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Improving Tolerance and Compliance of New Targeted Therapies with Homeopathy: A Major Challenge in Oncology 提高顺势疗法新靶向治疗的耐受性和依从性:肿瘤学的一个重大挑战
Pub Date : 2022-04-22 DOI: 10.21926/obm.icm.2203026
J. Bagot
The application of targeted therapies (TT) in oncology has prolonged survivals and even enabled complete remission of cancers previously considered incurable. With small therapeutic indices, the reduction in dosage or spacing out of the doses of TT due to side effects, represents a significant loss of treatment opportunity for the patients. In the absence of drug interaction and significant side effects, homeopathy used in supportive care improves the quality of life of patients, compliance with oncological treatments and consequently their survival. Based on the author’s clinical experience and published studies, a therapeutic regimen for systematic supportive care of TT is proposed in this study. The originality of the treatment lies in combining a symptomatic diluted and dynamised homeopathic medicine with the patient’s constitutional homeopathic medicine as well as the isotherapeutic agent used for targeted therapy in 7c (10-14). If needs be, the eponymous organotherapy of the organ most affected by the side effects can be added in 4c (10-8). This therapeutic regimen is well accepted and well tolerated. It has been prescribed to approximately 5,000 patients over 25 years including those patients who were given hormone therapy. Facilitating tolerance and acceptance of targeted therapies is very important in oncology in order to fully benefit from the TT efficacy. Homeopathy, organotherapy and isotherapy, by supporting the whole body and treating the major side effects, might improve observance and consequently therapeutic results. Clinical trials could be carried out following the designs and protocols presented in this article.
靶向治疗(TT)在肿瘤学中的应用延长了生存期,甚至使以前认为无法治愈的癌症完全缓解。在治疗指标较小的情况下,由于副作用导致的TT剂量减少或剂量间隔,对患者来说意味着治疗机会的重大损失。在没有药物相互作用和显著副作用的情况下,顺势疗法用于支持治疗可以提高患者的生活质量,提高肿瘤治疗的依从性,从而提高患者的生存率。根据作者的临床经验和已发表的研究,本研究提出了一种系统的TT支持治疗方案。该治疗的独创性在于将症状稀释和动态的顺势疗法药物与患者的体质顺势疗法药物以及用于7c(10-14)靶向治疗的等治疗剂结合起来。如果需要,可以在4c(10-8)中加入对受副作用影响最大的器官的同名器官疗法。这种治疗方案被广泛接受并且耐受性良好。25年来,包括那些接受激素治疗的患者在内,大约有5000名患者服用了这种药物。促进靶向治疗的耐受和接受在肿瘤学中是非常重要的,以便充分受益于TT的疗效。顺势疗法、器官疗法和等量疗法,通过支持整个身体和治疗主要副作用,可能会改善观察,从而改善治疗效果。临床试验可以按照本文提出的设计和方案进行。
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引用次数: 0
Clinical Significance of Stress, Depression, Anxiety, and Worry Symptom Improvement Following Mindfulness-based Stress Reduction 基于正念的减压后压力、抑郁、焦虑和担忧症状改善的临床意义
Pub Date : 2022-04-12 DOI: 10.21926/obm.icm.2202022
H. Hazlett-Stevens
Mindfulness-based stress reduction (MBSR) teaches mindfulness meditation to reduce stress, anxiety, depression, and related forms of distress among a variety of patients. Much research has documented statistically significant reductions across a variety of self-report measures following MBSR, but researchers rarely assessed and reported the clinical significance of MBSR symptom reduction in accordance with specific criteria famously established by Jacobson and Truax [1]. Patients reporting symptoms of anxiety, depression, and/or other stress-related concerns received MBSR in an outpatient mental health clinic. In order to assess the clinical significance of reported symptom reduction, specific criteria to determine reliable clinical improvement and recovery were applied to the data from each patient across the main symptom outcome measures. This secondary clinical significance analysis was conducted with all 23 patients who completed MBSR and completed assessment measures both before and after the intervention in the original open trial. A reliable change index and a cutoff point for outcome measures of worry, depression, anxiety, and stress were obtained so that reliable clinical improvement and recovery on each measure could be assessed for each patient. The proportion of patients who were elevated in the clinical range above the cutoff before the intervention was determined, as well as the proportion of those reporting symptom reduction, the proportion showing reliable improvement, and the proportion recovered at the final MBSR session. Clinical significance analyses revealed that over half of the patient sample scored in the clinical range on each measure before MBSR. At the end of the intervention, the vast majority of these patients reported symptom reduction, and depending on the measure, 45-69% of patients who were clinically elevated initially and reported symptom reduction following MBSR exhibited reliable clinical improvement. Furthermore, 29-50% of those patients showing reliable clinical improvement also met criteria as recovered at the conclusion of the MBSR program. These results suggest that the symptom reduction observed following MBSR is substantial and clinically meaningful for many patients – an outcome that cannot be determined with statistical tests of significance alone. Clinical significance criteria, such as those applied in this study, could be implemented in randomized controlled trial protocols to supplement conventional tests of statistical significance and shed light on how clinically meaningful obtained changes on outcome measures are for patients.
