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Bhanushali M, Kranick S, Inati S, Freeman A, Battiwalla M, Nath A. Herpes Virus Infections of the Brain Complicating Allogeneic Hematopoietic Stem Cell Transplantation (SCT) (S57.001). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s57.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abd Alazeez M, Ahmed H, Moore C, Kirkham A, Freeman A, Emberton M. The Role of mp-MRI in the Detection of Prostate Cancer. Clin Oncol (R Coll Radiol) 2012. [DOI: 10.1016/j.clon.2011.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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103
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Punwani S, Emberton M, Walkden M, Sohaib A, Freeman A, Ahmed H, Allen C, Kirkham A. Prostatic cancer surveillance following whole-gland high-intensity focused ultrasound: comparison of MRI and prostate-specific antigen for detection of residual or recurrent disease. Br J Radiol 2012; 85:720-8. [PMID: 22253342 DOI: 10.1259/bjr/61380797] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This retrospective study compares dynamic contrast-enhanced (DCE) MRI with the serial prostate-specific antigen (PSA) measurement for detection of residual disease following whole-gland high-intensity focused ultrasound (HIFU) therapy of prostate cancer. METHODS Patients in whom post-HIFU DCE-MRI was followed within 3 months by ultrasound-guided transrectal biopsy were selected from a local database. 26 patients met the study inclusion criteria. Serial PSA levels following HIFU and post-HIFU follow-up MRI were retrieved for each patient. Three radiologists unaware of other investigative results independently assessed post-HIFU MRI studies for the presence of cancer, scoring on a four-point scale (1, no disease; 2, probably no disease; 3, probably residual disease; and 4, residual disease). Sensitivity, specificity and receiver operating characteristic (ROC) analysis were performed for each reader, post-HIFU PSA nadir and pre-biopsy PSA level thresholds of >0.2 and >0.5 ng ml(-1). RESULTS The sensitivity of DCE-MRI for detection of residual disease for the three readers ranged between 73% and 87%, and the specificity between 73% and 82%. There was good agreement between readers (κ = 0.69-0.77). The sensitivity and specificity of PSA thresholds was 60-87% and 73-100%, respectively. The area under the ROC curve was greatest for pre-biopsy PSA (0.95). CONCLUSION DCE-MRI performed following whole-gland HIFU has similar sensitivity and specificity and ROC performance to serial PSA measurements for detection of residual or recurrent disease.
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Revuelta GJ, Benatar M, Freeman A, Wichmann T, Jinnah HA, DeLong MR, Factor SA. Clinical subtypes of anterocollis in parkinsonian syndromes. J Neurol Sci 2011; 315:100-3. [PMID: 22133481 DOI: 10.1016/j.jns.2011.11.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 11/03/2011] [Accepted: 11/07/2011] [Indexed: 12/27/2022]
Abstract
BACKGROUND Disproportionate anterocollis is a debilitating condition which occurs in the later stages of parkinsonian syndromes and for which there is no effective therapy. Multiple hypotheses have been proposed to explain its underlying etiology, including myopathy of the cervical extensors, and dystonia of the cervical flexors. METHODS We examined the records of 39 patients (8 prospectively) with anterocollis and parkinsonian syndromes to explore demographics, historical and clinical data, findings from electromyography and response to therapies. We classified our patients based on whether or not they were weak on neck extension and also based on primary diagnosis (PD vs atypical parkinsonian syndrome). Demographic, clinical, historical and EMG features are reported for each group. RESULTS There were no significant demographic differences between clinical subtypes, or primary diagnosis. Electromyographic (EMG) findings demonstrated myopathic changes in both groups, although they were more prominent in the group which was weak in extension. Historical features were similar between groups except for dopamine agonist use, which was more common in the myopathic subgroup (p=0.02). There were no other significant clinical differences between clinical subtypes or primary diagnosis with the exception that patients with atypical parkinsonian syndromes had more advanced motor symptoms. CONCLUSIONS We conclude that anterocollis is a heterogeneous condition in which at least two distinct subtypes exist. Recognizing these subtypes may help guide therapy and future research.
