Pilot Case Series Research Articles

‘Minds@Work’ Intervention for Job Tenure of Workers Living with Severe Mental Illness: A Feasibility and Acceptability Pilot Case Series

‘Minds@Work’ Intervention for Job Tenure of Workers Living with Severe Mental Illness: A Feasibility and Acceptability Pilot Case Series

High-Intensity Gait Training Intervention for Children With Cerebral Palsy: A Case Series.

The purpose of this pilot case series was to describe participation in high-intensity gait training (HIGT) and changes in (1) gait speed/endurance, (2) aerobic capacity, and (3) walking ability in children diagnosed with cerebral palsy (CP). Three children with CP participated in HIGT for 5weeks in lieu of their routine physical therapy. Outcome measures were collected at baseline and post-intervention. Post-intervention, all had at or above the minimal clinically important difference for 10-m walk test speed and 6-minute walk test distance. Two participants performed above the minimal clinically important difference in 7.5-m shuttle run test level and Gross Motor Function Measure-88 Dimension E score. This case series demonstrates short-term improvements in the walking outcome measures with participation in HIGT. Further research is needed with a larger and more diverse randomized controlled trial to determine parameters and long-term effects of HIGT in this population.

Topical Timolol for Treatment of Spider Angiomas in Children: A Case Series.

We report five cases of spider angiomas in children treated topically with timolol 0.5% (ophthalmic solution or gel-forming solution), for 6 months. Parents and patients were advised to apply one drop twice daily. Four of them showed either partial (2) or complete response (2) and only one patient had no clinical change. No adverse effects were reported. This pilot case series shows that topical timolol may prove useful as a noninvasive, available and well-tolerated treatment option for spider angiomas in children who seek a treatment alternative to pulsed dye laser.

Administration of carperitide in cases of pulmonary edema with preeclampsia: a pilot case series

Administration of carperitide in cases of pulmonary edema with preeclampsia: a pilot case series

Ketamine-assisted buprenorphine initiation: a pilot case series

BackgroundMany people with opioid use disorder who stand to benefit from buprenorphine treatment are unwilling to initiate it due to experience with or fear of both spontaneous and buprenorphine-precipitated opioid withdrawal (BPOW). An effective means of minimizing withdrawal symptoms would reduce patient apprehensiveness, lowering the barrier to buprenorphine initiation. Ketamine, approved by the FDA as a dissociative anesthetic, completely resolved BPOW in case reports when infused at a sub-anesthetic dose range in which dissociative symptoms are common. However, most patients attempt buprenorphine initiation in the outpatient setting where altered mental status is undesirable. We explored the potential of short-term use of ketamine, self-administered sublingually at a lower, sub-dissociative dose to assist ambulatory patients undergoing transition to buprenorphine from fentanyl and methadone.MethodsPatients prescribed ketamine were either (1) seeking transition to buprenorphine from illicit fentanyl and highly apprehensive of BPOW or (2) undergoing transition to buprenorphine from illicit fentanyl or methadone and experiencing BPOW. We prescribed 4–8 doses of sublingual ketamine 16 mg (each dose bioequivalent to 3–6% of an anesthetic dose), monitored patients daily or near-daily, and adjusted buprenorphine and ketamine dosing based on patient response and prescriber experience.ResultsOver a period of 14 months, 37 patients were prescribed ketamine. Buprenorphine initiation was completed by 16 patients, representing 43% of the 37 patients prescribed ketamine, and 67% of the 24 who reported trying it. Of the last 12 patients who completed buprenorphine initiation, 11 (92%) achieved 30-day retention in treatment. Most of the patients who tried ketamine reported reduction or elimination of spontaneous opioid withdrawal symptoms. Some patients reported avoidance of severe BPOW when used prophylactically or as treatment of established BPOW. We developed a ketamine protocol that allowed four of the last patients to complete buprenorphine initiation over four days reporting only mild withdrawal symptoms. Two patients described cognitive changes from ketamine at a dose that exceeded the effective dose range for the other patients.ConclusionsKetamine at a sub-dissociative dose allowed completion of buprenorphine initiation in the outpatient setting in the majority of patients who reported trying it. Further research is warranted to confirm these results and develop reliable protocols for a range of treatment settings.

Pilot Case Series Studying a Psychoeducational and Motivational Treatment for Children With Low-Weight Avoidant Restrictive Food Intake Disorder.

