scholarly journals Crisis intervention: the professionals' perspective

2001 ◽  
Vol 25 (3) ◽  
pp. 95-98 ◽  
Author(s):  
Fernando Lazaro ◽  
Elena Kulinskaya ◽  
Robert Tobiansky
Keyword(s):  
Crisis Intervention ◽  
Overall Response Rate ◽  
Response Rate ◽  
Clinical Implications ◽  
Staff Satisfaction ◽  
Overall Response ◽  
Clinical Responsibility ◽  
Intervention Service ◽  
Differences Of Opinion ◽  
Professional Disciplines

Aims and MethodTo describe the attitudes of the professionals of a multi-disciplinary crisis intervention service (CIS) towards the service they provide. To establish whether there are differences in attitudes between the different professional disciplines involved. A questionnaire was mailed to all the professionals working in the Barnet CIS (n=94). Differences were analysed using the Kruskal–Wallis test.ResultsThe overall response rate was 84%. Statistically significant differences were found between the different disciplines in 10 of the 37 questions (27%) on the questionnaire. Opinions differed most on issues of safety and acceptance of clinical responsibility.Clinical ImplicationsDespite general ag reement on most issues, we found differences of opinion in important areas such as arrangements for team safety and clinical responsibility. These differences may create tensions within the multi-disciplinary groups and may influence the attitudes of professionals to crisis work. Measures need to be taken to address these issues in order to improve morale and staff satisfaction.

scholarly journals Sources of stress, psychological distress and burnout in psychiatrists

1999 ◽  
Vol 23 (4) ◽  
pp. 207-212 ◽  
Author(s):  
Elspeth Guthrie ◽  
Teresa Tattan ◽  
Edwina Williams ◽  
Dawn Black ◽  
Himant Bacliocotti
Keyword(s):  
Psychological Distress ◽  
Job Stress ◽  
Overall Response Rate ◽  
Response Rate ◽  
Psychological Morbidity ◽  
Teaching Hospitals ◽  
Clinical Implications ◽  
Overall Response ◽  
Working Environments ◽  
Significant Difference

AimsTo assess the degree of psychological morbidity and burnout in 138 psychiatrists in three Manchester teaching hospitals.ResultsThe results for senior house officers (SHOs), registrars, senior registrars and consultants were compared. The overall response rate was 76.8%. There was no significant difference in psychological morbidity between the three training grades, but SHOs and registrars reported significantly higher levels of burnout than either senior registrars or consultants. Dealing with violent patients was stressful for all psychiatrists, no matter what the grade.Clinical implicationsFactors related to job stress in psychiatry need to be addressed. In particular, the provision of safer working environments needs to be considered for psychiatrists at all levels of training.

scholarly journals Influence of mailing strategies on response to questionnaires

1998 ◽  
Vol 22 (11) ◽  
pp. 692-694 ◽  
Author(s):  
Kate Newton ◽  
Samuel M. Stein ◽  
Clare Lucey
Keyword(s):  
Prospective Study ◽  
Child Psychiatry ◽  
Overall Response Rate ◽  
Response Rate ◽  
Clinical Information ◽  
Clinical Implications ◽  
Questionnaire Response ◽  
Overall Response ◽  
Patient Questionnaires ◽  
A Prospective Study

Aims and methodA prospective study was undertaken to evaluate the effect of a stamped addressed envelope, as compared to a non-stamped but addressed envelope or no envelope, on response to a mailed questionnaire. The correlation between questionnaire response and subsequent attendance at the first appointment was also studied.ResultsThe overall response rate was 26% of 176 families offered first appointments at a local child psychiatry service. Families provided with a stamped addressed envelope were more likely to return their questionnaire and those families who returned the questionnaire were more likely to attend their first appointment.Clinical implicationsThe return of patient questionnaires has significant clinical and resource implications. Only essential questionnaires should be sent out to referred families as nearly three-quarters will not be returned. The return rate can be enhanced by providing a stamped addressed envelope but, if questionnaires are not returned within 10 days, the likelihood of return is minimal. As more than half of the families who failed to return the questionnaire also failed to attend their first appointment, questionnaires can be used as a measure of motivation and likelihood of attendance as well as a source of clinical information.

