Rheumatic Disease
John S. Axford, Chris A. O'Callaghan in Medicine for Finals and Beyond, 2023
As the fundamental mechanisms of the immune response are becoming clearer, novel approaches to therapy are being developed for the treatment of RA and other systemic inflammatory diseases associated with autoimmunity. The major biological therapeutics in clinical use include protein molecules, such as monoclonal antibodies, and small molecule kinase inhibitors. Biological therapeutics have been developed that can: Interfere with cytokine function, signal transduction or productionInhibit the ‘second signal’ required for T-cell activationDeplete B cells
Spiritual Care
Gia Merlo, Kathy Berra in Lifestyle Nursing, 2023
Spiritual care ought to vary depending on the patient’s needs and preferences; spiritual care therapeutics also ought to reflect the expertise of the provider and the circumstances requiring intervention. Therapeutics could include different ways for helping a patient to ascribe meaningfulness to their situation or to life. For example, Taylor (2002) described how existential psychotherapist Yalom’s guidance could be implemented in nurse-provided spiritual care. A patient could be supported to contribute to a cause (e.g., political, artistic, environmental, religious), to pursue pleasurable experiences (e.g., smelling the roses and watching the sunset), to perform an altruistic deed (e.g., a random act of kindness), or to seek experiences that yield increased self-awareness (e.g., meditation, prayer, psychotherapy, dream analysis). Or, prompted by logotherapist and Nazi concentration camp survivor Frankl’s observations about how people develop a sense of meaning, the nurse can encourage a patient to reflect on what they take from the world, what they give to the world, and what attitude they choose to adopt in response to suffering (Taylor, 2002).
Food Interactions, Sirtuins, Genes, Homeostasis, and General Discussion
Chuong Pham-Huy, Bruno Pham Huy in Food and Lifestyle in Health and Disease, 2022
Food-drug interactions are defined as alterations of pharmacokinetics or pharmacodynamics of a drug or nutritional element or a compromise in nutritional status as a result of the addition of a drug (21). Pharmacokinetics is the study of the time course of drug absorption (A), distribution (D), metabolism (M), and excretion (E) by the body. The four phases of pharmacokinetics are abbreviated as ADME. Pharmacokinetics enables us to know the therapeutic effects of a drug. Pharmacodynamics refers to the physiologic or clinical effects of a drug in the body, or the study of the therapeutic action of a drug in the body (21). Food-drug interactions can result in two main clinical effects: either a decreased bioavailability of a drug, which predisposes to treatment failure, or an increased bioavailability, which increases the risk of adverse events and may even precipitate toxicities (21–23).
The effects of mechanical hippotherapy riding on postural control, balance, and quality of life (QoL) in patients with stroke
Published in Disability and Rehabilitation, 2023
With scientific and technological advances in stroke treatment, the life expectancy of patients has increased. The therapeutic goal is to provide comprehensive treatment to improve the quality of life and cure and prolong life. Beinotti et al. [28] showed that classical hippotherapy significantly improved general health data in stroke patients. In this study, the sub-parameters of SF-36 regarding physical function, physical role, and mental health showed statistically significant improvement in the study group compared to the CG. The effect of short-term and intensive mechanical hippotherapy exercises on quality of life slightly differed from the results of Beinotti et al. Although there was no significant improvement in the mental component scores of the cases, the physical component score of quality of life showed a statistically significant intragroup improvement in both the MHG and the CG, but there was no significant intergroup difference. This increase in physical component score may be attributed to the mechanical hippotherapy device being perceived as a game, increasing the patients’ motivation as they find it more fun. In addition, the mental component scores of our patients included in the study did not change because MMSE scores were selected as 24 and above in both groups, and these patients did not have mental problems.
Physiotherapist perspectives of airway clearance techniques in bronchiectasis
Published in Physiotherapy Theory and Practice, 2023
Lisa J Franks, James R Walsh, Kathleen Hall, Julie A Adsett, Norman R Morris
Personalized therapy has been used to describe the application of genomic, proteomics and biomarkers to tailor therapy according to an individual’s characteristics, thereby ensuring they receive therapies that increase the likelihood of benefit to their health and quality of life (Horne, 2017; McIlwaine, Bradley, Elborn, and Moran, 2017). The call to personalize ACTs for bronchiectasis is hindered by the weak body of supporting evidence. As such, the personalization of ACTs remains in the domain of clinical expertise, local training, and workplace culture. This lack of clear evidence has led both the United States and the European Multicenter Bronchiectasis Audit and Research Collaboration (EMBARC) to recommend that optimizing ACTs in bronchiectasis should be a primary research priority (Aliberti et al., 2016; Spinou and Chalmers, 2019).
Localized, on-demand, sustained drug delivery from biopolymer-based materials
Published in Expert Opinion on Drug Delivery, 2022
Junqi Wu, Sawnaz Shaidani, Sophia K. Theodossiou, Emily J. Hartzell, David L. Kaplan
The field of medicine depends on therapeutics to treat or cure diseases. In 2020, it was estimated that $1.3 trillion was spent globally on prescription drugs [1]. As more therapeutics are developed, there is an opportunity for refined modes of delivery to increase safety and efficacy. With any mode of drug delivery, the active pharmaceutical ingredient (API) should be delivered at a concentration that reaches the therapeutic index, which describes the dose range where a medication is effective without causing adverse effects [2]. This concentration can be challenging to achieve due to unpredictable drug release rates, the inability to precisely target the desired tissues, renal/hepatic clearance of the delivered drugs, and unreliable stability of the therapeutic [3]. As a result, when therapeutics are delivered systemically, they often must be delivered at much higher concentrations than the target requirements to achieve an effective dose (Figure 1), leading to adverse side effects or harm to other organs.
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