scholarly journals 4107 Implementation and evaluation of a novel protocol that uses clinical biomarkers to promote early diagnosis and treatment of Neurodevelopmental Disabilities

2020 ◽  
Vol 4 (s1) ◽  
pp. 72-73
Author(s):  
Tara Lynn Johnson ◽  
Sowmya Sivakumar ◽  
Namarta Kapil ◽  
Bittu Majmudar
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Early Diagnosis ◽  
Clinical Care ◽  
Standard Of Care ◽  
Early Intervention Services ◽  
Neurodevelopmental Disabilities ◽  
Clinical Biomarkers ◽  
High Risk Infants ◽  
New Biomarkers

OBJECTIVES/GOALS: Our objective was to establish a new protocol to evaluate new biomarkers to detect Neurodevelopmental Disabilities (NDD) in high-risk infants. As early intervention results in better outcomes, our goal was to implement the protocol to promote earlier NDD diagnosis and referral for treatment. METHODS/STUDY POPULATION: We implemented a new protocol using the General Movement Assessment (GMA), Hammersmith Infant Neurological Examination (HINE), and Capute Scales to evaluate infants who were at high risk of NDD. To determine the success of our protocol with these biomarkers, we studied former premature infants who were evaluated in follow-up clinic from 10/1/2018-10/1/2019. We defined our primary and secondary outcomes as the ages of neurodevelopmental diagnoses and referral to early intervention services before and after implementation of the new protocol, respectively. Our hypotheses were that infants who were evaluated with these biomarkers would be diagnosed with NDD and be referred for treatment at younger ages than their counterparts. RESULTS/ANTICIPATED RESULTS: Approximately 120 patients were evaluated during the time period that was defined. About half were evaluated prior to implementing the GMA and HINE, and the remainder were evaluated using GMA and other developmental measures. We anticipate that infants who underwent GMA will be diagnosed with NDD and referred for therapies at a younger age than their counterparts. DISCUSSION/SIGNIFICANCE OF IMPACT: Through our translational research, we will transform the standard of care for high-risk infants by incorporating clinical biomarkers into day-to-day clinical care for these infants. Implementation of this novel protocol will promote the early diagnosis and referral to treatment for NDD.

Design of a Web-Based Supporting System for Home-Centered Infant early Intervention Program

2013 ◽  
Vol 380-384 ◽  
pp. 2054-2057
Author(s):  
Chun Hua Liu ◽  
Kai Yan Wang
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Intervention Program ◽  
Early Intervention Program ◽  
Web Based ◽  
Supporting System ◽  
Early Intervention Services ◽  
Care Givers ◽  
High Risk Infants

Substantial literature indicates that it is necessary that infants receive early intervention services to improve long-term outcomes after birth. The effectiveness of parents as agents of intervention in the childs home environment is gradually realized. However, there a significant gap between the intensive service requirements for low-birth-weight (LBW) infants because the intervention requires intense one-on-one supervision by highly trained care givers. Based on web technology, we developed a supporting system to inform and teach parents in the early intervention of high risk infants. Results show the web-based training as a promising method of early intervention helps these caregivers in their practice of caring the high risk babies and may help overcome problems associated with the critical shortage of neonatal professionals.

Timing of Referral to Early Intervention Services in Infants With Severe Bronchopulmonary Dysplasia

2019 ◽  
Vol 58 (11-12) ◽  
pp. 1224-1231
Author(s):  
Valerie Martin ◽  
Jennifer M. Brady ◽  
Kelcy Wade ◽  
Marsha Gerdes ◽  
Sara B. DeMauro
Keyword(s):  
Early Intervention ◽  
Bronchopulmonary Dysplasia ◽  
Secondary Analysis ◽  
Case Series ◽  
Early Referral ◽  
Early Intervention Services ◽  
Initial Hospital ◽  
Prospective Case Series ◽  
High Risk Infants ◽  
Bayley Scales

This study is a secondary analysis of an observational prospective case series of 50 infants with severe bronchopulmonary dysplasia that describes patient factors associated with the time between initial hospital discharge and referral to early intervention (EI) services. It also evaluates associations between (1) timing of EI referral and reception of EI services and (2) early referral to EI and developmental outcomes at 18 to 36 months corrected age. The results demonstrated that a referral from a neonatologist versus a pediatrician was associated with fewer days between discharge and EI referral. Earlier EI referrals were associated with a shorter time to intake evaluation and service initiation. The Bayley-III (Bayley Scales of Infant and Toddler Development, 3rd Edition) scores at 24 months corrected age (n = 28) were not associated with timing of EI referral. In conclusion, an early referral to EI promoted earlier evaluation and initiation of EI services and should be standard for high-risk infants.

Prospective follow-up of primitive reflex profiles in high-risk infants: Clues to an early diagnosis of cerebral palsy

1995 ◽  
Vol 13 (2) ◽  
pp. 148-152 ◽  
Author(s):  
Dimitrios I Zafeiriou ◽  
Ioannis G Tsikoulas ◽  
George M Kremenopoulos
Keyword(s):  
Cerebral Palsy ◽  
High Risk ◽  
Early Diagnosis ◽  
High Risk Infants

scholarly journals Early intervention services in Greece: Time to focus on people at high risk

Psychiatriki ◽  
2018 ◽  
Vol 29 (1) ◽  
pp. 58-63
Author(s):  
S.I. Bargiota ◽  
◽  
V.P. Bozikas ◽  
G. Garyfallos ◽  
P. McGuire
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Early Intervention Services ◽  
Intervention Services

Design and Implementation of an Exoskeleton Glove for Infant Medical Rehabilitation

