Group treatment for postpartum depression: a pilot study

OBJECTIVE: There are few reports on the efficacy of treatment programs for women with postpartum depression, despite the long-term nature of this disorder. This study describes a pilot evaluation of a treatment program with educational, social support and cognitive-behavioural components. METHOD: Ten women with persistent depression originating in the postpartum period were offered a 10-week group treatment program and compared to a wait-list control group. RESULTS: Following treatment, a significant improvement in depression was demonstrated on the Edinburgh Post-Natal Depression Scale, Beck Depression Inventory, and Profile of Mood States. Several common factors in women suffering from postpartum depression were also identified, as were drop-out characteristics. CONCLUSION: These results are encouraging and suggest that a cognitive-behavioural group program might be effective as a treatment for depression in the postpartum period. However, further detailed studies are required to conform this pilot study.     

Prophylactic treatment for hemophilia A patients: a pilot study

Prophylactic treatment with factor VIII concentrate was given to six hemophilia A boys whose factor VIII:C ranged from 1% to 3.5% at Ramathibodi Hospital. The age ranged from 11 to 16 years with the median age of 12 years old. Each patient received factor VIII concentrate twice a week in the dosage of 8-10 unit per kg for one year. During the prophylactic period, bleeding episodes seldom occurred. They did not need hospitalization. The absence from school was reduced. They became muscular from regular daily exercise. They could join the activity at school and lived a near normal life. The patients and family were very happy since they did not have to worry about bleeding. No adverse effect was found. The only constraint was the cost. It cost 180,000 baht (US$ 7,200) per year or 15,000 baht (US$ 600) per month for a 25 kg hemophiliac boy.     

Pneumatization of the middle nasal turbinate: a CT study

Anatomic variations of the middle turbinate may be an important factor in the pathogenesis of inflammatory processes of the paranasal sinuses. A detailed analysis of coronal and axial plane CT scans of the paranasal sinuses obtained from 120 patients was performed. Paradoxical curve of the middle concha was detected in 24.2% of patients. Pneumatized middle turbinate was found in 42.5% and "true" concha bullosa in 8.3% of patients. Bilateral concha bullosa was found in 1.7% of patients.     

Fluoxetine treatment for dually diagnosed methadone maintained opioid addicts: a pilot study

Twenty-two methadone maintained opioid addicts with either depression or persistent cocaine use received open label fluoxetine in addition to their methadone. Fluoxetine significantly decreased depressive symptoms from pre-treatment to endpoint in subjects with depression, while its effect on substance use was inconclusive.     

Equatorial breast reduction: a new technique for the correction of moderate-to-large mammary hypertrophy

The author describes a personal technique for moderate-to-large breast hypertrophy, regardless of the degree of ptosis, based upon a personal experience of more than 200 breast reductions. It is a superior monopedicle nipple-areola flap procedure, which leaves an inverted-T scar. It was used in 35 cases over the last 3 years involving tissue reductions ranging from 500 to 1950 g per gland. All patients underwent follow-up evaluations 1, 3, 6, and 12 months after surgery. No complications were observed, and areolar sensation was preserved in all cases. Apart from its effectiveness in cases of massive hypertrophy and the absence of difficulties related to elevation of the nipple-areola complex, the equatorial technique offers the significant advantages of a simple preoperative marking phase and well-defined, reproducible parameters for reduction and reshaping. These characteristics reduce the need for subjective judgment and, therefore, the risk of error. The results obtained are highly satisfactory in terms of volume reduction, form, and symmetry.     

Radiofrequency tissue ablation: increased lesion diameter with a perfusion electrode

RATIONALE AND OBJECTIVES: We sought to induce large zones of coagulation necrosis using radiofrequency (RF) with perfusion electrodes and to define optimal parameters for this system. METHODS: We developed RF electrodes with internal cannulas to enable tip perfusion. Lesions were created with monopolar RF in ex vivo and in vivo liver and muscle tissue with and without perfusion of the electrode tip using 0 degree C saline. In separate experiments, wattage, current, procedure duration, tip exposure, and perfused tip temperatures were studied. RESULTS: In ex vivo liver tissue, a maximum lesion diameter of 3.1 cm without charring occurred with perfusion at 12 min and 50 W. In in vivo liver tissue with perfusion (tip temperature = 25-35 degrees C) and a 3-cm tip exposure, 80 W were deposited in muscle tissue and 65 W in liver tissue for 12 min without inducing charring. Lesion diameters were 4.5 cm and 2.4 cm, respectively. By comparison, without perfusion a maximum of 20 W could be deposited into either tissue type, resulting in 1.8-cm muscle lesions and 1.2-cm liver lesions. Tip temperatures between 45 degrees C and 55 degrees C resulted in charring. Smaller but predictable lesion diameters were created with a lower power, a shorter tip exposure, or both. Of all the parameters, diameter correlated best with the current applied. CONCLUSION: Perfusion of RF electrodes with chilled saline allows for increased power deposition without tissue charring, increasing the volume of coagulation necrosis created with a single electrode insertion. Perfusion electrodes therefore might decrease the number of probe insertions required for percutaneous tumor ablation therapy or allow for the treatment of larger lesions.     