Cisplatin in the treatment of recurrent childhood primary brain tumors.

1988 ◽  
Vol 6 (1) ◽  
pp. 62-66 ◽  
Author(s):  
R W Walker ◽  
J C Allen
Keyword(s):  
Brain Tumors ◽  
Germ Cell ◽  
Germ Cell Tumor ◽  
Overall Response Rate ◽  
Response Rate ◽  
Cell Tumor ◽  
Primitive Neuroectodermal Tumors ◽  
Primary Brain Tumors ◽  
Overall Response ◽  
Neuroectodermal Tumors

Thirty-three patients were treated with intravenous (IV) cisplatin (CPDD) of whom 32 were considered evaluable. There were 14 medulloblastomas, five primitive neuroectodermal tumors (PNET), nine gliomas, three ependymomas, and one germ cell tumor. The overall response rate was 13 of 32 (41%). Eleven responses (five complete [CR], five partial [PR], one mixed [MR]) were noted in the patients with medulloblastoma. The response rate within this group was 79%. Toxicity was tolerable, although it precluded further therapy in five patients.

scholarly journals Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) for Tinnitus: A Retrospective Study

2021 ◽  
pp. 014556132110168
Author(s):  
Haidi Yang ◽  
Gui Cheng ◽  
Zhengrong Liang ◽  
Wenting Deng ◽  
Xiayin Huang ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Overall Response Rate ◽  
Response Rate ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Subjective Assessment ◽  
Overall Response ◽  
Duration Of Disease ◽  
Vas Scores ◽  
Assessment Result

Objective: Current studies still find insufficient evidence to support the routine use of repetitive transcranial magnetic stimulation (rTMS) in tinnitus. This study aimed to assess response of tinnitus to treatment with rTMS and identify factors influencing the overall response. Methods: Between January 2016 and May 2017, 199 tinnitus patients were identified from a retrospective review of the electronic patient record at the Sun Yat-sen Memorial Hospital. All patients received rTMS treatment. Their clinicodemographic profile and outcomes, including the tinnitus handicap inventory (THI) and visual analog scale (VAS) scores, were extracted for analysis. Results: Regarding the THI results, 62.3% of all patients responded to rTMS. The analysis of the VAS score revealed an overall response rate of 66.3%. Both percentages were close to the patient’s subjective assessment result, of 63.8%. Patients with tinnitus of less than 1-week duration had the highest response rate to rTMS in terms of either THI/VAS scores or the patient’s subjective assessment of symptoms. Tinnitus duration was recognized as a factor influencing the overall response to the treatment. Conclusions: Repetitive transcranial magnetic stimulation treatment is effective for patients with tinnitus, but its efficacy is affected by tinnitus duration. Tinnitus patients are advised to attend for rTMS as soon as possible since therapy was more effective in those with a shorter duration of disease of less than 1 week.

Combination of trastuzumab, pertuzumab and docetaxel in patients with advanced non-small cell lung cancer (NSCLC) harboring HER2 mutation: Final results from the IFCT-1703 R2D2 trial.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 9015-9015
Author(s):  
Julien Mazieres ◽  
Claire Lafitte ◽  
Charles Ricordel ◽  
Laurent Greillier ◽  
Jean-Louis Pujol ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Overall Response Rate ◽  
Advanced Nsclc ◽  
Response Rate ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Loading Dose ◽  
Overall Response ◽  
Grade 3 ◽  
Exon 20