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Freeman A, Newman J, Hemingway-Foday J, Iriondo-Perez J, Stolka K, Akam W, Balimba A, Kalenga L, Mbaya M, Mfangam Molu B, Mukumbi H, Niyongabo T, Woelk G, Kiumbu M, Atibu J. Comparison of HIV-positive women with children and without children accessing HIV care and treatment in the IeDEA Central Africa cohort. AIDS Care 2011; 24:673-9. [DOI: 10.1080/09540121.2011.630364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Singh P, Ahmed H, Dalton E, Freeman A, Emberton M. MP-13.19 Clinically Significant Prostate Cancer Is Present Anteriorly in Nearly Fifty-Percent of Men Classified as Presumed Low-Risk on Diagnostic TRUS Biopsies. Urology 2011. [DOI: 10.1016/j.urology.2011.07.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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107
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Morrison L, McIntosh L, Freeman A. 268 UK national audit of physiotherapy clinical standards of care in cystic fibrosis. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60282-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chinnapongse R, Pappert EJ, Evatt M, Freeman A, Birmingham W. An open-label, sequential dose-escalation, safety, and tolerability study of rimabotulinumtoxinb in subjects with cervical dystonia. Int J Neurosci 2011; 120:703-10. [PMID: 20942584 DOI: 10.3109/00207454.2010.515047] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Evaluate the safety and efficacy of a sequential dose escalation of rimabotulinumtoxinB (BoNT-B) in cervical dystonia (CD) subjects. METHODS This multicenter, open-label, within-subject, sequential dose-escalation study (BoNT-B dosed at 10,000, 12,500, and 15,000 Units) evaluated subjects over each phase of treatment at preinjection and at periodic intervals postinjection. Adverse events, vital signs, and laboratory results were recorded. Efficacy measures included the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and three visual analog scales (VASs). RESULTS 119 out of 145 CD subjects received all three doses in sequence. Dry mouth and dysphagia were the most common adverse events, and both decreased in frequency by the final injection, despite the increasing doses of the escalation. TWSTRS-Total and subscale scores demonstrated significant improvements following all doses at the week 2, 4, 8, and 12 assessments, with the exception of disability and pain at week 12 with the lowest dose. All VAS scores demonstrated similar improvements following all doses. The mean number of weeks in each phase of the study was 12.1 weeks (10,000 Units), 12.9 weeks (12,500 Units), and 13.9 weeks (15,000 Units). CONCLUSION BoNT-B was well tolerated and efficacious at 10,000, 12,500, and 15,000 Units in this within-subject, sequential dose-escalation study in CD subjects.
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Blanc V, Nariculam J, Munson P, Freeman A, Klocker H, Masters J, Williamson M. A role for class 3 semaphorins in prostate cancer. Prostate 2011; 71:649-58. [PMID: 20949546 DOI: 10.1002/pros.21281] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 08/30/2010] [Indexed: 11/07/2022]
Abstract
BACKGROUND Class 3 semaphorins are secreted proteins that act as guidance cues for migrating cells via their transmembrane receptors plexins and neuropilins. Semaphorins have a role in cancer affecting tumor progression both directly, and indirectly by affecting angiogenesis. METHODS The expression of semaphorins and their receptors in prostate cancer cell lines and tissue was determined by RT-PCR, Western blotting and immunohistochemistry. The effect of Sema3E on prostate cancer cell lines was determined by adhesion assays and transwell migration assays. RESULTS Semaphorins and their receptors, plexins and neuropilins, are widely co-expressed in prostate cancer cell lines and tissue with a significant overexpression of Sema3E in tumor tissue. Sema3E affected integrin-mediated adhesion to fibronectin of prostate cancer cells, and inhibited their motility. Expression of Sema3C was upregulated and Sema3A and Sema3E were down regulated in prostate cells by hypoxia, consistent with an additional role for Sema3A and 3E as anti-angiogenic factors in prostate cancer. CONCLUSIONS Semaphorin 3E is aberrantly expressed in prostate cancer and affects adhesion and motility of prostate cancer cells, indicating a role for the Sema3E/PlexinD1 signaling pathway in prostate cancer and identifying a new possible target for therapy.
