This article explores the efficacy of sequential treatment involving medication and cognitive behavioral treatment (CBT) for insomnia. In a multiple baseline across-subjects design, 6 participants with primary chronic insomnia received 1 of the following treatment sequences: (a) concurrent combination of medication and CBT for the 10-week treatment duration (Combined); (b) ...

WG can be associated with serious consequences that can occur as a result of active disease or from the side effects of treatment. If the medications used to treat WG were safe, the risk of exposing even a significant proportion of individuals to unwarranted treatment might be a reasonable approach ...

OBJECTIVE: Nocturnal enuresis is a heterogeneous condition with various treatment options of both pharmacological and psychological origin. The three systems model previously proposed by us suggests a framework to facilitate understanding, identify a child's needs and specify the appropriate treatment option. In this study we sought to investigate the model ...

This manuscript reviews the time course and components of osteoporosis and the diagnostic tools and medication available for treatment; as well as discusses the role of the obstetrician-gynecologis in detection, prevention, and treatment of osteoporosis in the pre- and postmenopausal patient. It also updates a review that appeared in this ...

Various agents are used for the medical management of chronic constipation but few have been carefully studied. This review examines available data concerning several bulk and fiber products, lubricating agents, stimulants, and osmotic laxatives, alone and in combination. Popular therapeutic options for initial treatment of chronic constipation are dietary fiber ...

INTRODUCTION: Reno-ureteral colic presents with a complex of acute symptoms that usually indicate the presence of a stone in the collecting system, The aim of any treatment is pain relief, stone removal and preservation of kidney function. We focused our review on the pathophysiological aspects of reno-ureteral colic and, briefly, ...

Through an examination of recent incest treatment development, this article emphasizes the theoretical concept of integration within the treatment process for female adult incest survivors. Spirituality as a therapeutic foundation is discussed with examples of therapeutic techniques. A case study illustrates the psycho-spiritual process of treating a 29-year-old female incest ...

OBJECTIVES: To ascertain the prevalence of spasticity among adults living in a developmental center and to document the development of spasticity treatment plans for this population. DESIGN: Descriptions of the clinical features of medical disorders and a prevalence survey. SETTING: Residential developmental center. PARTICIPANTS: One hundred three adults. INTERVENTIONS: Not ...

PURPOSE: to propose and describe a new classification of diabetic macular edema (DME) based on its etiopathogenetic features and to present efficacy and safety data on medical and laser treatments currently used and under investigation. METHODS: available literature on DME has been reviewed and information provided by contact lens biomicroscopy, ...

Sildenafil citrate, the first internationally approved and widely used oral agent for the treatment of erectile dysfunction (ED), has revolutionized the treatment of ED throughout the past 5 years. This phosphodiesterase type-5 (PDE-5) inhibitor is selective for corpus cavernosum smooth muscle tissue and produces excellent erectile function. Its efficacy and ...

RDP-58, a decapeptide with inhibitory effects on tumor necrosis factor synthesis, is under development by SangStat Medical Corp for the potential treatment of Crohn's disease and ulcerative colitis; phase II trials for both these indications commenced in October 2001. SangStat also initiated a phase I trial in chemotherapy-induced diarrhea in ...

Since the introduction of the Infertility Treatment Act 1995 (Vic), it has been illegal to import into or export from Victoria a gamete or embryo outside the human body without the approval of the Infertility Treatment Authority. But is s 56 unconstitutional and therefore invalid by reason of contravening the ...

Since 1989, Médecins Sans Frontières (MSF) has provided medical humanitarian assistance during outbreaks of visceral leishmaniasis (VL; kala-azar) in Sudan. First, in western Upper Nile in southern Sudan, where a VL epidemic occurred after the resumption of the civil war in Sudan in 1983, with an estimated 100,000 deaths. Later, ...

Endometriosis and infertility have been linked in the discipline of gynecology for more than a century. There is evidence that endometriosis can and does decrease fertility. However, our ability to determine fertility prognosis based on a staging system is severely limited. Treatment options include medical therapy, surgical intervention, and assisted ...

Drug tolerability strongly influences patients' persistence with treatment. In this study, patterns of medication persistence with cyclooxygenase 2 (COX-2)-specific inhibitors and nonspecific nonsteroidal anti-inflammatory drugs (NSAIDs) were compared in a managed care setting. Pharmacy, enrollment, and medical claims data from 19 health plans were used to match subjects newly treated ...

The use of sulfonylurea medications in the treatment of type 2 diabetes mellitus is common. Patients who present to the Emergency Department after ingestion of excessive amounts of suflonylurea medications often have hypoglycemia refractory to dextrose administration. Standard care includes the administration of dextrose, glucagon, and diazoxide. Recently, the use ...

Priapism is a condition first described by Tripe in 1845. It has been defined as a pathological condition of penile erection that persists beyond or is unrelated to sexual stimulation. Two variants of priapism have been well described. The ischemic priapism (also known as low-flow priapism) and nonischemic priapism (or ...