9015 Background: Human epidermal growth factor receptor 2 ( HER2) exon 20 insertions and mutations are oncogenic drivers found in 1-2% of NSCLC. However, there are no approved therapies for these patients. Many studies suggest that the use of HER2 inhibitors developed for breast cancer patients might be of interest in this setting. The aim of this trial was to prospectively evaluate the interest of a combination of two antibodies against HER2 (trastuzumab and pertuzumab) with docetaxel. Methods: IFCT-1703 R2D2 trial is a multicenter, non-randomized phase 2 study with a two-stage design, a power of 90% and an alpha risk at 5% (one-sided). HER2 mutational status was assessed locally in certified molecular genetic centers. Main other inclusion criteria were advanced NSCLC, progression after ≥ 1 platinum-based chemotherapy, asymptomatic brain metastases, left ventricular ejection fraction (LVEF) ≥ 50%, and PS 0-2. Patients were treated every 3 weeks with pertuzumab at a loading dose of 840 mg, and 420 mg thereafter; plus trastuzumab at a loading dose of 8 mg/kg and 6 mg/kg thereafter; and docetaxel at 75 mg/m². Treatment was given until toxicity or disease progression. The primary outcome was overall response rate (ORR). Other endpoints included duration of response, progression-free survival and safety. NCT number: NCT03845270. Results: From May 2019 to October 2020, 45 patients were enrolled in 17 centers and received study treatment. Median age was 64.5 years (range 31–84), 72% females, 35% smokers, 100% non-squamous histology and 15% with ECOG PS 2. 31.1% patients had brain metastases. PD-L1 was expressed ≥ 1% and ≥ 50% in 36% and 7% of the patients, respectively. No other oncogene driver was found associated with HER2 exon 20 mutation. With a median follow-up of 12 months, 44 (98%) patients were evaluable for the primary endpoint. Overall response rate was 29% (n = 13), stable disease 56% (n = 26). Median PFS was 6.8 months (95% CI[4.0-8.5]). Median duration of treatment in patients with confirmed response (n = 13) was 10 months (95% CI[2.7-14.9]). At the time of data cut-off, 15 patients (33%) were still under treatment. Grade 3/4 treatment-related adverse events (AEs) were observed in 64% of patients. No patient experienced treatment discontinuation because of toxicity. One sudden death was possibly related to treatment. Most frequent grade ≥ 3 AEs were neutropenia (33%), diarrhea (13%) and anaemia (9%). Grade 1/2 dyspnea was observed in 3 (6.7%) patients. No ILD were reported. Variation LVEF was -1.72% on average (min: -18 %; max: 10 %). Conclusions: The triplet trastuzumab, pertuzumab and docetaxel is feasible and active in HER2 pretreated advanced NSCLC. These results confirm the activity of HER2 antibodies-based strategy which should be considered in these patients. Clinical trial information: NCT03845270.

scholarly journals Phase 1/2a study of 177Lu-lilotomab satetraxetan in relapsed/refractory indolent non-Hodgkin lymphoma

2020 ◽  
Vol 4 (17) ◽  
pp. 4091-4101
Author(s):  
Arne Kolstad ◽  
Tim Illidge ◽  
Nils Bolstad ◽  
Signe Spetalen ◽  
Ulf Madsbu ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Overall Response Rate ◽  
Response Rate ◽  
Phase 1 ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
Hematologic Toxicity ◽  
Overall Response ◽  
Non Hodgkin Lymphoma ◽  
Anti Cd20

Abstract For patients with indolent non-Hodgkin lymphoma who fail initial anti-CD20–based immunochemotherapy or develop relapsed or refractory disease, there remains a significant unmet clinical need for new therapeutic approaches to improve outcomes and quality of life. 177Lu-lilotomab satetraxetan is a next-generation single-dose CD37-directed radioimmunotherapy (RIT) which was investigated in a phase 1/2a study in 74 patients with relapsed/refractory indolent non-Hodgkin B-cell lymphoma, including 57 patients with follicular lymphoma (FL). To improve targeting of 177Lu-lilotomab satetraxetan to tumor tissue and decrease hematologic toxicity, its administration was preceded by the anti-CD20 monoclonal antibody rituximab and the “cold” anti-CD37 antibody lilotomab. The most common adverse events (AEs) were reversible grade 3/4 neutropenia (31.6%) and thrombocytopenia (26.3%) with neutrophil and platelet count nadirs 5 to 7 weeks after RIT. The most frequent nonhematologic AE was grade 1/2 nausea (15.8%). With a single administration, the overall response rate was 61% (65% in patients with FL), including 30% complete responses. For FL with ≥2 prior therapies (n = 37), the overall response rate was 70%, including 32% complete responses. For patients with rituximab-refractory FL ≥2 prior therapies (n = 21), the overall response rate was 67%, and the complete response rate was 24%. The overall median duration of response was 13.6 months (32.0 months for patients with a complete response). 177Lu-lilotomab satetraxetan may provide a valuable alternative treatment approach in relapsed/refractory non-Hodgkin lymphoma, particularly in patients with comorbidities unsuitable for more intensive approaches. This trial was registered at www.clinicaltrials.gov as #NCT01796171.

