

The Impact

While postoperative pain management was shown to reduce unwanted physiological and emotional outcomes, pediatric postoperative pain management remains suboptimal. Medical-clowns were shown to be beneficial in many medical contexts including reduction of stress, anxiety and pain. This study was set to assess the effectiveness of medical-clowns on pediatric postoperative pain reduction. Children age 4 or above, planned for elective hernia repair surgery were recruited. Children were randomly divided to a control or medicalclown escorted groups. Demographical and clinical data were collected using questionnaires and electronic sheets. Children escorted by clowns reported lower levels of pain upon admittance, discharge and 12-hours post-surgery. Statistically significant reduction of parental distress and significantly higher serum cortisol levels were observed in the clown-therapy group. Although small, our study supports the possibility that preoperative medical-clown therapy might be a cheap, safe and yet beneficial method for postoperative pain reduction.

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A randomized placebo-controlled cross-over study using a low frequency magnetic field in the treatment of fatigue in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458511415748 ◽

2011 ◽

Vol 18 (1) ◽

pp. 82-89 ◽

Cited By ~ 12

Author(s):

Maria Laura Lopes de Carvalho ◽

Roberta Motta ◽

Giovanna Konrad ◽

Mario Alberto Battaglia ◽

Giampaolo Brichetto

Keyword(s):

Magnetic Field ◽

Multiple Sclerosis ◽

Therapy Group ◽

Treatment Protocol ◽

Low Frequency ◽

Rehabilitation Centre ◽

Double Blind ◽

Beneficial Effects ◽

Frequency Magnetic Field ◽

The Impact

Background: Fatigue is one of the most common disabling symptoms in multiple sclerosis (MS). There is growing evidence in the literature for beneficial effects of magnetic fields on different MS symptoms and this has been reported to be beneficial in patients with MS, especially those with fatigue. Objectives: The aim of the study was to assess the effects on primary fatigue with a pulsed systemic low frequency magnetic field by means of clinical scales in a population of MS subjects. Methods: Randomized double-blind cross-over trial with 50 MS subjects with primary fatigue who were recruited among those followed as outpatients at the AISM Rehabilitation Centre, Genova, Italy. Subjects were randomized into two groups: magnetic field group and sham therapy group and evaluated with the Modified Fatigue Impact Scale (MFIS), the Fatigue Severity Scale (FSS), VAS and Time Walking Test 10 meter (TWT10m.) at the time points of the study. Each group received both sham therapy and magnetic field therapy with a wash-out period of 5 months. Subjects were treated for 24 min per session, three times per week, for 8 weeks. Statistical analysis was performed using multivariate analysis. Results: Results showed a statistically significant improvement in MFIS Physical Score for T0 − T1 ( p < 0.05) for TIME but not for TREATMENT and TIME*TREATMENT factors. No statistically significant differences were found for all other parameters considered in the study. Conclusions: Exposure to a low frequency magnetic field, within the parameters of this treatment protocol, has no advantage over sham exposure in reducing the impact of fatigue.

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The search for a container in a precarious environment

Group Analysis ◽

10.1177/0533316418813471 ◽

2018 ◽

Vol 52 (2) ◽

pp. 133-146

Author(s):

Judy O’Mahony ◽

Siobhán Bereen

Keyword(s):

Women Survivors ◽

Therapy Group ◽

Parallel Process ◽

Organizational Restructuring ◽

Flexible Approach ◽

Multicultural Therapy ◽

Group Members ◽

Survivors Of Torture ◽

The Impact

This article explores the impact of the parallel process of a precarious environment on a multicultural therapy group for women survivors of torture and persecution who had sought asylum in Ireland. The environments for both therapists and group members were experienced as producing ‘unthinkable anxiety’ (Winnicott, 1962: 57). For the therapists, their context was of threatened dismissal due to organizational restructuring, and for the group members it was the threat of deportation. The impact shaped decisions pertaining to the dynamic administration of how the group should be conducted and for how long. It led to a clinical crisis when the anxiety in the group became enmeshed, provoking primitive defences which affected the capacity to think, and blocked understanding on the part of the therapists. Flexibility in the level of leadership activity allowed for a containing process to take place and the group to become the therapist (Sclapobersky, 2016: 210). This flexible approach enabled the naming of an anxiety for the group as a whole which bound together the fragmented, intense emotions, and opened up the reflective space to the contents the members wished to have contained (Hinshelwood, 1994: 102). All names have been changed and the group gave consent for the authors to write about this experience.

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S39. THE IMPACT OF THE GROUP FACTOR ON OUTCOME IN GROUP THERAPY: FINAL RESULTS OF RCT INCLUDING 127 SCHIZOPHRENIA OUTPATIENTS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.105 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S46-S47

Author(s):

Daniel Mueller ◽

Conny Steichen ◽

Kristin Schaller ◽

Volker Roder

Keyword(s):

Group Therapy ◽

Negative Symptoms ◽

Therapy Group ◽

Cognitive Remediation ◽

Skills Training ◽

Group Factor ◽

Treatment As Usual ◽

Before And After ◽

Comparison Groups ◽

The Impact

Abstract Background Today, some evidence-based group therapy approaches focusing different treatment goals are available for the treatment of schizophrenia patients, e.g. psychoeducation, social skills training, CBTp or cognitive remediation. However, only few if any data are available regarding the impact of the group factor as an unspecific mechanism of change regarding outcome in schizophrenia patients. Does the participation in goal-oriented groups per se affect therapy outcome? Methods To bridge this gap, a cognitive remediation group approach (Integrated Neurocognitive Therapy, INT) developed in our lab has been compared with control patients not participating in therapy groups (Treatment as Usual, TAU). A total of 127 schizophrenia outpatients has been randomly assigned to INT (N=65) or TAU (n=62). INT was conducted twice a week over 15 weeks therapy duration. A comprehensive test battery was assessed before and after therapy as well as at 1-year follow up in both comparison groups. The group factor was assessed by the newly developed questionnaire “Experience and Behavior in Therapy groups EBIT”, a brief questionnaire including 13 items. Results The therapy group showed significantly better effects in EBIT outcome compared to controls regarding the global score (mean of all EBIT items) (GLM: F=4.23, p=.02) as well as regarding empirical 2-factor solution using factor analysis: factor 1 (affect and communication skills) (GLM: F=3.70; p=.03) and factor 2 (eye contact during communication) (F=3.35, p=.04). Additionally, EBIT scores are significantly associated with improvement in cognition and negative symptoms after treatment but not with positive symptoms. Discussion First of all, the group factor can be identified and measured using a brief questionnaire. Additionally, the group factor has a supplement positive effect on cognition and negative symptoms.

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