Research on treatments for children with avoidant restrictive food intake disorder (ARFID) is needed. This pilot case series describes outcome data for 20 children ages 6-12 years old with a diagnosis of ARFID and who are low-weight. Participants were recruited nationwide as part of an ongoing randomized clinical trial. All participants in this study received a 14-session psychoeducational and motivational treatment (PMT) protocol. Parents completed measures of ARFID severity (the Pica, ARFID, Rumination Disorder Interview) and parental self-efficacy (Parents vs. ARFID scale). Height and weight were self-reported by parents and percent of estimated body weight (%EBW) was calculated. Assessments occurred at baseline, 1-month within treatment, 2-months within treatment, end-of-treatment (EOT), and 6-month follow-up. Twenty children (10.34 ± 1.76 years; 85% Non-Hispanic; 75% White; 70% female; 84.16 ± 4.66% EBW) with low-weight ARFID and their parents received PMT-ARFID with a clinician specializing in eating disorders. By EOT, PARDI severity scores decreased (large effect size) parental self-efficacy increased (medium effect size), but %EBW remained unchanged. Additional research evaluating PMT in adequately powered clinical trials for youth with ARFID is needed.

Treatment of bacterially contaminated lower extremity ulcers with a fatty acid-containing wound matrix: a case series.

The aim was to evaluate the effectiveness of a marine omega fatty acid-containing multimodal wound matrix (MWM) in reducing bacterial contamination and supporting wound area reduction (WAR) in patients with hard-to-heal wounds of varying aetiologies. A prospective, single-site, pilot case series of patients with hard-to-heal wounds. All wounds were considered non-healing prior to inclusion as they had failed to achieve at least 50% WAR after at least four weeks of standard of care (SoC) treatments. Patients were seen once weekly for wound assessments, matrix application and dressing changes. Baseline and weekly fluorescence images, standard wound images and wound measurements were obtained. A total of three patients, two with venous leg ulcers (VLUs) and one with a diabetic foot ulcer (DFU) were enrolled in this pilot study. The mean baseline wound age prior to study enrolment was 24 weeks, with a mean baseline wound size of 8.61cm2. The two VLUs went on to complete closure. The DFU displayed a total WAR of 53% by six weeks, when the patient was lost to follow-up due to a geographical relocation. The mean percentage area reduction of all wounds combined was 82% upon study completion. The use of MWM proved to be effective and safe in this patient cohort. The wounds included in this case series failed to enter a healing trajectory with SoC wound therapies. The MWM supported wound closure and reduced bacterial loads in this patient cohort.

Poster 169: Preliminary Outcomes of Revision UCL Repair With Suture Tape Augmentation for Failure of Primary UCL Reconstruction in Professional and Collegiate Pitchers

Objectives: Injury of the ulnar collateral ligament (UCL) is common in baseball players and pitchers, in particular. The gold standard surgical treatment has been UCL reconstruction with autograft, although, UCL repair with collagen-coated suture tape has shown promise as an alternative recently. The outcomes of UCL reconstruction and UCL repair are well-studied, demonstrating high rates of return to sport and a predictable postoperative course of recovery. However, revision UCL reconstructions with allografts do not demonstrate comparable outcomes when compared with primary procedures. This pilot case series reports on the preliminary outcomes of collegiate and professional pitchers who underwent revision UCL repair with collagen-coated suture tape following failure of primary UCL reconstruction. Methods: We performed a retrospective query of a prospectively collected data repository to identify patients at our institution who had undergone UCL repair with internal brace. Additional inclusion criteria included: 1) prior failed UCL reconstruction with autograft; 2) aged between 15 and 45 years; 3) at least 1-year post-operative. From the included cohort, we collected demographic, clinical, and surgical data from the electronic health record. We further collected patient-reported outcomes data using either a web-based database platform or via telephone, including the American Shoulder and Elbow Surgeons Elbow assessment form (ASES-E; satisfaction, pain, and function subscales), the Kerlan Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC), Andrews Carson score, and information on return-to-sport timing and success. To evaluate outcomes, we reported the proportions of athletes that were able to successfully return-to-sport at the preinjury level or higher as well as return-to-sport timing and level of competition. Additionally, we reported summary statistics for patient-reported questionnaires evaluated at follow-up (ASES-E, KJOC, and Andrews Carson). Results: A total of 10 patients met inclusion criteria, and all were professional or collegiate pitchers at the time of their revision UCL repair surgery (40% professional and 60% collegiate). The mean follow-up time was 3.0 years (Table 1; range: 1-5 years). Table 1 shows complete return-to-sport data. All patients were able to return-to-sport at the same or higher level, and the mean time from surgery to return-to-sport was 9.3 months. Table 2 shows complete patient-reported outcomes data. Mean scores on elbow-related function questionnaires were high (ASES-E Function = 35.8 out of a maximum best of 36; KJOC = 88.3 out of a maximum best of 100; Andrews Carson = 94.5 out of a maximum best of 100) and mean pain scores were low (ASES-E Pain = 1 out of a maximum worst score of 50). Conclusions: This pilot case series demonstrated promising results of a novel UCL repair approach utilizing collagen-coated suture tape for high-level pitchers with recurrent medial elbow instability following initial UCL reconstruction with autograft. Specifically, we found excellent return-to-sport success and patient-reported outcomes in this preliminary cohort. Further study is warranted with larger sample sizes to further evaluate outcomes following revision of UCL reconstruction with UCL repair utilizing internal bracing.