基于正念的减压(MBSR)教授正念冥想,以减轻各种患者的压力、焦虑、抑郁和相关形式的痛苦。许多研究记录了MBSR后各种自我报告措施的统计学显著减少,但研究人员很少根据Jacobson和Truax[1]著名的特定标准评估和报告MBSR症状减少的临床意义。报告焦虑、抑郁和/或其他压力相关症状的患者在门诊心理健康诊所接受MBSR。为了评估报告的症状减轻的临床意义,将确定可靠临床改善和恢复的具体标准应用于每个患者的主要症状结果测量数据。这项次要临床意义分析是对所有23名完成MBSR并在原始开放试验干预前后完成评估措施的患者进行的。获得了一个可靠的变化指数和担忧、抑郁、焦虑和压力的结果测量的临界点,以便评估每个患者在每个测量方面的可靠临床改善和恢复。确定干预前在临床范围内高于临界值的患者比例,以及报告症状减轻的患者比例、显示可靠改善的比例和在最后一次MBSR治疗中康复的比例。临床显著性分析显示,超过一半的患者样本在MBSR前的每项测量中得分在临床范围内。在干预结束时,这些患者中的绝大多数报告症状减轻,根据测量结果,45-69%的最初临床升高并报告MBSR后症状减轻的患者表现出可靠的临床改善。此外,显示出可靠临床改善的患者中,29-50%在MBSR项目结束时也符合康复标准。这些结果表明,MBSR后观察到的症状减轻对许多患者来说是实质性的和有临床意义的——这一结果不能仅靠具有显著性的统计测试来确定。临床显著性标准,如本研究中应用的标准,可以在随机对照试验方案中实施,以补充具有统计学显著性的常规测试,并阐明患者在结果测量方面获得的具有临床意义的变化。
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引用次数: 1
Induction into Browning’s Strategy: Suggestions for Family Therapy 导入布朗宁的策略:对家庭治疗的建议
Pub Date : 2022-04-11 DOI: 10.21926/obm.icm.2203029
Rachel Hull, S. Browning, Melanie Puzio
The authors attempted to operationalize the clinical work of strategic theorist and expert family therapist, Scott Browning. Strategic therapy takes the position that a client is stuck, not necessarily sick. This focus encourages the clinician to create alternative perspectives such that a client learns to consider a problem from a new lens. Milton Erickson, a progenitor of strategic thinking, used hypnosis and paradox to nudge clients toward a useful alternative perspective [1]. The present article examined three interventions that have strategic roots. The specific application of these three interventions, demonstrated through the work of Browning’s therapy, provide unique application of strategic ideas. First, the authors compare and contrast Browning and Erickson’s [1] application of directional and non-directional paradox. Second, the well-established technique of systemic reframe is explored, along with application of acceptance. Next, empathy is discussed in the context of the common factor of therapeutic alliance [2] and Browning’s understanding of empathy. Finally, the importance of language in psychotherapy is particularly powerful in the context of hypnosis [1]. Browning’s semantic thoroughness and the concept of non-blaming precision in clinical work was discussed.