Phase I study of the combination of fludarabine, mitoxantrone, and dexamethasone in low-grade lymphoma.

1994 ◽  
Vol 12 (3) ◽  
pp. 575-579 ◽  
Author(s):  
P McLaughlin ◽  
F B Hagemeister ◽  
F Swan ◽  
F Cabanillas ◽  
O Pate ◽  
...  
Keyword(s):  
Overall Response Rate ◽  
Response Rate ◽  
Single Agent ◽  
Active Agent ◽  
Large Cell ◽  
Maximum Tolerated Dose ◽  
Low Grade ◽  
Overall Response ◽  
Nonhematologic Toxicity ◽  
High Fraction

PURPOSE Fludarabine is an active agent for patients with low-grade lymphoma (LGL) but has mainly been used as a single agent. This trial was designed to define the maximum-tolerated dose (MTD) of a combination of fludarabine, mitoxantrone, and dexamethasone (FND), to identify the toxicities of these agents in combination, and to make preliminary observations about the efficacy of this combination. PATIENTS AND METHODS Twenty-one patients with recurrent LGL or follicular large-cell lymphoma were treated, in cohorts of three, at stepwise escalating doses. Patients were required to have adequate marrow function and normal renal, hepatic, and cardiac function. RESULTS The MTD of the combination was found to be as follows: fludarabine, 25 mg/m2/d (days 1 to 3); mitoxantrone, 10 mg/m2 (day 1); and dexamethasone, 20 mg/d (days 1 to 5). Each course was administered monthly, and up to eight courses were given. Dose-limiting toxicities were neutropenia and infections. Thrombocytopenia was modest. Nonhematologic toxicity was very modest. Responses were seen at every dose level. The overall response rate was 71%, with a 43% complete remission (CR) rate. The median duration of CR was 18 months (with follow-up duration from 13 to 28+ months). CONCLUSION FND was well tolerated in this population. While our primary aim was to define the MTD, our preliminary observations on the efficacy of the regimen were favorable. The overall response rate was high, there was a high fraction of CRs, and our early impression is that these responses are durable.

scholarly journals Mantle Cell Lymphoma: Incidence of Gastrointestinal Involvement and Correlation with Overall Response- Retrospective Review of Multiple Multicenter Trials

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 33-34
Author(s):  
Surabhi Bajpai ◽  
Jayant Narang ◽  
Shweta Narang ◽  
Ravikanth Mankala ◽  
Rudresh Rajnikant Jarecha ◽  
...  
Keyword(s):  
Small Intestine ◽  
Overall Response Rate ◽  
Response Rate ◽  
Cell Lymphoma ◽  
Sustained Response ◽  
Oral Contrast ◽  
Gastrointestinal Involvement ◽  
Overall Response ◽  
Gi Symptoms ◽  
Bowel Involvement

