Development of Feedback Microwave Thermotherapy in Symptomatic Benign Prostatic Hyperplasia.

Abstract: The purpose of this thesis was to evaluate ProstaLund Feedback Treatment® (PLFT®) and the CoreTherm® device with regard to biophysics, mechanisms of action, treatment indications, additional techniques, efficacy and safety in the treatment of patients with benign prostatic hyperplasia (BPH). The application of two biophysical equations in the PLFT software is explained. The calculations provide the intraprostatic ?blood flow index? and amount of accumulated coagulation necrosis during treatment. The accuracy of the ?cell kill? calculations is compared to gadolinium-enhanced magnetic resonance imaging (MRI) and histology. The accumulated ?cell kill? monitored on-line during PLFT is considered a useful tool for helping the doctor to tailor the individual ?thermal dose? to each patient. The clinical efficacy, 1 and 5 years after PLFT and Trans-urethral Resection of the Prostate (TURP), is compared showing no statistically significant differences. Serious adverse events were more frequent after TURP. Expanded treatment indications for PLFT, to including patients with persistent urinary retention and patients with heavily enlarged prostates (>100 g), were studied in a retrospective survey and in a prospective randomized multicentre study comparing PLFT with surgery (TURP and open surgery). Responder rate after PLFT was close to 80% and statistically equivalent to surgery after 6 months. Serious adverse events were less frequent after PLFT. The intraprostatic blood flow works like a heat sink by transporting heat away from the treatment area during thermotherapy. This is the explanation for the unpredictable outcome and frequent treatment failures described after low-energy transurethral microwave thermotherapy. High-energy TUMT can compensate for this in many ways but results in significant patient discomfort from micturition urge, burning sensations and pain. A new device, the Schelin Catheter®, makes it possible to inject and infiltrate the prostate by the transurethral route. Injections in several locations with local anaesthetics containing epinephrine have a twofold aim: 1) to minimize the intraprostatic blood flow and 2) to achieve good analgesia. Treatment time was reduced by 50% and the total energy required was reduced by 60% when using this technique. The effects of the epinephrine on the intraprostatic blood flow were also verified with positron emission tomography, [15O]H2O-PET. The results in this thesis show that the efficacy, safety and methodological improvements of PLFT now make it a challenger to surgery (TURP and open surgery) as a convenient, office based and more available option. This truly minimally invasive treatment is an attractive option for patients that can replace surgery for the majority of patients with clinical BPH. It also reduces the cost to the taxpayer

Fundamentos filosóficos, teóricos y empíricos de la Terapia de Aceptación y Compromiso

This article has two main purposes. The first one is to present the philosophical, theoretical, and empirical underpinnings of Acceptance and Commitment Therapy (ACT). The second is to outline the importance of philosophy and theory in order to build an empirical clinical psychology that copes progressively with the needs of the field. To accomplish these purposes, we have structured the article in three distinct sections. In the first one, we will explore the philosophical assumptions of ACT, known as Functional Contextualism. In the second section, we will offer a brief history of the appliedand theoretical tradition of ACT, Behavior Analysis, and Relational Frame Theory (RFT), a modern account of human language and cognition. Finally, we will present some clinical outcomes that, although preliminary, exemplify the broad range of health problems and psychological disorders for which the ACT model has shown to have positive results. Overall we will offer a unified version of the ACT/RFT model that interconnects its multiple dimensions.El presente artículo cumple dos propósitos. En primer lugar presentar los fundamentos filosóficos, teóricos y empíricos de la Terapia de Aceptación y Compromiso (TAC), y, en segundo lugar, argumentar cuán importante es la filosofía y la teoría de cara a construir una psicología clínica empírica que afronte de un modo progresivo las necesidades del campo. Para cumplir estos propósitos, hemos estructurado el artículo en tres secciones. En la primera exploramos los presupuestos filosóficos de la TAC, el llamado Contextualismo Funcional. En la segunda sección ofrecemos una breve historia de la tradición aplicada y teórica de la TAC, esto es, el Análisis de Conducta, y acontinuación ofrecemos una aproximación moderna al lenguaje y la cognición, la Teoría de los Marcos Relacionales (TMR). Finalmente, presentamos una serie de estudios empíricos que ejemplifican de modo preliminar el amplio rango de problemas psicológicos y de la salud para los que la TAC ha mostrado resultados positivos. En conjunto, este artículo ofrece una versión unificada del modelo de la TAC/TMR que interconecta sus múltiples dimensiones