Combination of anodal tDCS of the cerebellum with a goal-oriented motor training to treat cervical dystonia: a pilot case series.

Transcranial Direct Current Stimulation (tDCS) of the cerebellum shows promise for the treatment of dystonia. Specific motor rehabilitation programs have also been developed in this context. However, the combination of these two approaches has not yet been evaluated to determine their therapeutic potential. We report a series of 5 patients with cervical dystonia (CD) poorly controlled by botulinum toxin injections. They were initially treated by a protocol of repeated daily sessions (for 3 or 5 days) of cerebellar anodal tDCS (cer-atDCS) applied alone. In a second time, additional protocols of cer-atDCS were performed in combination with a program of goal-oriented motor training exercises (Mot-Training), specifically developed for the treatment of CD. The clinical impact of the procedures was assessed on the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Compared to baseline, the maximum percentage of TWSTRS total score improvement was 37% on average after cer-atDCS performed alone (p = 0.147, not significant) and 53% on average after cer-atDCS combined with Mot-Training (p = 0.014, significant). The TWSTRS pain and functional handicap subscores also improved after the combined protocol. A score of (+3) to (+5) was rated on the TWSTRS response scale after cer-atDCS performed alone or the combined protocol, corresponding to a moderate to striking improvement on dystonia and pain. This improvement lasted longer after the combined protocol than after cer-atDCS alone (3.4 vs. 1.4 months on average, p = 0.011). The combination of cer-atDCS with Mot-Training produced a greater and more prolonged improvement than the application of cer-atDCS alone. Such a combined therapeutic procedure is easy to perform and opens important perspectives in the long-term treatment of CD. These results remain to be confirmed by a randomized sham-controlled trial on a larger sample.

Co-designing behavioural activation for depression for autistic adolescents: A case series.

Autistic youth are at high risk of depression, but there are few psychological interventions that have been specifically designed for use with this population. Behavioural activation (BA) is a particularly promising approach for autistic adolescents, having an established evidence-base for the treatment of depression in non-autistic people, and with a strong focus on behavioural, rather than cognitive change, which is a challenge for some autistic people. In this study, we worked with autistic adolescents and clinicians to co-design a BA-informed intervention to be delivered in an online format. We then conducted a pilot case-series with seven autistic adolescents with depression. Our focus was on establishing the acceptability and feasibility of the intervention but clinical outcomes on both self- and parent-reported symptoms of depression and anxiety are also presented. Our results indicate the intervention to be acceptable and feasible for autistic adolescents, with six out of seven participants being retained to the end of the intervention. Qualitative feedback indicated that all participants found the intervention a positive experience and would recommend it to others. Similarly, all participants found the online format acceptable, with 64% preferring this format to face-to-face therapy. Qualitative feedback and suggestions for refinement will also be discussed.

Preoperative Virtual Reality to Expose Patients With Breast Cancer to the Operating Room Environment: Feasibility and Pilot Case Series Study.

