Developing a reliable and cost-effective follow-up programme after a short-term head and neck reconstructive mission in Ethiopia: a pilot study

ABSTRACTThere is a clinical need to test new schemes of benznidazole administration that are expected to be at least as effective as the current therapeutic scheme but safer. This study assessed a new scheme of benznidazole administration in chronic Chagas disease patients. A pilot study with intermittent doses of benznidazole at 5 mg/kg/day in two daily doses every 5 days for a total of 60 days was designed. The main criterion of response was the comparison of quantitative PCR (qPCR) findings prior to and 1 week after the end of treatment. The safety profile was assessed by the rate of suspensions and severity of adverse effects. Twenty patients were analyzed for safety, while qPCR was tested for 17 of them. The average age was 43 ± 7.9 years; 55% were female. Sixty-five percent of treated subjects showed detectable qPCR results prior to treatment of 1.45 (0.63 to 2.81) and 2.1 (1.18 to 2.78) parasitic equivalents per milliliter of blood (par.eq/ml) for kinetoplastic DNA (kDNA) qPCR and nuclear repetitive sequence satellite DNA (SatDNA) qPCR, respectively. One patient showed detectable PCR at the end of treatment (1/17), corresponding to 6% treatment failure, compared with 11/17 (65%) patients pretreatment (P= 0.01). Adverse effects were present in 10/20 (50%) patients, but in only one case was treatment suspended. Eight patients showed mild adverse effects, whereas moderate reactions with increased liver enzymes were observed in two patients. The main accomplishment of this pilot study is the promising low rate of treatment suspension. Intermittent administration of benznidazole emerges a new potential therapeutic scheme, the efficacy of which should be confirmed by long-term assessment posttreatment.

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Current concepts of surveillance and its significance in head and neck cancer

Annals of The Royal College of Surgeons of England ◽

10.1308/003588411x604794 ◽

2011 ◽

Vol 93 (8) ◽

pp. 576-582 ◽

Cited By ~ 12

Author(s):

Kapila Manikantan ◽

Raghav C Dwivedi ◽

Suhail I Sayed ◽

KA Pathak ◽

Rehan Kazi

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Cost Effective ◽

Second Primary ◽

Evidence Based ◽

Significant Cost ◽

Second Primary Tumours ◽

Cost Implications

Follow-up in head and neck cancer (HNC) is essential to detect and manage locoregional recurrence or metastases, or second primary tumours at the earliest opportunity. A variety of guidelines and investigations have been published in the literature. This has led to oncologists using different guidelines across the globe. The follow-up protocols may have unnecessary investigations that may cause morbidity or discomfort to the patient and may have significant cost implications. In this evidence-based review we have tried to evaluate and address important issues like the frequency of follow-up visits, clinical and imaging strategies adopted, and biochemical methods used for the purpose. This review summarises strategies for follow-up, imaging modalities and key investigations in the literature published between 1980 and 2009. A set of recommendations is also presented for cost-effective, simple yet efficient surveillance in patients with head and neck cancer.

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A short-term follow-up after a randomised double-blind pilot study comparing Doloteffin® vs. rofecoxib for low back pain

Focus on Alternative and Complementary Therapies ◽

10.1111/j.2042-7166.2003.tb05784.x ◽

2010 ◽

Vol 8 (1) ◽

pp. 133-133 ◽

Cited By ~ 1

Author(s):

S Chrubasik ◽

O Künzel ◽

J Thanner ◽

C Conradt

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pilot Study ◽

Low Back ◽

Short Term ◽

Double Blind

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A Novel Digital Patient-Reported Outcome Platform for Head and Neck Oncology Patients–-A Pilot Study

Clinical Medicine Insights Ear Nose and Throat ◽

10.4137/cment.s40219 ◽

2016 ◽

Vol 9 ◽

pp. CMENT.S40219 ◽

Cited By ~ 9

Author(s):

Maria K. Peltola ◽

Joel S. Lehikoinen ◽

Lauri T. Sippola ◽

Kauko Saarilahti ◽

Antti A. Mäkitie

Keyword(s):

Quality Of Life ◽

Pilot Study ◽

Side Effects ◽

Head And Neck ◽

Cancer Patients ◽

Early Stage ◽

Patient Reported Outcome ◽

Patient Reported

Introduction The patient's role in toxicity reporting is increasingly acknowledged. There is also a need for developing modern communication methods between the patient and the medical personnel. Furthermore, the increasing number of head and neck cancer (HNC) patients is reflected in the volume of treatment follow-up visits, which remains a challenge for the health care. Electronic patient-reported outcome (ePRO) measures may provide a cost-efficient way to organize follow-up for cancer patients. Materials and Methods We tested a novel ePRO application called Kaiku®, which enables real-time, online collection of patient-reported outcomes, such as side effects caused by treatment and quality of life. We conducted a pilot study to assess the suitability of Kaiku® for HNC patients at the Department of Oncology, Helsinki University Hospital, Helsinki, Finland. Patients used Kaiku® during and one month after radiotherapy to report treatment-related side effects and quality of life. Two physicians and a nurse performed the practical electronic communication part of the study. Results Five of the nine patients agreed to participate in the study: three of them had local early-stage larynx cancer (T2N0, T1aN0, and T2N0) and the remaining two patients had early-stage base of tongue cancer (T2N0 and T1N2b). The degree of side effects reported by the patients via Kaiku® ranged from mild to life threatening. The number of outcome data points on patients' progress was significantly increased, which resulted in a better follow-up and improved communication between the patient and the care team. Conclusions Kaiku® seems to be a suitable tool to monitor side effects and quality of life during and after radiotherapy among HNC patients. Kaiku® and similar tools could be useful in organizing a cost-effective follow-up process for HNC patients. We recommend conducting a larger study to further assess the impact of an ePRO solution in routine clinical practice. • ePRO solutions may aid in the follow-up for cancer patients. • They seem suitable to monitor, for example, side effects and quality of life. • These systems ensure fast patient-driven reporting.

