Efficacy of Doll thErapy compared with standard treatment in the control of behavioral and psychologic Symptoms and CaRegIver Burden in dEmentia: DESCRIBE a randomized, controlled study

International Journal of Aging Research ◽

10.28933/ijoar-2021-02-1905 ◽

2021 ◽

pp. 79

Author(s):

Keyword(s):

Caregiver Burden ◽

Psychotropic Drugs ◽

Standard Treatment ◽

Nursing Home Residents ◽

Controlled Study ◽

First Line ◽

Clinical Scales ◽

Geriatric Unit ◽

Professional Caregiver ◽

Collateral Effects

Behavioral and psychologic symptoms of dementia (BPSD) are frequent and represent a burden for patients and caregivers; in particular, the presence of agitation and aggression (A/A) has an important impact on patients’ quality of life. As psychotropic drugs can induce severe collateral effects, the use of a first line non-pharmacologic approach is highly recommended. Here we evaluate the effect of doll therapy (DT) on A/A in geriatric patients with moderate to severe dementia hospitalized in an acute geriatric unit. We enrolled fifty-two acute in-patients with dementia and A/A. Subjects were randomized to DT (26) or standard treatment (ST, 26), we measured agitation and caregiver burden with standard clinical scales at baseline and during treatment. In order to evaluate the effect of DT withdrawal, we carried out a telephonic follow-up interview after 1 and 4 weeks from hospital discharge. DT is more effective than ST in the control of agitation, but not in reducing the professional caregiver burden. The use of pro re nata psychotropic drugs was reduced in patients treated with DT. After DT withdrawal, A/A progressively increased. In conclusion we show that DT may be more effective than ST in the control of A/A in acute geriatric in-patients affected by dementia. Our results suggest that, in patients affected by severe to moderate forms of dementia with A/A, DT may be used as a first line treatment, not only in nursing home residents, but also in acute care geriatric in-patients.

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The Doll Therapy as a First Line Treatment for Behavioral and Psychologic Symptoms of Dementia in Nursing Homes Residents: A Randomized, Controlled Study

10.21203/rs.3.rs-534727/v1 ◽

2021 ◽

Author(s):

Francesca Santagata ◽

Massimiliano Massaia ◽

Patrizia D'amelio

Keyword(s):

Nursing Homes ◽

Caregiver Burden ◽

Nursing Home Residents ◽

Confusion Assessment Method ◽

Assessment Method ◽

Controlled Study ◽

First Line ◽

Clinical Scales ◽

Randomized Controlled ◽

Registration Number

Abstract Background. Patients affected by dementia are severely affected by the development of behavioral and psychologic symptoms (BPSD) which represent a burden for patients and caregivers. The use of psychotropic drugs in the control of BPSD is widely diffused, however the use of a first line non-pharmacologic approach is highly recommended. Here we evaluate the effect of doll therapy (DT) in the management of BPSD, on the reduction of caregiver burden and delirium incidence in nursing home residents by a randomized controlled trial.Methods. We enrolled fifty-two nursing homes residents living with dementia and BPSD. Subjects were randomized to DT (26) or standard treatment (ST, 26), we measured BPSD, caregiver burden and delirium with standard clinical scales at baseline, after 45 and 90 days. In order to evaluate the presence of BPSD we used Neuropsychiatric Inventory (NPI) scale and the A.Di.CO scale, the caregiver burden was measured by the Greutzner scale and delirium by the Confusion Assessment Method (CAM) scale.Results. DT was more effective in reducing agitation and aggressiveness as respect to ST. Moreover DT globally reduced the presence of BPSD as dysphoria, wandering and apathy. We observed a significant reduction of the professional caregiver burden and the incidence of delirium was significantly reduced in subjects treated with DT.Conclusions. We show that DT is more effective that ST in the control of BSPD in patients affected by moderate to severe dementia. Moreover we suggest that DT may effective in reducing the incidence of delirium.Trial Registration: Retrospectively registered in ClinicalTrials.gov the 02nd June 2, 2021 trial registration number NCT04920591

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The doll therapy as a first line treatment for behavioral and psychologic symptoms of dementia in nursing homes residents: a randomized, controlled study

BMC Geriatrics ◽

10.1186/s12877-021-02496-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Francesca Santagata ◽

Massimiliano Massaia ◽

Patrizia D’Amelio

Keyword(s):