Background:Mantle cell lymphoma (MCL) is a rare kind of Non-Hodgkin Lymphoma. The incidence of Gastrointestinal (GI) involvement is an important factor in assessing patients and determining the disease burden, although it has not been studied extensively. It is relatively difficult to detect GI involvement by endoscopy especially for the small bowel however more frequent use of Positron Emission Tomography- Computed Tomography (PET-CT) has improved detection rates. GI involvement has an important role in staging and overall assessment. With this background we hypothesized that the patients with GI involvement will have a poorer Overall Response Rate (ORR) and sustained response as compared to patients without GI involvement. Methods:A total of 120 patients were included in this retrospective analysis of multiple, phase II, clinical trials with MCL. These patients were independently reviewed using Lugano criteria. Patients with GI involvement at baseline and their subsequent response at Follow up were assessed. The Overall response rate (patients who achieved at least a CR or PR) and the sustained responses (of at least 6 months) of patients with GI involvement were compared with patients without GI involvement in this analysis. The subset of anatomical location of GI involvement was also assessed. Results: Out of a total of 120 patients, 34 had GI involvement noted on imaging. Correlative endoscopy findings were noted in 14 patients whereas in 20 patients endoscopy was not performed. The anatomical distribution of the gastrointestinal involvement on imaging was noted as follows: 17 Colon, 11 Small intestine (2 in Duodenum, 9 ileum), 11 Gastric, 1 Esophagus. Some patients had multifocal GI involvement. In patients with GI involvement (n=34), CR was noted in 13 patients (sustained response in 11) while PR was documented in 11 patients (sustained response in 5). In patients without the GI involvement (n=86) CR was noted in 39 patients (sustained response in 31) while PR was documented in 27 patients (sustained response in 16). Conclusion: Based on the results above it was observed that GI involvement was noted in approximately 28.3% of patients. Colon was the most common site involved, in 50% patients. Small Intestine and Gastric involvement were the next most common, 32% each. The incidence of GI involvement highlights the importance of predefining the imaging guidelines with the use of oral contrast to improve the detection of GI involvement. Any MCL patient with GI symptoms and suspected bowel involvement on imaging should always be followed up via endoscopy and biopsy when feasible to confirm the lymphomatous bowel involvement. The ORR in cases with GI involvement was 70.5% (24/34) and out of these only 47% (16/34) patients showed sustained response. Patients without GI involvement was 76.7% (66/86) and out of these only 54% (47/86) patients showed sustained response. Our analysis suggests that the GI involvement in MCL patients have slightly less ORR as well as sustained response. Further prospective studies with larger number of patients may be needed to substantiate this claim, if GI involvement has poorer prognosis. Disclosures No relevant conflicts of interest to declare.

Efficacy of bevacizumab and temozolomide therapy in locally advanced, recurrent, and metastatic malignant solitary fibrous tumour: A population-based analysis

2018 ◽  
Vol 25 (6) ◽  
pp. 1301-1304 ◽  
Author(s):  
Mário L de Lemos ◽  
Isabell Kang ◽  
Kimberly Schaff
Keyword(s):  
Overall Survival ◽  
Overall Response Rate ◽  
Response Rate ◽  
Locally Advanced ◽  
Case Series ◽  
Progression Free Survival ◽  
Population Based ◽  
Solitary Fibrous Tumour ◽  
Free Survival ◽  
Overall Response

Background Patients with locally advanced, recurrent or metastatic solitary fibrous tumour are often treated with bevacizumab and temozolomide based on the clinical efficacy reported in a case series of 14 patients. Given the rarity of solitary fibrous tumour, large trials are not feasible. We report the efficacy of this regimen based on a population-based analysis. Methods This was a population-based retrospective, multi-centre analysis using patient data from a provincial cancer registry and treatment database. Cases from June 2006 through October 2016 were identified for patients receiving bevacizumab and temozolomide for locally advanced, recurrent or metastatic solitary fibrous tumour or hemangiopericytoma, which is sometimes used to describe tumours arising from the meninges. The primary outcome was overall response rate. Secondary outcomes included time to response, progression free survival and overall survival estimated using the Kaplan–Meier method. Results Fourteen patients were identified: median age 59 (range 44–70), male 78.6%. Diagnoses were solitary fibrous tumour in 10 (71.4%) and hemangiopericytoma in four (28.6%), with metastatic disease in 10 (72.7%) patients. The most common primary sites were meninges in four (28.6%) and pelvis in three (21.4%) patients. The median follow-up was 15.5 months, with median treatment of four months. Overall response rate was 21.4% (no complete response, 3 partial response), with median time to response of four months. Median progression free survival, six-month progression free survival and overall survival were 17 months, 65.0%, and 45 months, respectively. Conclusions Efficacy of bevacizumab and temozolomide in solitary fibrous tumour appeared to be similar to that previously reported. Our findings confirmed that bevacizumab and temozolomide is an effective and tolerated treatment for this patient population.

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