Clinically elevated preoperative distress and anxiety are common among patients undergoing cancer surgery. Preoperative interventions have been developed to mitigate this distress and anxiety but are inconsistent in efficacy and feasibility for broad implementation. This preliminary pilot study aims to assess the feasibility and utility of a newly developed virtual reality (VR) intervention to expose patients awaiting breast cancer surgery to the operating room environment and a simulation of anesthetic induction. Patients undergoing breast cancer surgery (N=7) were assigned to the VR intervention or control (treatment as usual) group and completed self-report measures of distress and anxiety before surgery, on the day of surgery, and after surgery (5 and 30 d postoperatively). Those in the intervention group trialed the VR simulation 1 to 2 weeks preoperatively and provided qualitative and quantitative feedback. We assessed the feasibility of recruitment capability and study design and evaluated participants' impressions of the intervention using self-report rating scales and open-ended questions. We also descriptively examined distress and anxiety levels throughout the duration of the study. Recruitment occurred between December 2021 and December 2022 and progressed slowly (rate: 1 participant/7 wk on average; some hesitancy because of stress and being overwhelmed). All participants who consented to participate completed the entire study. All participants were female and aged 56 (SD 10.56) years on average. In total, 57% (4/7) of the participants were assigned to the intervention group. On average, intervention participants spent 12 minutes engaged in the VR simulation. In general, the intervention was rated favorably (eg, clear information, enjoyable, and attractive presentation; mean% agreement 95.00-96.25, SD 4.79-10.00) and as helpful (mean% agreement 87.50, SD 25.00). Participants described the intervention as realistic (eg, "It was realistic to my past surgical experiences"), impacting their degree of preparedness and expectations for surgery (eg, "The sounds and sights and procedures give you a test run; they prepare you for the actual day"), and having a calming or relaxing effect (eg, "You feel more relaxed for the surgery"). This preoperative VR intervention demonstrated preliminary feasibility among a sample of patients undergoing breast cancer surgery. Results and participant feedback will inform modifications to the VR intervention and the study design of a large-scale randomized controlled trial to examine the efficacy of this intervention. ClinicalTrials.gov NCT04544618; https://clinicaltrials.gov/study/NCT04544618.

Monitoring the Effect of Continuous Topical Oxygen Therapy With Near-Infrared Spectroscopy: A Pilot Case Series in Wound Healing

Background. Sufficient oxygen is critical for multiple processes in wound healing. Nonhealing wounds have low tissue oxygen levels due to damaged microvasculature and comorbidities limiting tissue perfusion. Hypoxia may be reversed using continuous topical oxygen therapy (cTOT). Objective measures to identify and track hypoxic wounds and their response to adjunctive oxygen are key. Objective. To understand the effect of cTOT on recalcitrant wounds by tracking wound area and changes in tissue oxygenation using a near-infrared spectroscopy (NIRS) device. Materials and Methods. Five patients with nonhealing wounds received treatment with cTOT over 5 weeks. Routine wound measures and tissue oxygenation were recorded over that period. Results. Reductions in wound area and improvements in tissue oxygenation were seen in all 5 patients, with 3 patients healing within 5 weeks despite the previous long duration of their wounds. Trends in tissue oxygenation and relative wound surface area over the treatment period demonstrated a reduction in wound area as tissue oxygenation improved. Conclusion. This case series reinforces previous studies that cTOT is an effective, noninvasive treatment as a key adjunct to standard care in nonhealing wounds. Moreover, point-of-care tools such as the NIRS imaging device provided objective information concerning tissue oxygenation improvements, thus giving useful insights to the clinician.

Magnetic Resonance Imaging–Aided SmartFlow Convection Delivery of DNX-2401: A Pilot, Prospective Case Series

The Combination Adenovirus+ Pembrolizumab to Trigger Immune Virus Effects (CAPTIVE) study is a phase II clinical trial testing the efficacy of a recombinant adenovirus DNX-2401 combined with the immune checkpoint inhibitor pembrolizumab. Here, we report the first patients in this study who underwent viral delivery through real-time magnetic resonance imaging (MRI) stereotaxis-guided SmartFlow convection delivery of DNX-2401. Patients who underwent real-time MRI-guided DNX-2401 delivery through the SmartFlow convection catheter were prospectively followed. Precise catheter placement was achieved in all patients treated, and no adverse events were noted. Average radial error from target was 0.9 mm. Average procedural time was 3 hours 16 minutes and was comparable to other convection-enhanced delivery techniques. In 2 patients, delivery of DNX-2401 was visualized as >1 cm maximal diameter of T1 hypointensity infusate on MRI obtained immediately after completion of viral infusion. These patients exhibited partial response based on Response Assessment in Neuro-Oncology assessment. The remaining patient showed <1 cm maximal diameter of infusate on immediate postinfusion MRI and showed disease progression on subsequent MRI. Our pilot case series supports compatibility of the SmartFlow system with oncolytic adenovirus delivery and provides the basis for future validation studies.

A Systemic and Local Comparison of Senescence in an Acute Anterior Cruciate Ligament Injury-A Pilot Case Series.