作者试图将战略理论家和专家家庭治疗师斯科特·布朗宁的临床工作运作起来。策略疗法的立场是,客户被困住了,不一定是生病了。这种关注鼓励临床医生创造不同的观点,这样病人就能学会从新的角度考虑问题。米尔顿•埃里克森(Milton Erickson)是战略思维的鼻祖,他使用催眠术和悖论来推动客户转向另一种有用的观点。本文考察了具有战略根源的三种干预措施。这三种干预措施的具体应用,通过布朗宁治疗的工作证明,提供了独特的战略思想的应用。首先,作者比较和对比了布朗宁和埃里克森对定向悖论和非定向悖论的广泛应用。其次,探讨了系统重构的成熟技术,以及接受的应用。接下来,在治疗联盟的共同因素[2]和布朗宁对共情的理解的背景下讨论共情。最后,语言在心理治疗中的重要性在催眠情境中尤为突出。讨论了临床工作中勃朗宁的语义彻底性和不责备精确的概念。
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引用次数: 0
An Interview with Dr. James David Adams 詹姆斯·大卫·亚当斯博士访谈录
Pub Date : 2022-04-02 DOI: 10.21926/obm.icm.2202018
Interview with Dr. James David Adams. The skin is where pain is sensed and where chronic pain is created. The safest and most effective treatment for pain is topical plant medicines. Chronic pain can be cured with topical plant medicines. Transient receptor potential cation channels in the skin sense pain. Chronic pain involves a pain chemokine cycle. Monoterpenoids and diterpenoids from plants can stop this pain chemokine cycle and cure chronic pain.
詹姆斯·大卫·亚当斯博士访谈。皮肤是感受疼痛的地方,也是产生慢性疼痛的地方。治疗疼痛最安全、最有效的方法是外用植物药。慢性疼痛可以用局部植物药治愈。瞬时受体电位阳离子通道在皮肤感觉疼痛。慢性疼痛涉及疼痛趋化因子循环。植物中的单萜和二萜可以阻止这种疼痛趋化因子循环,治愈慢性疼痛。
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引用次数: 0
Clinical Practice Guidelines About Screening for Disruptive Behavior Problems at Well-Child Visits: A Rapid Review of the Literature on the Accuracy of Parents’ Behavioral Concerns 关于在Well Child就诊时筛查破坏性行为问题的临床实践指南:关于父母行为关注准确性的文献快速回顾
Pub Date : 2022-03-08 DOI: 10.21926/obm.icm.2203031
R. Baillargeon, M. Charette, François Tessier, K. Brand
The current recommendations of the Canadian Paediatric Society about monitoring children’s disruptive behaviors at well-child visits call for screening if behavioral concerns are being raised by parents. But do parents’ concerns about their child’s behavior constitute a reliable means for primary care providers (PCPs) to decide either in favor or against screening? We conducted a rapid systematic review of the literature by identifying documents that cited the landmark study by Glascoe and her colleagues (1991) on the accuracy of behavioral concerns at identifying children with a disruptive behavior problem. Citation tracking was done using Web of Science (Core Collection; 17 October 2018) and SCOPUS (19 October 2018). Only one recent published study was identified. The calibration of concerns’ specificity (and other indices alike) yielded, at best, a fair value of the weighted kappa coefficient κ(0,0) (i.e., 0.255 and 0.094). Also, the calibration of concerns’ sensitivity (and other indices alike) yielded, at best, a moderate value of the weighted kappa coefficient κ(1,0) (i.e., 0.533 and 0.392). Overall, the results do not support the current recommendations. In fact, behavioral concerns do not provide PCPs with enough information to reach a decision about screening. We discuss different ways of gathering the necessary information.
