Neuropsychological Screening As a Standard of Care in Psychiatric Hospitals: A Pilot Study

2013 ◽  
Author(s):  
Boaz Levy ◽  
Selda C. Demitras ◽  
Tinatin Surguladze
Keyword(s):  
Pilot Study ◽  
Psychiatric Hospitals ◽  
Standard Of Care ◽  
Neuropsychological Screening

scholarly journals Pre-exposure prophylaxis adherence with real-time adherence feedback and partner HIV self-testing: A pilot trial among postpartum women

2021 ◽  
Author(s):  
Dvora L Joseph Davey ◽  
Kathryn Dovel ◽  
Rufaro Mvududu ◽  
Dorothy Nyemba ◽  
Nyiko Mashele ◽  
...  
Keyword(s):  
Pilot Study ◽  
Real Time ◽  
Pilot Trial ◽  
Intervention Group ◽  
Standard Of Care ◽  
Postpartum Women ◽  
Care Clinic ◽  
The Past ◽  
Self Testing ◽  
Exposure Prophylaxis

Background: Pre-exposure prophylaxis (PrEP) is safe and effective in postpartum women. HIV self-testing (HIVST) for partners combined with biofeedback counselling through real-time adherence measures may improve daily PrEP use among postpartum women. Methods: Between August 2020 and April 2021 we conducted a pilot study in one primary care clinic in Cape Town, South Africa. We randomized postpartum women who initiated PrEP in pregnancy 1:1 to the intervention group (HIVST + biofeedback counselling following urine tenofovir test) or to standard of care (facility-based HIV tests and routine counselling without biofeedback). The outcomes of interest were PrEP adherence in the past 48-72hours via urine tenofovir tests and partner HIV testing, measured 1-month after randomisation. Secondary outcomes included proportion of partners who tested for HIV and discrepancy between self-reported PrEP adherence and urine tenofovir result. Results: We enrolled 106 women (median age=26 years; median months postpartum=2). Almost half of women reported having sex since giving birth (48%); 76% of those reported condomless sex at last sex. At enrolment most women (72%) reported missing <2 doses in the past 7-days; 36% of women had tenofovir present in her urine (no significant differences by arm). One month after enrolment, 62% (n=33) of women in the intervention arm had tenofovir present in their urine compared to 34% (n=18) in the standard of care arm (RR=1.83; 95% CI=1.19, 2.82). Two-thirds of women in the intervention arm reported that her partner tested for HIV (66%; n=35); compared to 17% (n=9) in the standard of care arm (RR=3.89; 95% CI=2.08, 7.27). The proportion of women with a discrepant adherence result (self-reported good recent adherence with no tenofovir in urine test) was significantly lower in the intervention group (n=8; 17%) compared to the standard of care group (n=24; 46%) (RR=0.33; 95% CI=0.17, 0.67). No social or clinical adverse events were reported in the intervention arm. Conclusions: In this pilot study, HIVST for partners and biofeedback counseling increased levels of recent PrEP adherence, pointing to the importance of these interventions to support PrEP use in this population.

Five-year Outcome and Prognosis in Schizophrenia: A Report from the London Field Research Centre of the International Pilot Study of Schizophrenia

1987 ◽  
Vol 150 (3) ◽  
pp. 345-354 ◽  
Author(s):  
R. Prudo ◽  
H. Munroe Blum
Keyword(s):  
Pilot Study ◽  
Field Research ◽  
Psychiatric Hospitals ◽  
Research Centre ◽  
Relationship Functioning ◽  
Social Outcome ◽  
Housing Status ◽  
Schizophrenic Patients ◽  
Symptomatic Outcome ◽  
London Field

A sample of 100 schizophrenic patients admitted to London area psychiatric hospitals were examined as part of the International Pilot Study of Schizophrenia. Clinical and social outcome were variable. At 5-year follow-up, 49% had good symptomatic outcome and 42%, good social outcome. Poor social functioning at inclusion was predictive of poor symptomatic outcome. Illness history (IH), occupational functioning (OF), social relationship functioning (SRF), negative and non-specific symptoms (NNS) at initial evaluation, and their interaction with sex and race accounted for 32% of the 5-year symptomatic outcome variance (n = 84; F=3.48; P<0.001). OF, SRF, housing status, NNS and their interaction with sex, race and age accounted for 47% of the social outcome variance (n = 62; F=2.62; P<0.007).

Tumor and systemic immune responses to preoperative (pre-op) cryoablation (cryo) plus immune therapy with ipilimumab (ipi) in early-stage breast cancer (ESBC).