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Ahmed H, Cathcart P, McCartan N, Kirkham A, Allen C, Freeman A, Emberton M. 225 FOCAL SALVAGE THERAPY COMPARED TO WHOLE-GLAND SALVAGE: A FEASIBILITY STUDY. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s1569-9056(11)60225-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Arumainayagam N, Ahmed H, Moore C, Freeman A, Sohaib A, Kirkham A, Allen C, Emberton M. 133 A NEGATIVE MULTI-PARAMETRIC MRI CAN RULE OUT UP TO 97% OF CLINICALLY SIGNIFICANT PROSTATE CANCER. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s1569-9056(11)60136-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Dystonia is defined as involuntary sustained muscle contractions producing twisting or squeezing movements and abnormal postures. The movements can be stereotyped and repetitive and they may vary in speed from rapid to slow; sustained contractions can result in fixed postures. Dystonic disorders are classified into primary and secondary forms. Several types of adult-onset primary dystonia have been identified but all share the characteristic that dystonia (including tremor) is the sole neurologic feature. The forms most commonly seen in neurological practice include cranial dystonia (blepharospasm, oromandibular and lingual dystonia and spasmodic dysphonia), cervical dystonia (also known as spasmodic torticollis) and writer's cramp. These are the disorders that benefit most from botulinum toxin injections. A general characteristic of dystonia is that the movements or postures may occur in relation to specific voluntary actions by the involved muscle groups (such as in writer's cramp). Dystonic contractions may occur in one body segment with movement of another (overflow dystonia). With progression, dystonia often becomes present at rest. Dystonic movements typically worsen with anxiety, heightened emotions, and fatigue, decrease with relaxation, and disappear during sleep. There may be diurnal fluctuations in the dystonia, which manifest as little or no involuntary movement in the morning followed by severe disabling dystonia in the afternoon and evening. Morning improvement (or honeymoon) is seen with several types of dystonia. Patients often discover maneuvers that reduce the dystonia and which involve sensory stimuli such as touching the chin lightly in cervical dystonia. These maneuvers are known as sensory tricks, or gestes antagonistes. This chapter focuses on adult-onset focal dystonias including cranial dystonia, cervical dystonia, and writer's cramp. The chapter begins with a review of the epidemiology of focal dystonias, followed by discussions of each major type of focal dystonia, covering clinical phenomenology, differential genetics, and diagnosis. The chapter concludes with discussions of the pathophysiology, the few pathological cases published of adult-onset focal dystonia and management options, and a a brief look at the future.
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Webb IJ, Scholssman RL, Jiroutek M, Doss D, Cohen CA, Freeman A, Schott DM, Anderson KC. Predictors of high yield and purify of CD34(+) cell-selected PBPC, collected from patients with multiple myeloma. Cytotherapy 2010; 1:175-82. [PMID: 12881173 DOI: 10.1080/14653249910001591256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Wide ranges i n cell recovery and purity may be observed following CD34(+) cell selection of mobilized HPC componetns. Characteristics of the mobilized HPC, associated with isolation of a high CD34(+) cell yield and purity following cell selection, have yet to be defined. METHODS Cell number and purities were determined before and after 56 CD34(+) cell-selection procedures, performed using the CellPro Ceprate SC system from April 1997 to February 1998. HPC were collected from 28 patients with multiple myeloma, following cyclophosphamide (60mg/kg) and G-CSF (10microg/kg) mobilization. RESULTS A medium of 47.9% (range 1.5-109.6%) CD34(+) cells were recovered in the enriched (ENR) fraction. A linear correlation existed between total CD34(+) cells in the ENR fraction and total CD34(+) cells in the START fraction (R2=0.93); there was a logarithmic correlation between CD34 ENR fraction purity and START fraction purity (R2=0.73). A START CD34(+) cell purity > 0.42% improved purity in the ENR fraction. A median of one (range one to nine) procedure was required to isolate 2 x 10 6 CD34(+) cells/kg. Three patients pretreated with alkylating agents failed to mobilized adequate numbers of HPC. DISCUSSION Isolation of highly purified CD34(+) cell-selected components using the Ceprate SC system in dependent on the CD34(+) purity of the lekapheresis component collected. Mobilization regimens should be used to maximize CD34(+) cell purity in stem cell authografts if CD34(+) cell selection is to be performed. Similar strategies should be used to evaluate other cell-selection devices as they become available.
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Esper CD, Freeman A, Factor SA. Lingual protrusion dystonia: frequency, etiology and botulinum toxin therapy. Parkinsonism Relat Disord 2010; 16:438-41. [PMID: 20494607 DOI: 10.1016/j.parkreldis.2010.04.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Accepted: 04/19/2010] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to examine lingual protrusion dystonia (LPD); its frequency, etiology and response to botulinum toxin therapy. Previous literature suggests that LPD is more frequently the result of heredodegenerative disease and that the use of botulinum toxin therapy in LPD is associated with significant adverse effects. This is a retrospective database and record review from a movement disorder clinic. Of 421 dystonia patients, we identified 17 with LPD (4%). Of these cases, the diagnoses were: primary cranial dystonia (5), primary generalized dystonia (2), tardive dystonia (7), heredodegenerative disease (1), multifactorial (1) and post-infectious (1). All primary cases had concomitant oromandibular dystonia. In some secondary cases the LPD was the only cranial feature. Nine received botulinum toxin injections and 55.6% sustained moderate or marked improvement. Of 89 total botulinum toxin sessions, 66.3% had an excellent response, and 92.1% had some response. 97.8% of the sessions resulted in no significant adverse effects. On one occasion one patient developed severe dysphagia requiring placement of a percutaneous gastrostomy (PEG) tube. We conclude that LPD is rare, most commonly the result of tardive and primary dystonia. Botulinum toxin therapy may be very effective but needs to be utilized with care because of the possibility for the development of dysphagia.