A 74-year-old man was admitted with rhabdomyolysis after undergoing initial treatment for gastrointestinal cancer with irinotecan. The syndrome partially resolved after the discontinuation of all of his usual medications, including his chronic selective serotonin reuptake inhibitor (SSRI). The rhabdomyolysis was exacerbated upon reinitiation of the SSRI and disappeared when the ...

Atrial ectopic tachycardia is an incessant supraventricular tachycardia and is frequently refractory to medical treatment. Because it can cause tachycardia-induced cardiomyopathy, early diagnosis and treatment is important. We present a 16-year-old boy who was diagnosed as atrial ectopic tachycardia. The tachycardia, originating from the lower region of the right atrium ...

A 2-month-old foal was presented with clinical signs of colic. Gastroduodenal ulceration was suspected. A poor response to medical treatment and signs of gastroduodenal obstruction led to celiotomy and an attempted bypass procedure. The foal was euthanized and postmortem examination revealed gastric ulceration, segmental duodenal stenosis, and severe chronic cholangiohepatitis ...

Empowerment and disempowerment is studied in terms of the way persons with long and persistent schizophrenia evaluate their psychiatric outpatient treatment. One hundred persons with the diagnosis of schizophrenia (ICD-10 F 20.0) were interviewed about their perceptions and evaluation of the treatment process by means of problem-focused interviews. Transcribed interviews ...

OBJECTIVE: To determine the odds of moderate or severe gastric ulceration in racehorses treated with various antiulcer medications. DESIGN: Unmatched case-control study. ANIMALS: 798 horses in active race training (252 Thoroughbreds and 546 Standardbreds). Only horses that had been receiving a single antiulcer medication or no antiulcer medication for at ...

BACKGROUND: Gastric mucus usually induces artefacts during endoscopic ultrasonography. AIM: To investigate the effectiveness of pre-medication with the proteolytic enzyme, pronase, before endoscopic ultrasonography. METHODS: Out-patients scheduled for endoscopic ultrasonography were randomly assigned to oral pre-medication with the anti-foam agent, dimethylpolysiloxane, alone (treatment A; n = 29), with dimethylpolysiloxane plus ...

Cross-sex hormone treatment is an important component in medical treatment of transsexual people. Endocrinologists are often faced with designing treatment recommendations. Although guidelines from organizations, such as the Harry Benjamin International Gender Dysphoria Association, have been helpful, management remains complex and experience guided. We discuss the range of treatment used ...

The adverse effects of insomnia on health and quality of life are matters receiving increasing attention. Yet, surveys have consistently shown that most people suffering from insomnia do not seek medical help, perhaps, in part, because of a concern of becoming dependent on hypnotic medication. The treatment of chronic insomnia ...

BACKGROUND: Fordyce spots are heterotopic sebaceous glands that can be located at the lips' vermilion or the oral mucosa. Although this is considered a rather common disorder, a treatment for this condition that sometimes affects patients from only a cosmetic viewpoint has not yet been described. OBJECTIVE: To evaluate CO2 ...

Corneal fungal diseases, including fungal keratitis and stromal abscess, are uncommon in small animals. Ocular infection secondary to systemic mycosis is reported far more frequently. Suspicion of a fungal corneal ulcer should be raised based on a history of underlying trauma, especially with plant material, geographic location, chronic use of ...

OBJECTIVE: The aim of this study was to identify the clinical baseline factors that affect the long-term treatment failure of benign prostatic hyperplasia (BPH). METHODS: 437 men over 50 years of age with BPH were enrolled for this analysis. Patients were allocated to a medication and a surgical treatment (following ...

Involuntary treatment is a concept often familiar to psychiatrists. In clinical practice, it usually involves the hospitalization and pharmacological management of patients with severe mental disorders. However, the scope of involuntary treatment is not limited to the management of mental illness alone. Psychiatric patients afflicted with medical illnesses may require ...

The practice of self-medication is widespread in the Republic of Yemen. The objectives of this study were to describe the treatment of malaria in households and to promote rational treatment. We surveyed 201 households with family members suffering from malaria or being treated with antimalarials. Numbers of prescribed and non-prescribed ...

Over the last two decades there have been major advances in the medical treatment of gastro-oesophageal reflux disease (GORD) and Barrett's oesophagus. Motility agents, H(2)-receptor antagonists and proton-pump inhibitors (PPI) have all been evaluated in short- and long-term studies. Symptomatic response needs to be differentiated from healing of oesophagitis and ...

BACKGROUND: Closed macrocomedones are unsightly lesions that may be resistant to medical treatments and comedone extractors. Light cautery has been used to treat macrocomedones, which are 1 to 3 mm in size; however, its success in larger and chronic lesions is limited. OBJECTIVE: To introduce an alternative treatment technique for ...

Post-herpetic neuralgic affects up to 20% of patients after an attack of trigeminal Herpes Zoster infection. Past medical and surgical treatments have been unrewarding. We report the successful treatment of such a case with deep brain stimulation into the region of the contralateral periventricular grey area (PVG) and ventral posterior ...