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 64-64 ◽  
Author(s):  
David B. Page ◽  
Jianda Yuan ◽  
Arielle Ginsberg ◽  
Zhiwan Dong ◽  
Phillip Wong ◽  
...  
Keyword(s):  
Immune Response ◽  
T Cells ◽  
T Cell ◽  
Pilot Study ◽  
Early Stage ◽  
Immune Therapy ◽  
Cell Activity ◽  
Standard Of Care ◽  
Cell Receptor ◽  
Hormone Receptor Positive

64 Background: In mice, tumor cryo plus immunologic checkpoint blockade generates tumor antigen release, proliferation of tumor-specific T-cells, and enhanced survival. We previously demonstrated in a pilot study that pre-op cryo+ipi is well tolerated in women with ESBC and did not delay standard of care surgical resection. Here, we analyze pilot study tissue and blood to explore immune response. Methods: 18 ESBC patients (pts) were treated with preop cryo (n=6), single-dose ipi 10mg/kg (n=6), or cryo+ipi (n=6). As a potential surrogate for tumor immunogenicity, baseline T-cell tumor infiltrating lymphocyte (TIL) density was evaluated by T-cell receptor quantitative DNA sequencing. We explored the systemic immune response to cryo and/or ipi using previously described laboratory measures including inducible costimulator (ICOS, a marker of activated CD4+ T-cells) and plasma interferon gamma (IFNγ, a cytokine associated with T-cell activity). Results: Of the 18 study pts, 13 pts had hormone receptor-positive (HR+) disease, 2 pts had HER2+ disease (both treated with ipi alone) and 3 pts had triple-negative (TN) disease (1 ipi alone and 2 cryo/ipi). Baseline TIL density was highly variable overall (range 2-30%), but higher in HER2+ and TN pts (median 15%) compared with HR+ pts (median 5%). Sustained >2-fold elevations in ICOS and IFNγ were observed in the majority of cryo+ipi pts 30 days following treatment (ICOS: 5/6 pts; IFNγ: 4/6 pts), but in the minority of ipi pts (ICOS: 2/6 pts; IFNγ: 2/6 pts) or cryo pts (ICOS: 0/6 pts; IFNγ: 0/6 pts). Sustained ICOS and IFNγ elevations were observed regardless of baseline TIL density. Conclusions: Cryo+ipi was more likely to induce systemic immune activation compared to cryo or ipi alone. These potentially beneficial immune effects were observed in both HR+ and HR- subtypes, as well as in tumors with low or high baseline TIL density. These data support further studies of cryo+ipi in ESBC across HR+ and HR- subtypes, as well as in tumors that do not appear immunogenic at baseline.

scholarly journals P3-170: Neuropsychological screening battery for prediction of conversion to dementia: A pilot study

2008 ◽  
Vol 4 ◽  
pp. T569-T570
Author(s):  
Ninni Persson ◽  
Marianne Carlsson ◽  
Lena Kilander ◽  
Maria Lindau
Keyword(s):  
Pilot Study ◽  
Neuropsychological Screening ◽  
Screening Battery

scholarly journals Efficacy and Safety of Leflunomide for Refractory COVID-19: A Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Qiang Wang ◽  
Haipeng Guo ◽  
Yu Li ◽  
Xiangdong Jian ◽  
Xinguo Hou ◽  
...  
Keyword(s):  
Pilot Study ◽  
Clearance Rate ◽  
Standard Care ◽  
Discharge Rate ◽  
Controlled Trial ◽  
Standard Of Care ◽  
Large Sample Size ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
To Receive

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may persist in patients with coronavirus disease 2019 (COVID-19) despite receiving standard care.Methods: In this pilot study of hospitalized adult patients (≥18 years of age), with radiologically confirmed pneumonia who were SARS-CoV-2 positive for more than 28 days despite standard care, were assigned to receive standard of care (SOC, grp I) or leflunomide + SOC (grp 2). After 2 weeks, grp 1 and grp 2 patients who continued to be SARS-CoV-2-positive received leflunomide for 14 days while continuing SOC. The primary outcomes were the rate of and time to SARS-CoV-2 clearance and the 14-day and 30-day hospital discharge rate.Results: 12 patients were enrolled in grp 1 and 15 patients were in grp 2. The 14 days SARS-CoV-2 viral clearance rate was 80.0% (12/15) for grp 2 patients receiving leflunomide vs. 16.7% for grp 1 patients (2/12) (p = 0.002). By day 14, the median time to SARS-CoV-2 clearance was 6.0 days (range 1–12, IQR 1–12) for grp 2 patients. In grp 1, two patients converted to viral negative on days 1 and 6 (p = 0.002). The 14-day discharge rate was 73.3% (11/15) for the grp 2 vs. 8.3% (1/12) for grp 1 (p = 0.001). The 30 days discharge rate was 100% (15/15) for the grp 2 vs. 66.7% (8/12) for grp 1. No severe adverse events or deaths were reported.Conclusion: Leflunomide may improve the SARS-CoV-2 clearance rate and discharge rate in patients with refractory COVID-19. The tolerability of the 14–28 days course of treatment with leflunomide is acceptable. These preliminary observations need to be verified by a large sample size and randomized controlled trial.