Senescence, a characteristic of cellular aging and inflammation, has been linked to the acceleration of osteoarthritis. The purpose of this study is to prospectively identify, measure, and compare senescent profiles in synovial fluid and peripheral blood in patients with an acute knee injury within 48 h. Seven subjects, aged 18-60 years, with an acute ACL tear with effusion were prospectively enrolled. Synovial fluid and peripheral blood samples were collected and analyzed by flow cytometry, using senescent markers C12FDG and CD87. The senescent versus pro-regenerative phenotype was probed at a gene and protein level using qRT-PCR and multiplex immunoassays. C12FDG and CD87 positive senescent cells were detected in the synovial fluid and peripheral blood of all patients. Pro-inflammatory IL-1β gene expression measured in synovial fluid was significantly higher (p = 0.0156) than systemic/blood expression. Senescent-associated factor MMP-3 and regenerative factor TIMP-2 were significantly higher in synovial fluid compared to blood serum. Senescent-associated factor MMP-9 and regenerative factor TGFβ-2 were significantly elevated in serum compared to synovial fluid. Correlation analysis revealed that C12FDG++/CD87++ senescent cells in synovial fluid positively correlated with age-related growth-regulated-oncogene (ρ = 1.00, p < 0.001), IFNγ (ρ = 1.00, p < 0.001), IL-8 (ρ = 0.90, p = 0.0374), and gene marker p16 (ρ = 0.83, p = 0.0416). There is an abundance of senescent cells locally and systemically after an acute ACL tear without a significant difference between those present in peripheral blood compared to synovial fluid. This preliminary data may have a role in identifying strategies to modify the acute environment within the synovial fluid, either at the time of acute ligament injury or reconstruction surgery.

Blue light laser recontouring for pediatric benign fibrovascular vocal fold lesions

Up to 40% of children with hoarseness due to benign fibrovascular vocal fold lesions do not respond to voice therapy and could benefit from further intervention to improve their communication abilities. Currently there are limited surgical options for children too young to comply with post-operative voice rest. We have begun using the 445 nm laser to recontour benign fibrovascular vocal fold lesions without post-operative voice rest in young children with hoarseness due to vocal fold nodules that is unresponsive to voice therapy. This report presents pilot data on the effect of this treatment on pediatric voice-related quality of life.Pediatric patients with benign fibrovascular lesions and severe subjective dysphonia (per parents or teachers) were given the option of undergoing surgery or continuing voice therapy. Those that opted for surgery underwent 445 nm laser recontouring of their vocal folds. They were discharged home the same day with no voice rest required. Pre- and post-demographic, acoustic measures, auditory perceptual assessments, and validated patient quality of life measures were collected.Four patients (ages 3-8y, all male) were selected for surgery. The mean pre- and post-op PVRQOL scores were 59.4 (range: 22.5-80) and 98.1 (range: 97.5-100), respectively (low scores suggest lower voice-related QOL), and a mean change of 38.8 (previously established minimum clinically important difference: 12). Pre- and post-acoustic and aerodynamic measures similarly reflected this improvement.This pilot case series addresses a commonly seen population (children with benign fibrovascular lesions and significant dysphonia despite voice therapy) where the best practice for timing and types of surgical intervention is unclear. Photoangiolytic lasers (including the 445 nm laser) are gaining popularity for the treatment of benign laryngeal pathologies, and their use may expand treatment possibilities for children with severe dysphonia due to benign vocal fold lesions that do not respond to voice therapy. Further longitudinal investigations are necessary to confirm the safety and efficacy.

Amantadine in Treatment of Dysthymia-The Pilot Case Series Study.

Dysthymia is a common chronic mood disorder in which isolated symptoms of depression persist for at least 2 years. Despite the many medications recommended for the treatment of dysthymia, no recommendations have yet been made for the treatment of patients who fail to achieve clinical improvement. This justifies attempts to identify second-line drugs for the treatment of dysthymia. In an open and naturalistic case study, five patients diagnosed with dysthymia in whom at least one antidepressant treatment was ineffective were treated with amantadine. In the age- and gender-matched external control group, patients were treated with sertraline at 100 mg/day. Depressive symptoms were assessed using HDRS-17. Two men and three women were treated with 100 mg amantadine for 3 months with 3-5 months follow-up. After 1 month of treatment with amantadine, a significant reduction in the intensity of depressive symptoms was achieved in all patients, and the clinical improvement increased over the next 2 months of treatment. No deterioration in well-being was observed in any patient after discontinuation of amantadine. The effect of amantadine treatment was comparable to that of sertraline treatment in patients with dysthymia who improved with this drug. The present study indicates that amantadine is an effective and well-tolerated drug in the treatment of dysthymia. Amantadine may be associated with a quick improvement in symptoms in the treatment of dysthymia. Treatment with this drug seems to be associated with good tolerability and persistency of the therapeutic effect after the discontinuation of the treatment.