Bilingual effects of unilingual neuropsychological treatment of dyslexic adolescents: a pilot study

Fourteen young adolescents with specific reading disabilities received short term neuropsychological treatment--specifically left hemisphere (LH) or right hemisphere (RH) stimulation--in a clinical pilot project. The effects on single-word and passage reading were evaluated when the language of treatment was either Dutch (mother tongue) or English (foreign language). Transfer effects across the two languages were also studied. In general, the results indicate that these short term interventions may prove successful for the treated language and with the additional transfer to a second (not treated) language.     

Topical clonidine for orofacial pain: a pilot study

BACKGROUND: To preserve postoperative digestive function in patients with esophageal carcinoma, jejunal or colonic segments on long vascular pedicles are transplanted and anastomosed between the esophagus and residual stomach. A postoperative survey showed pedicled jejunum transplantation to be superior in terms of digestive and absorptive functions, intraesophageal pressure, pH, and the quality of life of long-term postoperative survivors. Anastomotic leakage and necrosis of the pedicled intestinal graft are occasional complications; circulatory disorders of the pedicled intestine are a probable cause of both complications. STUDY DESIGN: To simulate pedicled jejunum transplantation, we prepared pedicled colonic segments from dogs and measured blood flow volume at the cut end of the oral side of the colonic segments using the hydrogen clearance method and at the nutrient vascular pedicle with an electromagnetic blood flowmeter. RESULTS: Resection of excess colon increased blood flow volume per unit weight of the colonic segment. CONCLUSIONS: It is essential to resect excess intestine and keep only the minimum length of pedicled intestinal graft needed for reconstruction of the esophagus.     

Comparative results of thrombolysis treatment with rt-PA and urokinase: a pilot study

AlphaT3-1 cells showed a slope resistance of 1.8 Gomega. The cell membrane surface was not smooth and a scanning electron micrograph showed a complex structure with blebs and microvilli like projections. The cells showed spontaneous fluctuations at zero current resting membrane potential and hyperpolarization increased the amplitude of membrane potential fluctuations. The amplitude of membrane potential fluctuations at hyperpolarized membrane potential was attenuated on application of TTX to the bath solution. The potential at which half steady state inactivation of isolated sodium current occurred, was at a very hyperpolarized potential (-95.4 mV). The study presented in this paper shows that the voltage gated sodium channels contribute to the increase in the amplitude of electrical noise with hyperpolarization in alphaT3-1 cells.     

Culture-responsive one-session treatment for phobic Asian Americans: A pilot study.

In this pilot trial, 15 phobic Asian Americans were randomly assigned to standard one-session treatment (OSTS), culturally adapted one-session treatment (OST-CA), or manualized self-help. At posttreatment, OST (combined standard and culturally adapted) led to greater reductions in phobic avoidance and anxiety than self-help. Moreover, analyses comparing the two active treatments showed trends favoring OST-CA over OST-S. Results suggest that Asian Americans may benefit most from empirically supported treatments that consider Asian cultural values. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intraarterial vs intravenous administration of antivenin for the treatment of Crotalidae atrox envenomation: a pilot study

OBJECTIVE: Standard therapy for significant snake envenomation includes antivenin. i.v. administration is currently the only recommended route. Intraarterial (i.a.) administration has potential advantages over i.v. that could improve outcome. To study this, the authors compared i.v. and i.a. antivenin administrations for the treatment of experimental snake envenomations. METHODS: 14 adult female swine were anesthetized and prepared with femoral artery and ear vein catheters, and baseline hoof, forearm, and thigh circumference and volume displacement measurements were taken. Crotalidae atrox venom was injected into the subcutaneous tissue of the hoof. The doses of venom were 4.75, 9.50, 19.00, 37.90, 47.30, 56.90, and 66.40 mg. Immediately following injection of venom, polyvalent antivenin (Crotalidae) (0.285 mg/10 mL saline) was infused over 30 minutes into the femoral artery (i.a. group) or ear vein (i.v. group). As a control, 10 mL of saline was infused into the ear vein (i.a. group) or femoral artery (i.v. group). Measurements were recorded up to 48 hours. Linear mixed-effect regression models were used for each measurement and to compare the i.a. and i.v. groups. RESULTS: Venom dose and time after administrations were associated with increased circumferences and increased volumes (p < 0.05). i.v. administration was associated with larger hoof (1.26 cm) and forearm (0.42 cm) sizes and volume displacement (21.71 mL) when compared with i.a. administration ( p < 0.05). CONCLUSION: i.a. antivenin results in a modest but significant decrease in tissue edema when compared with i.v..     