Nursing Homes ◽

Caregiver Burden ◽

Controlled Trial ◽

Nursing Home Residents ◽

Assessment Method ◽

Trial Registration ◽

Controlled Study ◽

First Line ◽

Randomized Controlled ◽

Link Type

Abstract Background Patients living with dementia are severely affected by the development of behavioral and psychologic symptoms (BPSD) which represent a burden for patients and caregivers. The use of psychotropic drugs in the control of BPSD is widely diffused, however the use of a first line non-pharmacologic approach is highly recommended. Here we evaluate the effect of doll therapy (DT) in the management of BPSD, on the reduction of caregiver burden and delirium incidence in nursing home residents by a randomized controlled trial. Methods We enrolled fifty-two nursing homes residents living with dementia and BPSD. Subjects were randomized to DT (26) or standard treatment (ST, 26), we measured BPSD, caregiver burden and delirium with standard clinical scales at baseline, after 45 and 90 days. In order to evaluate the presence of BPSD we used Neuropsychiatric Inventory (NPI) scale and the A.Di.CO scale, the caregiver burden was measured by the Greutzner scale and delirium by the Confusion Assessment Method (CAM) scale. Results DT was more effective in reducing agitation and aggressiveness as respect to ST. Moreover DT globally reduced the presence of BPSD as dysphoria, wandering and apathy. We observed a significant reduction of the professional caregiver burden and the incidence of delirium was significantly reduced in subjects treated with DT. Conclusions We show that DT is more effective that ST in the control of BSPD in patients affected by moderate to severe dementia. Moreover we suggest that DT may effective in reducing the incidence of delirium. Trial registration Retrospectively registered in ClinicalTrials.gov the 10th June 2, 2021 trial registration number NCT04920591.

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Biology and Management of Dedifferentiated Liposarcoma: State of the Art and Perspectives

Journal of Clinical Medicine ◽

10.3390/jcm10153230 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3230

Author(s):

Jun Nishio ◽

Shizuhide Nakayama ◽

Kazuki Nabeshima ◽

Takuaki Yamamoto

Keyword(s):

Standard Treatment ◽

Clinical Presentation ◽

Current Knowledge ◽

Single Agent ◽

Dedifferentiated Liposarcoma ◽

Cyclin Dependent Kinase ◽

First Line ◽

First Line Therapy ◽

Well Differentiated ◽

Genetic Events

Dedifferentiated liposarcoma (DDL) is defined as the transition from well-differentiated liposarcoma (WDL)/atypical lipomatous tumor (ALT) to non-lipogenic sarcoma, which arises mostly in the retroperitoneum and deep soft tissue of proximal extremities. It is characterized by a supernumerary ring and giant marker chromosomes, both of which contain amplified sequences of 12q13-15 including murinedouble minute 2 (MDM2) and cyclin-dependent kinase 4 (CDK4) cell cycle oncogenes. Detection of MDM2 (and/or CDK4) amplification serves to distinguish DDL from other undifferentiated sarcomas. Recently, CTDSP1/2-DNM3OS fusion genes have been identified in a subset of DDL. However, the genetic events associated with dedifferentiation of WDL/ALT remain to be clarified. The standard treatment for localized DDL is surgery, with or without radiotherapy. In advanced disease, the standard first-line therapy is an anthracycline-based regimen, with either single-agent anthracycline or anthracycline in combination with the alkylating agent ifosfamide. Unfortunately, this regimen has not necessarily led to a satisfactory clinical outcome. Recent advances in the understanding of the pathogenesis of DDL may allow for the development of more-effective innovative therapeutic strategies. This review provides an overview of the current knowledge on the clinical presentation, pathogenesis, histopathology and treatment of DDL.

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Use of psychotropic medications by caregivers of elderly patients with dementia: is this a sign of caregiver burden?

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2012000300003 ◽

2012 ◽

Vol 70 (3) ◽

pp. 169-174 ◽

Cited By ~ 7

Author(s):

Einstein Francisco Camargos ◽

Andrea Brígida Souza ◽

Aline Silva Nascimento ◽

Alessandra Cicari Morais-e-Silva ◽

Juliana Lima Quintas ◽

...