A pilot case series for concurrent validation of inertial measurement units to motion capture in individuals who use unilateral lower-limb prostheses.

Inertial measurement units (IMUs) may be viable options to collect gait data in clinics. This study compared IMU to motion capture data in individuals who use unilateral lower-limb prostheses. Participants walked with lower-body IMUs and reflective markers in a motion analysis space. Sagittal plane hip, knee, and ankle waveforms were extracted for the entire gait cycle. Discrete points of peak flexion, peak extension, and range of motion were extracted from the waveforms. Stance times were also extracted to assess the IMU software's accuracy at detecting gait events. IMU and motion capture-derived data were compared using absolute differences and root mean square error (RMSE). Five individuals (n = 3 transtibial; n = 2 transfemoral) participated. IMU prosthetic limb data was similar to motion capture (RMSE: waveform ≤4.65°; discrete point ≤9.04°; stance ≤0.03s). However, one transfemoral participant had larger differences at the microprocessor knee joint (RMSE: waveform ≤15.64°; discrete ≤29.21°) from IMU magnetometer interference. Intact limbs tended to have minimal differences between IMU and motion capture data (RMSE: waveform ≤6.33°; discrete ≤9.87°; stance ≤0.04s). Findings from this pilot study suggest IMUs have the potential to collect data similar to motion capture systems in sagittal plane kinematics and stance time.

Preoperative n-BCA embolization in the resection of submandibular lymphatic malformations refractory to sclerotherapy treatment: A pilot case series.

Lymphatic malformations in the submandibular neck pose unique challenges to treatment that elevate their risk of recurrence. This case series provides a review of five patients, previously treated with sclerotherapy or with a history of multiple infections, who were treated in a novel fashion: single-stage resection using preoperative n-butyl cyanoacrylate (n-BCA) glue embolization. We performed a retrospective medical record review of five patients who underwent single-stage n-BCA embolization by Interventional Radiology followed by surgical resection by Otolaryngology, including a review of their symptoms, previous treatments, and post-treatment surveillance, with follow-up ranging from 4 to 24 months after the treatment of interest. All study subjects had unremarkable perioperative courses, and four patients did not demonstrate any evidence of disease recurrence or persistence during the follow-up period. One patient was found to have a small area of persistent disease on post-treatment imaging, but has remained symptom free. Treatment of submandibular lymphatic malformations with n-BCA embolization followed by surgical resection can be performed in a single stage. This case series demonstrates that this approach can yield durable relief of symptoms, even in patients whose lesions were refractory to previous treatments.

Research Highlights.

Research Highlights.

Early intervention in post-traumatic stress disorder without exposure to trauma memories using internet-delivered cognitive therapy: A pilot case series.

Trauma-focussed psychological interventions are the treatments of choice for post-traumatic stress disorder (PTSD). As many clinical services receive high demand for PTSD interventions, strategies to improve treatment efficiency are needed. Some people seek help in the early phase post-trauma, including as soon as the first few months. It is unclear whether all components of trauma-focussed CBT are needed in this initial stage. Providing brief intervention in this early phase without work on trauma memories may be feasible and effective. This service evaluation study describes a case series of five participants experiencing PTSD following recent traumas. Participants completed a shortened 6-week form of Internet-delivered Cognitive Therapy for PTSD (iCT-PTSD), which used fewer treatment modules and focussed primarily on psychoeducation about PTSD, and two key treatment components, 'reclaiming your life' and trigger discrimination. Unlike the full course of iCT-PTSD, this format did not include working directly with trauma memories. The intervention was associated with large reductions in symptoms of PTSD, depression and anxiety at the 6-week timepoint, which were maintained at 3-month follow-up. Scores on the composite PTSD measure showed an average reduction of 91% between baseline and end of follow-up. One client required an extension to the weekly phase of treatment and received further treatment modules. All were discharged after follow-up and did not require further treatment. The findings provide preliminary evidence that this briefer format of iCT-PTSD was of benefit for those seeking support following recent traumas. Further examination in a larger controlled study is required.