Diltiazem slow-release and left-ventricular hypertrophy: a volumetric approach of left ventricular mass using magnetic resonance imaging

AIMS: This study was designed to assess the changes in left ventricular mass (LVM) in hypertensive patients with left ventricular hypertrophy under drug therapy with once-daily slow-release diltiazem. Magnetic resonance imaging (MRI) was used for this purpose because of its higher reproducibility than M-mode or two-dimensional echocardiography. METHODS: Patients suffering from essential hypertension were included if their baseline LVM index (LVMI) was > or = 105 g/m2 in male or > or = 85 g/m2 in female patients, ie, equal or higher to the median values observed in hypertensive patients in our institution. MRI consisted in a true short-axis, electrocardiogram (ECG) gated spin-echo slice acquisition at baseline, after 3 and 6 months of therapy (M0, M3, and M6). Data were stored on magnetic tapes and read subsequently under blind conditions and the control of an external auditor. RESULTS: Thirty-five patients were included. Of these, 14 patients (40%) were not previously treated. Inter- and intra-observer variability for LVMI measurement were 5.6 +/- 4.3% and 2.1 +/- 3.0%, respectively. Mean baseline LVMI was 110 +/- 16 g/m2 in male and 96 +/- 16 g/m2 in female patients. It decreased by 3.6% at M3 (P = 0.05) and by 6.0% at M6 (P = 0.02). A trend towards a greater LVMI reduction was observed in previously untreated patients. CONCLUSION: This study confirms that MRI is a reproducible technique for the measurement of LVM. It demonstrates a significant reduction in LVMI as early as the 3rd month of therapy in hypertensive patients treated with once-daily sustained release (SR) diltiazem, although baseline LVMI in the majority of participating patients was only moderately increased.     

Ursodeoxycholic acid for treatment of cholestasis in children on long-term total parenteral nutrition: a pilot study

BACKGROUND & AIMS: Cholestatic liver disease (CLD) is a frequent and sometimes fatal complication of total parenteral nutrition (TPN) that may require withdrawal of TPN. The aim of this pilot study was to evaluate ursodeoxycholic acid (UDCA) as treatment of TPN-associated CLD. METHODS: Seven children (4 boys and 3 girls) undergoing long-term TPN because of intractable diarrhea syndrome developed cholestasis and were treated with UDCA. Treatment efficacy was evaluated by monitoring clinical and biochemical markers of CLD, including gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), conjugated bilirubin, and alanine aminotransferase (ALT). RESULTS: In all children, UDCA was associated with the disappearance of signs of CLD and with normalization of biochemical markers of cholestasis within 4-8 weeks. A rebound increase of GGT, ALP, and ALT serum levels was observed in 3 children in whom UDCA was temporarily discontinued while they were still undergoing TPN. However, after reinstitution of UDCA, markers of cholestasis normalized in all cases. UDCA was withdrawn on reinstitution of full oral feeding; there was no relapse of cholestasis. Six children fully recovered. One child died because of the lack of vascular access. CONCLUSIONS: UDCA appears to be an effective treatment for TPN-related cholestasis in children.     

Validity of a perceived exertion scale for children: a pilot study

The purpose of this study was to examine the validity of a recently developed rating scale of perceived exertion, the Children's Effort Rating Table (CERT), for controlling exercise intensity in young children. 16 children (M age = 9.9 yr., SD = 1.2) performed three separate exercise tests on a mechanically braked cycle ergometer. Stage I (response protocol) consisted of a graded test with heart rate and perceived effort rating recorded in response to specified steady-state work outputs. Stage II (production protocol) examined subjects' ability to produce work outputs corresponding to levels 5, 7, and 9 of the CERT. This protocol was repeated on a further occasion (Stage III) to assess the reliability of the findings. Pearson correlations between ratings and heart rate (0.76) and ratings and work output (0.75) highlight the potential of the scale as a valid measure of exercise intensity. Also, the work rates produced by subjects in Stage II correlated 0.89 with those predicted from Stage I; however, analysis of variance showed that work output was significantly lower in Stage II than predicted. Finally, an intraclass correlation of 0.91 between Stages II and III suggests that the scale gave a reliable estimate of exercise intensity of children. The findings from this pilot study suggest that children's perceptions of effort might be used to guide intensity of exercise during structured activity classes.     