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Diaz-Moreno S, Hayama S, Amboage M, Freeman A, Sutter J, Duller G. I20; the Versatile X-ray Absorption spectroscopy beamline at Diamond Light Source. ACTA ACUST UNITED AC 2009. [DOI: 10.1088/1742-6596/190/1/012038] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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116
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Sahu M, Ahmed H, Kumaar S, Arumainayagam N, Rogers K, Scott R, Kirkham A, Allen C, Freeman A, Emberton M. UP-2.160: Treating Unilateral Localised Prostate Cancer with Hemi-Ablation High Intensity Focused Ultrasound (HIFU): Results of a NCRN-Approved Phase II Focal Therapy Clinical Trial. Urology 2009. [DOI: 10.1016/j.urology.2009.07.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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117
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Sahu M, Ahmed H, Kumaar S, Arumainayagam N, Rogers K, Scott R, Kirkham A, Allen C, Freeman A, Emberton M. UP-2.161: Focal High Intensity Focused Ultrasound (HIFU) Therapy in the Treatment of Localised Prostate Cancer: Early Results of a Phase II Trial. Urology 2009. [DOI: 10.1016/j.urology.2009.07.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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118
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Arumainayagam N, Kumaar S, Ahmed H, Moore C, Sahu M, Payne H, Freeman A, Allen C, Kirkham A, Emberton M. MP-21.13: Accuracy of Multi-sequence Magnetic Resonance Imaging of Radio-recurrent Prostate Cancer. Urology 2009. [DOI: 10.1016/j.urology.2009.07.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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119
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Rouse P, Shaw G, Ahmed H, Calleary J, Illing R, Kirkham A, Freeman A, Allen C, Emberton M. 928 PRE-BIOPSY MULTI-SEQUENCE MAGNETIC RESONANCE IMAGING OF THE PROSTATE IN THE DETECTION OF PROSTATE CANCER. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1569-9056(09)60913-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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120
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Zesiewicz TA, Sullivan KL, Freeman A, Juncos JL. Treatment of imbalance with varenicline Chantix(R): report of a patient with fragile X tremor/ataxia syndrome. Acta Neurol Scand 2009; 119:135-8. [PMID: 18771524 DOI: 10.1111/j.1600-0404.2008.01070.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We describe the case of a man with Fragile X tremor/ataxia syndrome, whose ataxia and imbalance improved with the use of varenicline (Chantix) and reverted to baseline 10 days after varenicline was discontinued. Varenicline was started as part of a smoking cessation program.
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Freeman A. Neuropsychological Markers for Cognitve Performance (Symposium or Panel). Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)70952-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Chair: Dr. Norey Nigro (USA)Discussant Prof. dr. Arthur Freeman (USA)Panelists: Prof. dr. Andrzej Kokoszka (Poland)Prof. dr. Daniel David (Romania)Dr. Corey Nigro (USA)
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Freeman A. The Patient that we Love to Hate: Cognitive Behavioral Treatment of the Narcissistic Personality Disorder (mini workshop). Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)70563-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The patient with a narcissistic personality disorder may be among the most difficult patients in the clinician's caseload to treat. They may take more time in therapy, more of the theraapist's energy, and overwhelm the therapist's ability to dea;l with the countertransference. Given their self-serving and demanding style, they are more frequently "sent" to therapy than electing to come for treatment. Thus the morivation for therapy and for change is severely limited. The patient's ability to establish a working therapeutic bond is also limited by the very nature of their disorder. Given all of this they can be treated. The active, directive, structred, and problem oriented facets of Cognitive Behavior Therapy make this model an ideal treatment modality. Helping the patient to examine what is in their best personal interest, the therapy proceeds by examining the patienbt's thoughts, feelings, and behaviors.
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Patel A, Modarai B, Freeman A, Padayachee T, Taylor P. Unilateral Blindness Following Excision of a Carotid Body Tumour. Eur J Vasc Endovasc Surg 2008. [DOI: 10.1016/j.ejvs.2008.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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124
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Freeman A. Radiologic clinics of North America. Advances in gastrointestinal imaging. Clin Radiol 2008. [DOI: 10.1016/j.crad.2008.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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125
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Britton P, Goud A, Barter S, Eleti A, Freeman A, Gaskarth M, Moyle P, Rajan P, Sinnatamby R, Slattery J, Provenzano E, Pinder S, Godward S, Wishart G. Ultrasound-guided axillary node core biopsy in the staging of newly diagnosed breast cancer. Breast Cancer Res 2008. [PMCID: PMC3332587 DOI: 10.1186/bcr2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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