scholarly journals Activity Aprons for Inpatients Requiring Individual Nursing Assignment Care: A Prospective Randomized Controlled Pilot Study

2018 ◽  
Vol 8 (4) ◽  
pp. 183-187
Author(s):  
Michael W. Ruff ◽  
Anthony Fine ◽  
Jay Mandrekar ◽  
Cindy Sweeney ◽  
Lyell K. Jones ◽  
...  
Keyword(s):  
Pilot Study ◽  
Standard Care ◽  
Hospital Setting ◽  
Length Of Hospital Stay ◽  
Standard Of Care ◽  
Control Group ◽  
Inpatient Setting ◽  
Term Care ◽  
Randomized Controlled ◽  
Restraint Use

Background: Activity aprons are commercially available products used to occupy patients with dementia at home or in long-term care facilities. We hypothesized that inpatient use of activity aprons could potentially reduce or eliminate behaviors that result in self-harm, increased nursing supervision, and restraint use in an inpatient hospital setting. Methods: A single-center prospective randomized controlled pilot study was performed from July 2015 to November 2016 comparing activity apron plus standard care versus standard care alone. Consecutively enrolled patients were randomized by stratified randomization using age (cutoff: 80 years) and preexisting diagnosis of dementia or cognitive impairment. Primary outcomes were safety and feasibility of apron use. Secondary outcomes included duration of hospitalization postrandomization and individual nursing assignment (IA), time in restraints, nonphysical restraints use, falls, apron-related complications, dismissal destination, and 30-day hospital readmission. Results: Thirty patients were enrolled, with 13 randomized to apron and 17 randomized to the control group. There was no statistically significant reduction in mean length of hospital stay (15.8 vs 21.5 day; P = .40), duration of IA compared to non-apron control group (6.4 vs 9.1, respectively; P = .39), or antipsychotic medication use (61.5% vs 70.6% in control group; P = .60). No complications secondary to apron use were seen. Conclusions: Activity aprons are a safe addition to the standard of care when managing encephalopathic patients in the inpatient setting. These aprons may have a role as part of a comprehensive complement of interventions to address delirium and encephalopathy in hospitalized patients.

scholarly journals A Pilot Study of an Esophageal Cooling Device During Radiofrequency Ablation for Atrial Fibrillation

2020 ◽  
Author(s):  
Brad Clark ◽  
Nazia Alvi ◽  
Joseph Hanks ◽  
Brad Suprenant
Keyword(s):  
Atrial Fibrillation ◽  
Pilot Study ◽  
Catheter Ablation ◽  
Cold Water ◽  
Standard Of Care ◽  
Mucosal Damage ◽  
Esophageal Injury ◽  
Esophageal Mucosa ◽  
Cooling Device ◽  
Circulating Water

AbstractBackgroundEsophageal thermal injury is a risk of ablation of the posterior left atrium despite various devices utilized to date.ObjectiveEvaluate the potential of a commercially-available esophageal cooling device to provide esophageal protection during left atrial catheter ablation.MethodsIn this pilot study, we randomized 6 patients undergoing catheter ablation for atrial fibrillation. Three patients received standard of care for our site (use of a single-sensor temperature probe, with adjunct iced-water instillation for any temperature increases >1°C). Three patients received standard ablation after placement of the esophageal cooling device using a circulating water temperature of 4°C. All patients underwent transesophageal echocardiogram (TEE) and esophagogastroduodenoscopy (EGD) on the day prior to ablation followed by EGD on the day after.ResultsIn the 3 control patients, one had no evidence of esophageal mucosal damage, one had diffuse sloughing of the esophageal mucosa and multiple ulcerations, and one had a superficial ulcer with large clot. Both patients with lesions were classified as Zargar 2a. In the 3 patients treated with the cooling device, one had no evidence of esophageal mucosal damage, one had esophageal erythema (Zargar 1), and one had a solitary Zargar 2a lesion. At 3-month follow-up, 1 patient in each group had recurrence of atrial fibrillation.ConclusionsThe extent of esophageal injury was less severe with a commercially available esophageal cooling device than with reactive instillation of ice-cold water. This pilot study supports further evaluation with a larger clinical trial.