Intratumoral cisplatin/epinephrine-injectable gel as a palliative treatment for accessible solid tumors: a multicenter pilot study

Intratumoral injections of cisplatin/epinephrine-injectable gel were administered weekly for 4 weeks in 45 patients with malignant tumors of various histologic types. Tumors were located on the skin and subcutaneous tissue primarily of the head, neck, and trunk, and on the tongue, oral pharynx, and esophagus. Patients were not candidates for surgery, radiation, or systemic chemotherapy. Each of the treated tumors (n = 82) was evaluated 2, 4, 8, and 12 weeks after the final injection. The initial dose of cisplatin was 1 mg/cm3 tumor volume, with escalation to 6 mg/cm3 allowed, depending on observed toxicities. The mean cumulative dose per patient for the four treatments ranged from 0.56 to 380 mg cisplatin. No dose-limiting cisplatin-related toxicities, such as nephrotoxicity, neurotoxicity, or ototoxicity, were observed. The overall objective tumor response rate was 50% (41 of 82), with 40% (33 of 82) complete responses and a median response duration of 160 days. Complete responses for adenocarcinoma and squamous cell carcinoma were 58% (21 of 36) and 38% (12 of 32), respectively. These results justified further clinical trials to evaluate the role of local chemotherapy with intratumoral cisplatin/epinephrine-injectable gel in the palliative treatment of patients with selected accessible solid tumors.     

A pilot study of a short cognitive-behavioral group treatment for female recurrent suicide attempters

The SLT2(MPK1) mitogen-activated protein kinase signal transduction pa thway has been implicated in several biological processes in Saccharomyces cerevisiae, including the regulation of cytoskeletal and cell wall structure, polarized cell growth, and response to nutrient availability, hypo-osmotic shock and heat shock. We examined the conditions under which the SLT2 pathway is activated. We found that the SLT2 kinase is tyrosine phosphorylated and activated during periods in which yeast cells are undergoing polarized cell growth, namely during bud formation of vegetative cell division and during projection formation upon treatment with mating pheromone. BCK1(SLK1), a MEK kinase, is required for SLT2 activation in both of these situations. Upstream of BCK1(SLK1), we found that the STE20 kinase was required for SLT2 activation by mating pheromone, but was unnecessary for its activation during the vegetative cell cycle. Finally, SLT2 activation during vegetative growth was partially dependent on CDC28 in that the stimulation of SLT2 tyrosine phosphorylation was significantly reduced directly after a temperature shift in cdc28 ts mutants. Our data are consistent with a role for SLT2 in promoting polarized cell growth.     

Mindfulness-based stress reduction as a method for personnel development: A pilot evaluation.

Mindfulness-Based Stress Reduction (MBSR) is a potential candidate for learning to cope with stress in a high-stress professional environment. In a pilot study the authors evaluated the potential of MBSR for stress management. Workers participated in an MBSR training for stress-related problems (treatment, n = 12) or waited for such a course (control, n = 11). The authors conducted interviews and measured coping and well-being. Qualitative interviews indicated that subjects had attained more awareness of work-related problems contributing to stress and had grown more critical toward their work environment. In the treatment group, positive strategies of coping with stress increased and negative strategies of coping decreased (significant difference at post treatment: p = .039 compared to control). Eighty-two percent of the participants reported having reached their personal goal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief treatment for young substance abusers: A pilot study in an addiction treatment setting.

The present study evaluated a motivationally based, 4-session outpatient intervention for young substance abusers presenting for addiction treatment. Follow-up interviews were conducted 6 months after assessment on (a) clients who sought additional help (n = 22) and (b) clients who did not seek additional help (n = 28). Results indicated that (a) participating in an assessment and brief intervention was associated with reduced use and consequences and increased confidence in high-risk situations up to 6 months after entry into the program, and (b) clients who participated in additional treatment showed less of a decrease in substance-related consequences. These findings suggest that brief interventions can serve as either a stand-alone intervention for individuals who need short-term assistance or a first-step intervention for those with more specialized or long-term needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A pilot study of L-methionine for the treatment of AIDS-associated myelopathy

The pathogenesis of AIDS-associated vacuolar myelopathy (VM) may be related to abnormality of transmethylation mechanisms in the nervous system. To evaluate the safety and potential efficacy of the methyl-group donor L-methionine in AIDS-associated VM, we conducted a pilot clinical trial in 12 patients with VM. Seven of the nine patients who completed the study had clinical and electrophysiologic improvement. Controlled studies may be indicated to assess the efficacy and safety of L-methionine in AIDS-associated VM.