2018 ◽  
Author(s):  
Eric Refour ◽  
Bijo Sebastian ◽  
Pinhas Ben-Tzvi
Keyword(s):  
Cerebral Palsy ◽  
High Risk ◽  
Early Diagnosis ◽  
Software Architecture ◽  
Experimental Validation ◽  
Hand Movement ◽  
Medical Rehabilitation ◽  
Modes Of Operation ◽  
Design And Implementation ◽  
High Risk Infants

This paper describes the design and implementation of an exoskeleton glove for infants of ages ranging from 12 months to 3 years. The glove is capable of assisting the patient in achieving a pincer grasp in active and passive modes of operation. It can record information about the hand movement, forces exerted by the fingers on the exoskeleton frame, and provide vibration stimuli to the finger tips. The data recorded by the glove can be used in early diagnosis of cerebral palsy among high risk infants. It can also be used as a standalone device for rehabilitation purposes. The hardware, software architecture and experimental validation of the system are outlined in this paper.

scholarly journals O4.5. LONG TERM EFFECTS OF EARLY INTERVENTION SERVICES FOR FIRST EPISODE PSYCHOSIS: OUTCOMES OVER FIVE YEARS FROM THE RECOVERY AFTER A 1ST EPISODE OF SCHIZOPHRENIA-EARLY TREATMENT PROGRAM (RAISE-ETP)

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S10-S11
Author(s):  
Delbert Robinson ◽  
Nina Schooler ◽  
John Kane
Keyword(s):  
Clinical Trial ◽  
Early Intervention ◽  
Usual Care ◽  
Standard Care ◽  
Clinical Care ◽  
First Episode Psychosis ◽  
First Episode ◽  
Early Intervention Services ◽  
Episode Psychosis

Abstract Background Early intervention services (EIS) for first episode psychosis (FEP) are now implemented worldwide and these integrated and team-based treatment programs improve FEP outcomes while patients are participating. EIS service and treatment models provide care for limited periods followed by return to standard services. Cross sectional follow-up studies conducted after EIS participation ends have not been able to find advantages compared with standard care. The RAISE-ETP study was the first US-based, multi-center randomized clinical trial to compare an EIS, labeled NAVIGATE, to usual clinical care. Those who received NAVIGATE experienced significant improvement in symptoms and functioning compared to those who received usual care during the initial two-year treatment period. We now report clinical outcomes covering five years, a time frame that includes care after EIS participation ended. Methods RAISE-ETP was a cluster randomized clinical trial conducted at 34 US sites; 17 sites provided NAVIGATE to 223 participants and 17 sites provided usual clinical care to 181 participants. NAVIGATE was available until the last randomized subject had the opportunity for two years of services. Participants were assessed every six months for up to 60 months by masked, centralized assessors utilizing live two-way video and with the Heinrichs-Carpenter Quality of Life Scale (QLS) and the Positive and Negative Syndrome Scale (PANSS). Results Participants had a mean age of 23 years and the majority were male; (78% in NAVIGATE and 66% in usual care). The mean opportunity for NAVIGATE treatment was 33.8 (SD=5.1) months; the longest 44.4 months. Compared with usual care, NAVIGATE over 5 years was associated with a 13.14 unit QLS (p<0.001) and 7.73 unit PANSS (p<0.002) better improvement and 2.5 fewer inpatient days (p=0.02). NAVIGATE opportunity length did not affect QLS outcome; duration of untreated psychosis did not moderate differential QLS outcome. Discussion RAISE-ETP provides compelling evidence of a substantial long-term benefit for FEP treatment with the NAVIGATE EIS compared with standard care.

Review of clinical and emerging biomarkers for early diagnosis and treatment management of pancreatic cancer: towards personalised medicine

2021 ◽  
pp. 1-13
Author(s):  
Ernest Osei ◽  
Christabel Oghinan ◽  
Akua Asare ◽  
Hillary Ho ◽  
Solomon Manful
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Early Detection ◽  
Early Diagnosis ◽  
Specific Treatment ◽  
High Specificity ◽  
Patient Specific ◽  
Patient Response ◽  
Clinical Biomarkers ◽  
Specificity And Sensitivity

Abstract Background: Pancreatic cancer is the 12th most commonly diagnosed cancer and the 3rd leading cause of cancer mortality and accounts for approximately 2·7% of all newly diagnosed cancer cases and 6·4% of all cancer mortalities in Canada. It has a very poor survival rate mainly due to the difficulty of detecting the disease at an early stage. Consequently, in the advancement of disease management towards the concept of precision medicine that takes individual patient variabilities into account, several investigators have focused on the identification of effective clinical biomarkers with high specificity and sensitivity, capable of early diagnosis of symptomatic patients and early detection of the disease in asymptomatic individuals at high risk for developing pancreatic cancer. Materials and methods: We searched several databases from August to December 2020 for relevant studies published in English between 2000 and 2020 and reporting on biomarkers for the management of pancreatic cancer. In this narrative review paper, we describe 13 clinical and emerging biomarkers for pancreatic cancers used in screening for early detection and diagnosis, to identify patients’ risk for metastatic disease and subsequent relapse, to monitor patient response to specific treatment and to provide clinicians the possibility of prospectively identifying groups of patients who will benefit from a particular treatment. Conclusions: Current and emerging biomarkers for pancreatic cancer with high specificity and sensitivity has the potential to account for individual patient variabilities, for early detection of disease before the onset of metastasis to improve treatment outcome and patients’ survival, help screen high-risk populations, predict prognosis, provide accurate information of patient response to specific treatment and improve patients monitoring during treatment. Thus, the future holds promise for the use of effective clinical biomarkers or a panel of biomarkers for personalised patient-specific targeted medicine for pancreatic cancer.

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