Defining treatment

Method of orthograde and retrograde forced bouginage for treatment of 533 patients with cicatricial strictures of the esophagus was used during 1975-1995 years (486 procedures). In comparison with routine methods it has shown high effectiveness and safety. Perforation of the esophagus was detected only in 2 (0.43%) patients. Good and favourable immediate results were obtained in 95.1% patients. Follow-up results up to 20 years are available for 336 (71.8%) patients. Good result was obtained in 78.6% patients, favourable--in 16.1%, poor results--in 5.2%. It is emphasized, that the principal method for treatment of patients with cicatricial strictures of the esophagus is bouginage. The method of orthograde and retrograde bouginage of the esophagus contributes to steady remission of the disease in 95% of patients.     

Multimodal treatment package for substance abuse treatment programs.

Describes a multimodal treatment design for a short-term, residential, hospital-based program for drug abusers. Each patient is expected to attend all program services with the intent that one or several will provide the corrective emotional experience facilitating change. Services included medical care, individual counseling/psychotherapy, group counseling, health education seminars, milieu/recreational therapy, Narcotics Anonymous meetings, linkage with aftercare components, and ancillary services (vocational rehabilitation, court liaison, and 90-day follow-up). Psychology interns and students are utilized. Results of internal follow-up show that 40% of Ss admitted over 3 yrs stated they were drug-free at 90 days and 1.5 yrs. (3 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Three-dimensional optimization of treatment planning for gamma unit treatment system

During a treatment using the Leksell gamma unit, the physician and physicist need to determine a treatment plan by changing the parameters such as collimator sizes, the position of isocenters and isocenters' weights. This is a complex problem because the set of parameters is large, especially when targets are geometrically close to a critical structure. For this reason, we present here an optimization algorithm, namely the multiplier penalty method, to mathematically determine those parameters. Two cases are presented in this article: the first one is really planned by a physicist in a clinical treatment, and is redone in our optimization algorithm to show the effectiveness of this method; the second one is theoretical where a critical structure is placed close to the target volume. The results show that this method achieves an excellent conformation to the specified isodose curve with the contour of the target volume, allowing minimal damage to surrounding healthy tissue.     

CMV retinitis treatment

The two drugs known to be useful in the treatment of cytomegalovirus (CMV) retinitis are ganciclovir and foscarnet--usually they are given intravenously. Intravitreal ganciclovir seems to be even more effective. A pump system to deliver the drug into the vitreous is being developed.     

Early orthodontic treatment

Early orthodontic treatment will not resolve all potential orthodontic problems or totally inhibit adverse skeletal growth patterns. However, by identifying problems at an early age it is possible to redirect skeletal growth; improve the occlusal relationship; enhance the patient's esthetics and self-image and, perhaps of even greater importance, achieve results that are unattainable later with the eruption of teeth and the cessation of growth.     

Sclerotherapy treatment insights

The permanent eradication of ectatic veins while minimizing the incidence of adverse effects, minimizing patient discomfort, and treating the maximal number of veins during each session are goals of injection sclerotherapy. Accomplishing these goals requires more than skill at cannulation and injection into a vein. An understanding of the mechanism of action of sclerotherapy, and knowledge of lower extremity venous anatomy and hemodynamics are crucial. Insuring a satisfactory outcome also requires that the patient is thoroughly informed about the procedure and its possible risks. In addition to addressing these issues, this author presents the salient aspects of his pretreatment consultation, posttreatment recommendations, and appropriate documentation.     

Pharmacologic pain treatment

Pharmacotherapy of chronic pain uses the following groups of drugs: simple analgesics, NSAID's, opioids, calcitonin, antidepressants, neuroleptic drugs and myorelaxants. Diseases of the locomotor system are very often chronic or chronically recurrent. We therefore need a tailored longterm therapy. We have to consider not only the effect but also side effects of the different drugs. The aim of the therapy is an optimal quality of life for the individual patient. To this end we have to avoid polypragmasia.