Institutional Barriers to PPPs: - A Case Study of a Road User Charging Development Project

This paper provides a theoretical overview of the public-private partnerships for policy and concept development. We use a case study from Sweden of a road user charging development prject to explore institutional barriers to PPPs and to describe how a more informal co-operation not only brings added value to the project but also enables an ongoing innovation process which we hope will result in robust project results

Collisional effects in the tokamap

AbstractPlasmas confined in tokamaks with non-symmetric perturbations are surrounded by a chaotic layer of magnetic field lines that guide charged particles to the tokamak wall. We use an analytical two-dimensional symplectic mapping to study the resulting fractal patterns of field line escape. However, particles may experience several collisions before escaping toward the tokamaks wall. We add a random collisional term to the field line mapping to investigate how the particle collisions modify their escape patterns

Fundamentos filosóficos, teóricos y empíricos de la Terapia de Aceptación y Compromiso

This article has two main purposes. The first one is to present the philosophical, theoretical, and empirical underpinnings of Acceptance and Commitment Therapy (ACT). The second is to outline the importance of philosophy and theory in order to build an empirical clinical psychology that copes progressively with the needs of the field. To accomplish these purposes, we have structured the article in three distinct sections. In the first one, we will explore the philosophical assumptions of ACT, known as Functional Contextualism. In the second section, we will offer a brief history of the appliedand theoretical tradition of ACT, Behavior Analysis, and Relational Frame Theory (RFT), a modern account of human language and cognition. Finally, we will present some clinical outcomes that, although preliminary, exemplify the broad range of health problems and psychological disorders for which the ACT model has shown to have positive results. Overall we will offer a unified version of the ACT/RFT model that interconnects its multiple dimensions.El presente artículo cumple dos propósitos. En primer lugar presentar los fundamentos filosóficos, teóricos y empíricos de la Terapia de Aceptación y Compromiso (TAC), y, en segundo lugar, argumentar cuán importante es la filosofía y la teoría de cara a construir una psicología clínica empírica que afronte de un modo progresivo las necesidades del campo. Para cumplir estos propósitos, hemos estructurado el artículo en tres secciones. En la primera exploramos los presupuestos filosóficos de la TAC, el llamado Contextualismo Funcional. En la segunda sección ofrecemos una breve historia de la tradición aplicada y teórica de la TAC, esto es, el Análisis de Conducta, y acontinuación ofrecemos una aproximación moderna al lenguaje y la cognición, la Teoría de los Marcos Relacionales (TMR). Finalmente, presentamos una serie de estudios empíricos que ejemplifican de modo preliminar el amplio rango de problemas psicológicos y de la salud para los que la TAC ha mostrado resultados positivos. En conjunto, este artículo ofrece una versión unificada del modelo de la TAC/TMR que interconecta sus múltiples dimensiones

A distância entre criador e criação: uma análise de uma análise de um curta-metragem

Lovesick é um filme de curta-metragem que está sendo analisado por estudiosos de várias áreas cientí­ficas: cinema, filosofia, teologia, psicologia, musicologia. Este artigo faz um resumo das análises feitas pelos autores e levanta questionamentos sobre o olhar do cineasta e do espectador, ambos moldadores em potencial do filme.Palavras-chave: Espectator. Autoria. Análise. Olhar