加拿大儿科学会目前的建议是,在健康儿童访视中监测儿童的破坏性行为,要求对父母是否提出了行为担忧进行筛查。但是,父母对孩子行为的担忧是否构成初级保健提供者(pcp)决定支持或反对筛查的可靠手段?我们对文献进行了快速系统的回顾,找出了引用Glascoe和她的同事(1991)的里程碑式研究的文件,该研究是关于行为关注在识别具有破坏性行为问题的儿童方面的准确性。引文跟踪使用Web of Science (Core Collection;2018年10月17日)和SCOPUS(2018年10月19日)。只有最近发表的一项研究得到了证实。对关注的特异性(以及其他类似的指标)的校准最多产生一个加权kappa系数κ(0,0)的公允值(即0.255和0.094)。此外,对关注点的敏感性(以及其他类似指标)的校准最多产生一个加权kappa系数κ(1,0)的中等值(即0.533和0.392)。总的来说,研究结果并不支持目前的建议。事实上,对行为的关注并不能为pcp提供足够的信息来决定是否进行筛查。我们讨论了收集必要信息的不同方法。
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引用次数: 0
Associations between Prenatal Factors and Self-Reported Emotional Availability at 3- and 6-Months Postpartum 产前因素与产后3个月和6个月自我报告的情绪可用性之间的关系
Pub Date : 2022-03-07 DOI: 10.21926/obm.icm.2203028
Julia Caldwell, P. Meredith, K. Whittingham, J. Ziviani
Positive perceptions of pregnancy are associated with better postpartum outcomes, including stronger relationship with baby. Although better self-reported emotional availability (EA-SR) is associated with greater attachment security with infants, research has not yet explored the relationship between prenatal maternal factors and EA-SR. The aim of the study was to explore the associations between prenatal variables (adult attachment, shame, compassion) and EA-SR at 3- and 6-months postpartum. A cross-sectional survey design based on a convenience sample of pregnant Australian women completed the survey at three time points: pregnancy (3rd trimester, n = 133), and again at 3- (n = 65) and 6-months (n = 40) postpartum. Five, 5-step, hierarchical multiple regressions revealed the model (mean maternal age/prenatal attachment/shame/compassion/psychological adjustment) significantly explained 62% in self-reported maternal hostility, 53% in self-reported child involvement, and 52% in self-reported mutual attunement, at 6-months postpartum. Higher levels of prenatal internal shame were related to less self-reported child involvement (p = 0.04), and more self-reported maternal hostility (p = 0.03), at 3-months postpartum. More prenatal giving compassion was associated with better self-reported affect quality at 3- (p = 0.01) and 6-months postpartum (p = 0.01), and less self-reported hostility (p = 0.02) at 6-months postpartum. Greater understanding of the relationship between prenatal factors and EA-SR may help enhance prenatal care pathways to support women and families at risk of adverse postpartum outcomes.
对怀孕的积极看法与更好的产后结果有关,包括与婴儿的关系更强。尽管更好的自我报告情绪可用性(EA-SR)与婴儿更大的依恋安全性有关,但研究尚未探索产前母体因素与EA-SR之间的关系。本研究的目的是探讨产前变量(成人依恋、羞耻、同情)与产后3个月和6个月EA-SR之间的关系。一项基于澳大利亚孕妇方便样本的横断面调查设计在三个时间点完成了调查:妊娠期(妊娠晚期,n=133),产后3个月(n=65)和6个月(n=40)。五步、五步、分层多元回归显示,该模型(平均产妇年龄/产前依恋/羞耻感/同情心/心理调整)在产后6个月时显著解释了62%的自我报告的产妇敌意、53%的自我报告儿童参与和52%的自我报告相互协调。产后3个月时,较高水平的产前内部羞耻感与较少的自我报告的儿童参与(p=0.04)和较多的自我报告母亲敌意(p=0.03)有关。产前给予同情越多,产后3个月(p=0.01)和6个月(p=0.01)自我报告的情感质量越好,产后6个月自我报告的敌意越少(p=0.02)。更好地了解产前因素与EA-SR之间的关系可能有助于加强产前护理途径,以支持有产后不良后果风险的妇女和家庭。
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引用次数: 1
Co-administration of Zingiber officinale Extract and Sodium Valproate Ameliorates Seizure Severity, Cognitive Deficit, and Neuronal Cell Loss in Pentylenetetrazole-kindled Mice 生姜提取物和丙戊酸钠共同给药可改善戊四唑点燃小鼠癫痫发作严重程度、认知缺陷和神经元细胞损失
Pub Date : 2022-02-25 DOI: 10.21926/obm.icm.2201013
M. I. Yakubu, Nahu Mohammed Danjamu, M. Magaji, S. Malami, A. Becker, M. Abbas, B. Chindo
Preparations of Zingiber officinale are used in Nigerian folk medicine to manage colds, pain, arthritis, nausea, and epilepsy. The ameliorative effects of co-administering aqueous Zingiber officinale extract (GE) and sodium valproate (SDV) on pentylenetetrazole-kindled mice were evaluated regarding cognitive deficits, neuronal cell loss, and seizure severity. GFAP was also quantified. Male mice were pretreated with GE (50 mg/kg), SDV (100 and 200 mg/kg), and GE + SDV before kindling. After kindling, the mice underwent a learning performance test. The animals received a challenge dose of pentylenetetrazole one week after kindling. The brains were excised one day after the challenge test and were processed for GFAP immunohistochemistry and histopathology. GE alone did not affect PTZ-kindled seizures. However, treatment with GE and SDV significantly improved learning performance and protected against neuronal cell loss in pentylenetetrazole-kindled mice. The level of astrocyte activation was reduced in the kindled group pretreated with the extract. The results obtained suggested that co-administration of GE and a low dose of SDV significantly ameliorated learning deficits and protected against neuronal cell loss, astrogliosis, and neuroinflammation, suggesting that GE might be a beneficial co-medication in the management of epilepsy.