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Patients' preferences concerning follow‐up after curative head and neck cancer treatment: A cross‐sectional pilot study

Head & Neck ◽

10.1002/hed.25686 ◽

2019 ◽

Vol 41 (7) ◽

pp. 2174-2181 ◽

Cited By ~ 4

Author(s):

Simon Andreas Mueller ◽

Julia Riggauer ◽

Olgun Elicin ◽

Daniela Blaser ◽

Sven Trelle ◽

...

Keyword(s):

Head And Neck Cancer ◽

Pilot Study ◽

Cancer Treatment ◽

Head And Neck ◽

Neck Cancer ◽

Cross Sectional

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Long-term effects of warren ripping for rabbit control in semi-arid South Australia.

The Rangeland Journal ◽

10.1071/rj9910096 ◽

1991 ◽

Vol 13 (2) ◽

pp. 96 ◽

Cited By ~ 15

Author(s):

GJ Mutze

Keyword(s):

South Australia ◽

Cost Effective ◽

Long Term Effects ◽

Short Term ◽

Long Term Effect ◽

Perennial Shrubs ◽

Control Work ◽

Semi Arid

Warren ripping and poisoning were used to control rabbits on the flood-out plain of a major creek system on Manunda Station, a sheep-grazing property near Yunta in semi-arid South Australia. Rabbit numbers were initially reduced by >99 per cent, as indicated by the number of active entrances remaining in rabbit warrens. After nearly 10 years without follow-up control work, ripped warrens had only two per cent of the pre-control number of active entrances. Poisoning effectively reduced rabbit numbers in the short-term, but had no long-term effect on the number of active entrances, either in ripped or unripped warrens. Perennial shrubs regenerated on and around ripped warrens. Warren ripping on this part of Manunda is a cost-effective management option.

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Who Attends and Who Benefits from CBT “Self-Confidence” Workshops Run in Routine Practice? A Pilot Study

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465809990129 ◽

2009 ◽

Vol 37 (5) ◽

pp. 585-593 ◽

Cited By ~ 3

Author(s):

Marta Prytys ◽

Kate Harman ◽

Rachel Lee ◽

June S. L. Brown

Keyword(s):

Pilot Study ◽

Repeated Measures ◽

Effective Means ◽

Cost Effective ◽

Psychological Interventions ◽

Routine Practice ◽

The Public ◽

Self Confidence ◽

Depression Symptomatology

Background:This study examined characteristics of members of the public who self-referred and the effectiveness of psycho-educational CBT self-confidence workshops when run in routine practice.Method:Repeated measures were employed at pre- and post-workshop stages.Results:Of the 56 members of the general public who self-referred to the workshops, 70% were above the clinical cut-offs for Global Distress (CORE OM) and 86% were above the clinical cut offs for depression symptomatology (CES-D). Follow up data (n= 31) showed significant reduction in self-reported distress and depression at 4-week follow-up. A further analysis showed that those whose scores were above the clinical threshold at initial presentation benefited most but those with scores below the threshold did not seem to benefit.Conclusions:This study demonstrates that psycho-educational CBT workshops attract those with high levels of distress and depression, and have potential as a cost effective means of disseminating psychological interventions.

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The Effectiveness of Three Psychotherapies of Different type and Length in the Treatment of Patients Suffering from Anxiety Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1472 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s777-s777

Author(s):

P. Knekt ◽

O. Lindfors ◽

T. Maljanen

Keyword(s):

Anxiety Disorder ◽

Work Ability ◽

Psychodynamic Psychotherapy ◽

Cost Effective ◽

Term Therapy ◽

Short Term ◽

Number Of Patients ◽

Axis I

IntroductionData on the comparative effect of short and long-term psychotherapy in anxiety disorder is scarce.AimTo compare the effectiveness of two short-term therapies and one long-term psychotherapy in the treatment of patients with anxiety disorder.MethodsAltogether 50 outpatients with anxiety disorder as the only axis I diagnosis, were randomly assigned to long-term psychodynamic psychotherapy (LPP), short-term psychodynamic psychotherapy (SPP), and solution-focused therapy (SFT) and were followed for 5 years. The outcome measures were psychiatric symptoms, working ability, need for psychiatric treatment, remission, and cost-effectiveness.ResultsDuring the first year of follow-up, no significant differences in the effectiveness between the therapies were noted. During the following 3 years, LPP and SFT more effectively reduced symptoms, improved work ability, and elevated the remission rate than SPP. No significant differences between LPP and SFT were seen. At the end of the follow-up, the use of auxiliary treatment was lowest in the SFT group whereas remission rates or changes in psychiatric symptom or work ability did not differ between the groups. The average total direct costs were about three times higher in the LPP group than in the short-term therapy groups.ConclusionsThe difference in effectiveness of LPP and SFT was negligible, whereas SPP appeared less effective. Thus, the resource-oriented SFT may be a cost-effective option in this selected patient group, while unconsidered allocation of patients to LPP does not appear to be cost-effective. Given the small number of patients, no firm conclusions should, however be drawn based on this study.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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