La alianza terapéutica en la danza movimiento terapia con pacientes con discapacidad intelectual : estudio de caso

Presentamos un estudio de caso cualitativo descriptivo. La participante es una mujer de 39 años con Discapacidad Intelectual, específicamente Síndrome de Down, que realizó una intervención individual en Danza Movimiento Terapia (DMT). Los objetivos del estudio son: (1) conocer los elementos relevantes de la Alianza Terapéutica (AT) que se estableció durante la intervención consistente en 19 sesiones en DMT y (2) observar si estos elementos de la AT contribuyen al éxito de los objetivos de la intervención. Los objetivos de la intervención fueron: aumentar el conocimiento del propio cuerpo, aumentar el control de impulsos y la tolerancia a la frustración, mejorar la comunicación y la relación con el otro y fomentar la iniciativa, la creatividad, la seguridad y su autonomía. El terapeuta realizó notas de campo para recoger los elementos más importantes del caso en relación a la construcción de la AT y de los objetivos de la intervención. Posteriormente se realizó un análisis de contenido. Los resultados muestran que se construyó una AT saludable, lo cual permitió alcanzar los objetivos de la terapia. Así mimo, este estudio de caso es una aportación al ámbito de la DMT, que nos permite conocer mejor el trabajo realizado en este tipo de intervenciones

Objective breast symmetry analysis with the breast analyzing tool (BAT) : improved tool for clinical trials

Purpose Objective cosmetic analysis is important to evaluate the cosmetic outcome after breast surgery or breast radiotherapy. For this purpose, we aimed to improve our recently developed objective scoring software, the Breast Analyzing Tool (BAT®). Methods A questionnaire about important factors for breast symmetry was handed out to ten experts (surgeons) and eight non-experts (students). Using these factors, the first-generation BAT® software formula has been modified and the breast symmetry index (BSI) from 129 women after breast surgery has been calculated by the first author with this new BAT® formula. The resulting BSI values of these 129 breast cancer patients were then correlated with subjective symmetry scores from the 18 observers using the Harris scale. The BSI of ten images was also calculated from five observers different from the first author to calculate inter-rater reliability. In a second phase, the new BAT® formula was validated and correlated with subjective scores of additional 50 women after breast surgery. Results The inter-rater reliability analysis of the objective evaluation by the BAT® from five individuals showed an ICC of 0.992 with almost no difference between different observers. All subjective scores of 50 patients correlated with the modified BSI score with a high Pearson correlation coefficient of 0.909 (p < .001) which was better compared to the old software (r = 0.769; p < .001). Conclusions The modified BAT® software improves the correlation between subjective and objective BSI values, and may be a new standard for trials evaluating breast symmetry.(VLID)354530

La alianza terapeutica en la danza movimiento terapia con pacientes con discapacidad intelectual. Estudio de caso

This is a qualitative descriptive case study. The participant was a woman of 39 years with Intellectual Disability, specifically Down syndrome, who performed an individual intervention in Dance/Movement Therapy (DMT). The objectives of this study were: (1) to know the relevant elements of the Therapeutic Alliance (TA) which was established during the therapeutic process for 19 sessions DMT and (2) to observe if these elements of the TA contributed to the success of the objectives of the intervention. The objectives of the intervention were: to increase knowledge of her own body, to increase impulse control and frustration tolerance, to improve communication and relationship with the others and encourage initiative, creativity, security and autonomy. The therapist got field notes to collect the most important elements of the case in relation to the construction of the AT and objectives of the intervention. Later, it was performed a content analysis. The results showed that a healthy AT was constructed, which allowed achieving the objectives of the therapy. Additionally, this case study becomes contribution to the field of DMT and it allows us to better understand the work developed in these interventions.Presentamos un estudio de caso cualitativo descriptivo. La participante es una mujer de 39 años con Discapacidad Intelectual, específicamente Síndrome de Down, que realizó una intervención individual en Danza Movimiento Terapia (DMT). Los objetivos del estudio son: (1) conocer los elementos relevantes de la  Alianza Terapéutica (AT) que se estableció durante la intervención consistente en 19 sesiones en DMT y (2) observar si estos elementos de la AT contribuyen al éxito de los objetivos de la intervención. Los objetivos de la intervención fueron: aumentar el conocimiento del propio cuerpo, aumentar el control de impulsos y la tolerancia a la frustración, mejorar la comunicación y la relación con el otro y fomentar la iniciativa, la creatividad, la seguridad y su autonomía. El terapeuta realizó notas de campo para recoger los elementos más importantes del caso en relación a la construcción de la AT y de los objetivos de la intervención. Posteriormente se realizó un análisis de contenido. Los resultados muestran que se construyó una AT saludable, lo cual permitió alcanzar los objetivos de la terapia. Así mimo, este estudio de caso es una aportación al ámbito de la DMT, que nos permite conocer mejor el trabajo realizado en este tipo de intervenciones