鲜姜制剂在尼日利亚民间医药中用于治疗感冒、疼痛、关节炎、恶心和癫痫。在认知缺陷、神经元细胞损失和癫痫发作严重程度方面,研究了共给药生姜提取物(GE)和丙戊酸钠(SDV)对戊四唑点燃小鼠的改善作用。GFAP也被量化。雄性小鼠在点火前分别给予GE (50 mg/kg)、SDV(100、200 mg/kg)和GE + SDV预处理。点燃后,老鼠进行了学习表现测试。这些动物在点燃后一周接受了戊四唑的刺激剂量。攻毒试验后1天切除脑组织,进行GFAP免疫组化和组织病理学检查。单独使用GE对ptz点燃的癫痫发作没有影响。然而,用GE和SDV治疗可显著改善戊四唑点燃小鼠的学习表现,并防止神经元细胞丢失。经提取物预处理的点燃组星形胶质细胞活化水平降低。结果表明,GE和低剂量SDV联合用药可显著改善学习缺陷,防止神经元细胞丢失、星形胶质细胞增生和神经炎症,表明GE可能是治疗癫痫的一种有益的联合用药。
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引用次数: 0
The Use of Yoga in Clinical Practice: A Descriptive Study 瑜伽在临床实践中的应用:一项描述性研究
Pub Date : 2022-02-06 DOI: 10.21926/obm.icm.2202020
Em V. Adams, B. Crowe, Jasmine Vanadore, M. V. Puymbroeck, A. Schmid
The purpose of this descriptive survey was to explore how, and for what purpose, health care practitioners use yoga in clinical practice. A survey was administered to professionals who identified as healthcare practitioners who used yoga in their practice. There were 205 completed responses from a combination of healthcare practitioners including occupational therapists, physical therapists, yoga therapists, recreational therapists, speech-language pathologists, and mental health counselors. Practitioners worked in outpatient, community, and acute rehab settings. Open-ended survey questions were analyzed using directed content analysis. Themes included how to discuss and document yoga, selecting yoga based on patient preference and clinical judgment, and finally, practitioners’ recommendations for implementing yoga into practice. Implications of the study are further discussed.