Keyword(s):

Elderly Patients ◽

Caregiver Burden ◽

Psychotropic Drugs ◽

Cross Sectional Study ◽

Psychotropic Medications ◽

Sectional Study ◽

Structured Interviews ◽

Cross Sectional ◽

Sleeping Pills

This study evaluated the consumption of psychotropic medications by caregivers of elderly patients with or without dementia. This was a cross-sectional study conducted at all geriatric units in Brasília, Brazil, during a two-month period. Structured interviews were performed with 311 caregivers of people with or without dementia and they completed questionnaires. Among the caregivers, 196 (63%) were caregivers of patients with dementia and 115 (37%) were caregivers of patients without dementia. Forty-four caregivers (14.1%) were taking psychotropic drugs (benzodiazepines or antidepressants), and this usage was more frequent among caregivers of patients with dementia (p<0.01). Twenty-two caregivers of patients with dementia (11.4%) had used sleeping pills after beginning care, compared with only five (4.3%) caregivers of patients without dementia (p<0.01). In conclusion, this study found that caregivers of patients with dementia took psychotropic drugs (benzodiazepines and antidepressants) more frequently than the ones of patients without dementia.

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Adjuvancy and reactogenicity of N-acetylglucosaminyl-N-acetylmuramyl-dipeptide (GMDP) orally administered just prior to trivalent influenza subunit vaccine. A double-blind placebo-controlled study in nursing home residents

Vaccine ◽

10.1016/s0264-410x(96)00075-8 ◽

1996 ◽

Vol 14 (14) ◽

pp. 1327-1330 ◽

Cited By ~ 2

Author(s):

A.M. Palache ◽

W.E.P. Beyer ◽

E. Hendriksen ◽

L. Gerez ◽

R. Aston ◽

...

Keyword(s):

Nursing Home ◽

Subunit Vaccine ◽

Nursing Home Residents ◽

Controlled Study ◽

Double Blind ◽

Double Blind Placebo

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Comparing Outcomes Between Thiazide Diuretics and Other First-line Antihypertensive Drugs in Long-term Nursing Home Residents

Clinical Therapeutics ◽

10.1016/j.clinthera.2020.02.016 ◽

2020 ◽

Vol 42 (4) ◽

pp. 583-591 ◽

Cited By ~ 2

Author(s):

Kenneth S. Boockvar ◽

Wei Song ◽

Sei Lee ◽

Orna Intrator

Keyword(s):

Nursing Home ◽

Antihypertensive Drugs ◽

Nursing Home Residents ◽

Thiazide Diuretics ◽

First Line

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EGFR Tyrosine Kinase Inhibitor (TKI) Combined With Concurrent or Sequential Chemotherapy for Patients With Advanced Lung Cancer and Gradual Progression After First-Line EGFR-TKI Therapy: A Randomized Controlled Study

Clinical Lung Cancer ◽

10.1016/j.cllc.2020.06.005 ◽

2020 ◽

Author(s):

Qing Chang ◽

Jianlin Xu ◽

Huiping Qiang ◽

Jiajun Teng ◽

Jialin Qian ◽

...

Keyword(s):

Lung Cancer ◽

Tyrosine Kinase Inhibitor ◽

Kinase Inhibitor ◽

Advanced Lung Cancer ◽

Controlled Study ◽

First Line ◽

Sequential Chemotherapy ◽

Egfr Tyrosine Kinase Inhibitor ◽

Randomized Controlled ◽

Egfr Tki

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Granulocyte-stimulating factor and severe aplastic anemia: a survey by the European Group for Blood and Marrow Transplantation (EBMT)

Blood ◽

10.1182/blood-2006-07-034272 ◽

2006 ◽

Vol 109 (7) ◽

pp. 2794-2796 ◽

Cited By ~ 59

Author(s):

Gerard Socie ◽

Jean-Yves Mary ◽

Hubert Schrezenmeier ◽

Judith Marsh ◽

Andrea Bacigalupo ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Aplastic Anemia ◽

Myeloid Leukemia ◽

Standard Treatment ◽

Severe Aplastic Anemia ◽

First Line ◽

Blood And Marrow Transplantation ◽

Stimulating Factor ◽

European Group ◽

Acute Myeloid

Abstract Previous studies suggested a link between the use of G-CSF and increased incidence of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) after immunosuppressive therapy (IST) for severe aplastic anemia (SAA). This European survey included 840 patients who received a first-line IST with (43%) or without (57%) G-CSF. The incidences of MDS/AML in patients who did or did not receive G-CSF were 10.9% and 5.8%, respectively. A significantly higher hazard (1.9) of MDS/AML was associated with use of G-CSF. Relapse of aplastic anemia was not associated with a worse outcome in patients who did not receive G-CSF as first therapy, whereas relapse was associated with a significantly worse outcome in those patients who received G-CSF. These results emphasize the necessity of the current European randomized trial comparing IST with or without G-CSF and to alert physicians that adding G-CSF to IST is currently not standard treatment for SAA.

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