Adjunctive homeopathic treatment of hospitalized COVID-19 patients (COVIHOM): A retrospective case series.

and purpose. COVID-19 is a novel viral disease causing worldwide pandemia. The aim of this study was to describe the effect of adjunctive individualized homeopathic treatment delivered to hospitalized patients with confirmed symptomatic SARS-CoV-2 infection. Thirteen patients with COVID-19 were admitted. Mean age was 73.4 ± 15.0 (SD) years. Twelve (92.3%) were speedily discharged without relevant sequelae after 14.4 ± 8.9 days. A single patient admitted in an advanced stage of septic disease died in hospital. A time-dependent improvement of relevant clinical symptoms was observed in the 12 surviving patients. Six (46.2%) were critically ill and treated in the intensive care unit (ICU). Mean stay at the ICU of the 5 surviving patients was 18.8 ± 6.8 days. In six patients (46.2%) gastrointestinal disorders accompanied COVID-19. The observations suggest that adjunctive homeopathic treatment may be helpful to treat patients with confirmed COVID-19 even in high - risk patients especially since there is no conventional treatment of COVID-19 available at present. [Abstract copyright: Copyright © 2021 Elsevier Ltd. All rights reserved.

Is Endocrine Therapy Really Pleasant? Considerations about the Long-Term Use of Antihormonal Therapy and Its Benefit/Side Effect Ratio

Endocrine therapy has become a key part in the adjuvant treatment of hormone responsive breast cancer. The positive effect on relapse risk reduction is well defined, but therapy is not free from bothersome side effects for which estrogen deprivation accounts to a great extent. Since endocrine therapy is usually prescribed for 5 years or longer to optimally display its protective effect, and because physical strain is missing, good tolerability and safety properties are important, particularly in low-risk patients. While tamoxifen has been the standard adjuvant endocrine treatment with well documented efficiency, it is increasingly replaced by third generation aromatase inhibitors due to their better effectiveness and tolerability. Because tamoxifen holds a risk for life-threatening adverse events such as endometrial cancer, pulmonary embolism, and stroke, its recommended duration of therapy is limited to 5 years, also because extension beyond that time did not produce a measurable advantage. While some side effects are present both with tamoxifen and aromatase inhibitors, differences in side effect profiles are well established. Although side effects of aromatase inhibitor-related therapy usually are mild and common to symptoms of menopause, misconception of the symptoms and their mechanism of action, as well as lack of knowledge about how to handle them, can easily lead to dangerous discontinuation of therapy

Adjuvant bisphosphonates in endocrine-responsive breast cancer: what is their place in therapy?

Recent advances in the treatment of early breast cancer have improved clinical outcomes and prolonged survival, especially in women with endocrine-responsive disease. However, cancer therapies including cytotoxic chemotherapy, ovarian suppression, and aromatase inhibitors can drastically reduce circulating estrogen, increasing bone loss and fracture risk. Because most women with early breast cancer will live for many years, it is important to protect bone health during cancer therapy. Several recent clinical trials combining adjuvant endocrine therapy with bisphosphonates have demonstrated efficacy for preventing cancer treatment-induced bone loss in pre- and postmenopausal women with early breast cancer. The largest body of evidence supporting the use of adjuvant bisphosphonates comes from studies with zoledronic acid; however, studies with risedronate, ibandronate, and denosumab (a biologic agent) have also demonstrated efficacy for preventing bone loss. Adding zoledronic acid to endocrine therapy prevents bone loss and improves bone mineral density (BMD). In addition, preclinical studies suggest that bisphosphonates have direct and indirect antitumor activity, such as inducing tumor cell apoptosis, reducing tumor cell adhesion and invasion, reducing angiogenesis, activating immune responses, and synergy with chemotherapy agents, among others. Clinical trials have demonstrated significantly improved disease-free survival in patients receiving adjuvant endocrine therapy plus zoledronic acid compared with endocrine therapy alone. Ongoing studies will further define the role of adjuvant bisphosphonates in maintaining bone health and improving clinical outcomes. The available evidence suggests that pre- and postmenopausal patients may receive clinical benefit from including bisphosphonates as part of their adjuvant treatment regimen for endocrine-responsive early breast cancer