The scope of this review is to describe the epidemiology, physiology, symptomatology, and treatment of diabetic painful neuropathy, which is a common complication of diabetes with significant morbidity. This article focuses on treatment options. Various clinical trials of several classes of medications (eg, antidepressants, anticonvulsants, and topical medications) and alternative ...

We report the first successful area-wide reduction of Ixodes scapularis by using minimal amounts of permethrin self-applied by free-ranging white-tailed deer in as little as 3 y of nearly continuous treatment. The study to control all active stages of L. scapularis Say was initiated in April 1995, at the Goddard ...

This interim final rule amends the Federal opioid treatment program regulations by adding buprenorphine and buprenorphine combination products to the list of approved opioid treatment medications that may be used in federally certified and registered opioid treatment programs. The Food and Drug Administration (FDA) recently approved Subutex[reg] (buprenorphine) and Suboxone[reg] ...

In 1973 Mr Richard Hughes, who was working on the third novel of his trilogy on the rise of the Nazi Party and Adolf Hitler, came to see me regarding a document, some 300 pages long, on the medical treatment given by Dr Theodore Morell to Hitler. The document had ...

From all available minimally invasive methods for the treatment of symptomatic benign prostatic hyperplasia (BPH), transurethral microwave thermotherapy (TUMT) has gained a firm position as the most attractive option. Recent research has produced innovations in high-energy TUMT, including new treatment protocols, refined selection criteria, and monitoring of intraprostatic temperature. Furthermore, ...

The use of glucosamine and chondroitin sulfate for the symptomatic treatment of osteoarthritis has been a subject of controversy for several reasons. First, the medical community in general took offense at the title of Theodosakis' book, The Arthritis Cure. Second, the medical community is becoming divided into "traditional" and "alternative" ...

Tinnitus is a significant medical problem affecting approximately 50 million Americans, 12 million of them severely. Once a thorough evaluation has been performed by a qualified otolaryngologist, and no life-threatening pathology has been identified, the opportunity for treatment exists. Treatment options are extensive and range from approved protocols to anecdotal ...

In some acromegalic patients medical treatment does not succeed in normalizing GH/IGF-I values. Data showing IGF-I suppression in acromegaly by estrogen and by tamoxifen use prompted us to reevaluate the effects of estroprogestins (EP) supplementation on GH/IGF-I levels in acromegalic women resistant or only partially sensitive to medical treatment. Eight ...

To determine the treatment preferences (, medication, counseling, or both) for victims of recent trauma at risk for posttraumatic stress disorder and the determinants of those choices, preferences were elicited from 466 consecutive victims of physical or sexual assault at an urban emergency department as part of the routine clinical ...

An ulcer involving the left posterior mandibular lingual mucosa was the chief complaint of this 55-year old white man. (Figure 1) The ulcer was first noted about one month previously and no local eliciting factors could be identified. The ulcer had become progressively more painful in spite of antibiotic treatment ...

An important aspect of health professional's duty of care is to advise patients of the available options of treatment so that the patient can choose the form of treatment that suits her or his requirements. As CAM becomes more evidence-based and accepted, medical doctors need to consider the extent to ...

In the past 2 years, intranasal nebulized medications have emerged as a widely prescribed treatment for medical management of chronic rhinosinusitis. This represents an innovative and advanced approach to treating acute exacerbations of chronic rhinosinusitis topically. The use of specially formulated medication compounds delivered by unique nebulization equipment is reviewed ...

Early identification of patients with acute severe colitis is essential so that prompt treatment can be instigated. Corticosteroids have remained the mainstay of treatment since 1955. The introduction of ciclosporin into the pharmacological armamentarium has reduced early colectomy rates but even with modern medical management up to 30% of patients ...

More than 37 million Americans experience tinnitus, and adults age 40 to 70 are most often affected. Tinnitus is a symptom, not a disease, and as such has many different causes. Tinnitus is classified as vibratory and nonvibratory and is further subdivided into objective and subjective categories. The evaluation of ...

Orthodontists routinely use radiography to diagnose malocclusions, plan treatment, and assess progress or the achievement of treatment goals. These films often contain evidence of oral or dentofacial pathology that require dental or medical consultation and treatment. This study is a cross-sectional survey of 396 orthodontic patients under treatment at a ...

Stress urinary incontinence (SUI) is the involuntary loss of urine associated with physical activities such as running, jumping, or lifting, or with sneezing and coughing. For many patients it can be a very bothersome symptom, causing social isolation, loss of self-esteem, and increased expenses. Although there is currently no single ...

Enhanced external counterpulsation (EECP) is effective in patients with angina refractory to medical therapy or revascularization. However, as a noninvasive treatment it should perhaps be considered the first-line treatment with invasive revascularization reserved for EECP failures or high-risk patients. The International EECP Patient Registry was used to analyze a cohort ...