scholarly journals Pilot study of micromotion nailing for mechanical stimulation of tibial fracture healing

2021 ◽  
Vol 2 (10) ◽  
pp. 825-833
Author(s):  
Hannah L. Dailey ◽  
Peter Schwarzenberg ◽  
Edmund B. Webb, III ◽  
Sinead A. M. Boran ◽  
Shane Guerin ◽  
...  
Keyword(s):  
Pilot Study ◽  
Fracture Healing ◽  
Bone Healing ◽  
Injury Risk ◽  
Group Versus ◽  
Standard Of Care ◽  
Trauma Centre ◽  
Ct Scans ◽  
Control Group ◽  
Study Objective

Aims The study objective was to prospectively assess clinical outcomes for a pilot cohort of tibial shaft fractures treated with a new tibial nailing system that produces controlled axial interfragmentary micromotion. The hypothesis was that axial micromotion enhances fracture healing compared to static interlocking. Methods Patients were treated in a single level I trauma centre over a 2.5-year period. Group allocation was not randomized; both the micromotion nail and standard-of-care static locking nails (control group) were commercially available and selected at the discretion of the treating surgeons. Injury risk levels were quantified using the Nonunion Risk Determination (NURD) score. Radiological healing was assessed until 24 weeks or clinical union. Low-dose CT scans were acquired at 12 weeks and virtual mechanical testing was performed to objectively assess structural bone healing. Results A total of 37 micromotion patients and 46 control patients were evaluated. There were no significant differences between groups in terms of age, sex, the proportion of open fractures, or NURD score. There were no nonunions (0%) in the micromotion group versus five (11%) in the control group. The proportion of fractures united was significantly higher in the micromotion group compared to control at 12 weeks (54% vs 30% united; p = 0.043), 18 weeks (81% vs 59%; p = 0.034), and 24 weeks (97% vs 74%; p = 0.005). Structural bone healing scores as assessed by CT scans tended to be higher with micromotion compared to control and this difference reached significance in patients who had biological comorbidities such as smoking. Conclusion In this pilot study, micromotion fixation was associated with improved healing compared to standard tibial nailing. Further prospective clinical studies will be needed to assess the strength and generalizability of any potential benefits of micromotion fixation. Cite this article: Bone Jt Open 2021;2(10):825–833.

Alternative Schedule of Filgrastim after Autologous Transplantation: Less Dosing, Same Efficacy

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4334-4334
Author(s):  
Aida B. Sousa ◽  
Fatima Costa ◽  
Gilda Ferreira
Keyword(s):  
Pilot Study ◽  
Median Time ◽  
Autologous Transplantation ◽  
Standard Of Care ◽  
Control Group ◽  
Study Group ◽  
Current Standard ◽  
Transfusion Requirements ◽  
Clinical Instability ◽  
Grade 3

Abstract Administration of colony-stimulating factors (CSF) after autologous peripheral-blood progenitor cell transplantation is the current standard of care, and G-CSF is usually given from day +5 or +7 until engraftment. Recent preliminary data in a non-transplant setting suggest that 2 doses of G-CSF may be equivalent to the standard schedule. In this pilot study, we evaluated the safety and efficacy of giving only 2 doses of filgrastim post-transplant (days +7 and +9) in non-myeloma pts; exclusion criteria were re-transplants and clinical instability at day +7. From July 07 to June 08, 19 consecutive pts were included (16 lymphomas, 3 acute leukaemias) and their outcome was compared to a historical control group of 42 similar pts transplanted from Jan 06 to Jun 07, who received filgrastim from d+7 until 1000 neutrophils/ul (4–18 days, median 9). There were no significant differences in primary endpoints: median time to neutrophil engraftment (500/ul reached on day +12 vs +11) rate of documented infections (with bacteremia in 23% of transplants in the study group vs 36% in the control group) and median length of hospitalisation (both 22 days). Median duration of intravenous antibiotics (11 vs 12 days) median time to platelet engraftment (20,000/ul reached on day +13 vs +14) incidence of grade 3/4 mucositis and transfusion requirements were also similar. There were no deaths at day +30 in the study group. In 2 of the 19 pts a secondary prescription of filgrastim was made (for 2 and 4 days). In this pilot study, reducing filgrastim administration to 2 doses seems possible without undue risks. If confirmed in a randomized trial, these findings could have a significant impact on the cost of transplantation.

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