这项描述性调查的目的是探索医疗保健从业者在临床实践中如何使用瑜伽以及出于什么目的使用瑜伽。一项调查是针对那些在实践中使用瑜伽的医疗从业者进行的。共有205份来自医疗从业者的完整回复,包括职业治疗师、物理治疗师、瑜伽治疗师、娱乐治疗师、言语病理学家和心理健康顾问。执业医师在门诊、社区和急性康复机构工作。采用定向内容分析法对开放式调查问题进行分析。主题包括如何讨论和记录瑜伽,根据患者的偏好和临床判断选择瑜伽,最后,从业者建议将瑜伽付诸实践。进一步讨论了该研究的意义。
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引用次数: 2
Photobiomodulation Therapy (PBMT) is Feasible and Acceptable in Pre-conditioning and Post-operative Recovery of Patients after Total Knee arthroplasty (TKA): A Clinical Case Series 光生物调制疗法(PBMT)在全膝关节置换术(TKA)患者术前和术后恢复中是可行和可接受的:一个临床病例系列
Pub Date : 2022-02-03 DOI: 10.21926/obm.icm.2201012
P. G. Vassão, E. Laakso
Photobiomodulation therapy (PBMT) for minimal to moderate Kellgren and Lawrence grade knee osteoarthritis has significant evidence for effectiveness. The effect of PBMT in severe grades of osteoarthritis is less clear; and no studies have investigated the effect of PBMT before and after knee replacement surgery. This small study (n=4) aimed to understand the potential feasibility of undertaking a future randomised controlled clinical trial of a self-administered, home-based light patch system before and after total knee arthroplasty (TKA) The PBM device (450nm (6.75 mW/cm2) and 640nm (2.25 mW/cm2); 33kHz frequency, 4.5 J/cm2 radiant exposure) was self-applied by patients daily for 30 minutes for one week before, and 3 times in the week following hospital discharge after TKA. We measured numeric pain ratings, physical function and patient-reported outcomes at baseline one week prior to surgery, the day prior to surgery, at Day 4 after surgery, and at 1, 2, 4 and 6 weeks after hospital discharge. The study protocol and methods were found to be feasible and acceptable to participants. No pain was reported by any participants at 6-week follow-up. Functional measures of timed-up-and-go and 30 second chair stands test demonstrated marked improvement over the study period. No patients were requiring opioid analgesia at 6-week follow-up. Limitations included lack of gender diversity, the small number of participants and absence of information about post-hospital discharge opioid analgesic requirements from control group. The results provide confidence in progressing this research in an adequately powered, placebo-controlled, randomised clinical trial.
光生物调制疗法(PBMT)治疗最小至中度Kellgren和Lawrence级膝关节骨性关节炎具有显著的有效性。PBMT在严重骨关节炎中的作用尚不清楚;并且没有研究调查PBMT在膝关节置换手术前后的作用。这项小型研究(n=4)旨在了解在全膝关节置换术(TKA)前后对自行管理的家庭光贴片系统进行未来随机对照临床试验的潜在可行性;33kHz频率,4.5J/cm2辐射暴露)由患者在TKA前一周内每天自行施用30分钟,在TKA出院后一周内施用3次。我们测量了手术前一周、手术前一天、手术后第4天以及出院后1、2、4和6周基线时的数字疼痛评分、身体功能和患者报告的结果。研究方案和方法被认为是可行的,参与者可以接受。在6周的随访中,没有任何参与者报告疼痛。在研究期间,计时即用和30秒椅子站立测试的功能指标显示出显著的改善。在6周的随访中,没有患者需要阿片类镇痛。局限性包括缺乏性别多样性、参与者人数少以及对照组缺乏出院后阿片类镇痛需求的信息。这一结果为在一项充分有力的安慰剂对照随机临床试验中推进这项研究提供了信心。
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引用次数: 1
Integrating Mindfulness Practice in Cognitive Behavioral Hypnotic Psychotherapy 将正念实践融入认知行为催眠心理治疗
Pub Date : 2022-01-28 DOI: 10.21926/obm.icm.2202021
Z. Arnon
After the emergence of Mindfulness in the Western world, many studies proved its mental and physical benefits. However, implementing Mindfulness in psychotherapy has several challenges: therapists are not formal Mindfulness instructors; the Mindfulness course is a continuous eight-week course, which many patients do not attend during therapy, while others attend and drop out. Thus, Hypnosis was applied to shorten and strengthen the desired changes. The article describes the logic behind this integration, demonstrates it using a case study, and details the ideas, philosophy, and hypnotic scripts in the appendix.
在西方世界出现正念之后,许多研究证明了它对精神和身体的好处。然而,在心理治疗中实施正念有几个挑战:治疗师不是正式的正念导师;正念课程是一个连续的八周课程,许多患者在治疗期间没有参加,而其他人参加并退出。因此,催眠被用于缩短和加强所期望的变化。本文描述了这种集成背后的逻辑,使用案例研究进行了演示,并在附录中详细介绍了其思想、哲学和催眠脚本。
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引用次数: 0
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OBM integrative and complimentary medicine
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