Distinguishing bipolar from unipolar depression: the importance of clinical symptoms and illness features

BackgroundDistinguishing bipolar disorder (BP) from major depressive disorder (MDD) has important relevance for prognosis and treatment. Prior studies have identified clinical features that differ between these two diseases but have been limited by heterogeneity and lack of replication. We sought to identify depression-related features that distinguish BP from MDD in large samples with replication.MethodUsing a large, opportunistically ascertained collection of subjects with BP and MDD we selected 34 depression-related clinical features to test across the diagnostic categories in an initial discovery dataset consisting of 1228 subjects (386 BPI, 158 BPII and 684 MDD). Features significantly associated with BP were tested in an independent sample of 1000 BPI cases and 1000 MDD cases for classifying ability in receiver operating characteristic (ROC) analysis.ResultsSeven clinical features showed significant association with BPI compared with MDD: delusions, psychomotor retardation, incapacitation, greater number of mixed symptoms, greater number of episodes, shorter episode length, and a history of experiencing a high after depression treatment. ROC analyses of a model including these seven factors showed significant evidence for discrimination between BPI and MDD in an independent dataset (area under the curve = 0.83). Only two features (number of mixed symptoms, and feeling high after an antidepressant) showed an association with BPII versus MDD.ConclusionsOur study suggests that clinical features distinguishing depression in BPI versus MDD have important classification potential for clinical practice, and should also be incorporated as ‘baseline’ features in the evaluation of novel diagnostic biomarkers.

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A Comparative Study on the Clinical Features of Coronavirus 2019 (COVID-19) Pneumonia With Other Pneumonias

Clinical Infectious Diseases ◽

10.1093/cid/ciaa247 ◽

2020 ◽

Vol 71 (15) ◽

pp. 756-761 ◽

Cited By ~ 95

Author(s):

Dahai Zhao ◽

Feifei Yao ◽

Lijie Wang ◽

Ling Zheng ◽

Yongjun Gao ◽

...

Keyword(s):

Clinical Features ◽

Clinical Symptoms ◽

Severe Pneumonia ◽

Ground Glass Opacity ◽

Chest Ct ◽

Rt Pcr ◽

Bilateral Involvement ◽

Radiological Features ◽

History Of ◽

Novel Coronavirus

Abstract Background A novel coronavirus (COVID-19) has raised world concern since it emerged in Wuhan, China in December 2019. The infection may result in severe pneumonia with clusters of illness onsets. Its impacts on public health make it paramount to clarify the clinical features with other pneumonias. Methods Nineteen COVID-19 and 15 other patients with pneumonia (non-COVID-19) in areas outside of Hubei were involved in this study. Both COVID-19 and non-COVID-19 patients were confirmed to be infected using throat swabs and/or sputa with/without COVID-2019 by real-time RT-PCR. We analyzed the demographic, epidemiological, clinical, and radiological features from those patients, and compared the differences between COVID-19 and non-COVID-19. Results All patients had a history of exposure to confirmed cases of COVID-19 or travel to Hubei before illness. The median (IQR) duration was 8 (6–11) and 5 (4–11) days from exposure to onset in COVID-19 and non-COVID-19 cases, respectively. The clinical symptoms were similar between COVID-19 and non-COVID-19. The most common symptoms were fever and cough. Fifteen (78.95%) COVID-19 but 4 (26.67%) non-COVID-19 patients had bilateral involvement while 17 COVID-19 patients (89.47%) but 1 non-COVID-19 patient (6.67%) had multiple mottling and ground-glass opacity on chest CT images. Compared with non-COVID-19, COVID-19 presents remarkably more abnormal laboratory tests, including AST, ALT, γ-GT, LDH, and α-HBDH. Conclusions The COVID-19 infection has onsets similar to other pneumonias. CT scan may be a reliable test for screening COVID-19 cases. Liver function damage is more frequent in COVID-19 than non-COVID-19 patients. LDH and α-HBDH may be considerable markers for evaluation of COVID-19.

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Rapid COVID-19 Antigen Testing in Croatia: Risk Perception Plays an Important Role in the Epidemic Control

Frontiers in Public Health ◽

10.3389/fpubh.2021.708907 ◽

2021 ◽

Vol 9 ◽

Author(s):

Dragan Primorac ◽

Vitorio Perić ◽

Vid Matišić ◽

Vilim Molnar ◽

Renata Zadro ◽

...

Keyword(s):

Risk Perception ◽

Clinical Symptoms ◽

Area Under The Curve ◽

Clinical Score ◽

International Travel ◽

Preventative Measures ◽

History Of ◽

Antigen Testing ◽

Test Result

Aim: To explore the clinical presentation and epidemiological history of the subjects who underwent SARS-CoV-2 antigen testing.Methods: We included 1,000 consecutive subjects who presented themselves at the diagnostic clinic in Croatia and analyzed their symptoms and epidemiological history. All subjects were classified into three groups, according to their reason of arrival; symptomatic, contacts of confirmed patients, and those who were tested due to administrative reasons.Results: On average, there were 24% of positive antigen results; the positivity rate was 51% among symptomatic, 16% in contacts, and 5% of administrative patients. The commonest symptoms of the disease included febrility and anosmia. We developed a clinical score to predict SARS-CoV-2 positivity, which had an area under the curve of 79.3 [95% confidence intervals (CI) 75.8–82.8]. Contact with the isolated person [odds ratio 0.54 (95% CI 0.31–0.94)] and international travel had a protective effect [0.20 (0.09–0.43)], suggesting that risk perception and mandatory pretravel measures had a key role in the determination of the infection risk.Conclusions: A combination of clinical symptoms can have reasonable predictive power for an antigen-positive test result. Risk perception seems to have a role in the epidemic spread, probably via stricter adherence to personal preventative measures.

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Clinical Features, Diagnosis and Management of Patients with Suspicion of Fascioliasis in Kohgiluyeh and Boyer-Ahmad Province, Southwestern Iran

Iranian Journal of Parasitology ◽

10.18502/ijpa.v15i1.2530 ◽

2020 ◽

Author(s):

Abdolali MOSHFE ◽

Arash ARIA ◽

Najme ERFANI ◽

Ali JAMSHIDI ◽

Bahador SARKARI ◽

...

Keyword(s):

Clinical Features ◽

Clinical Symptoms ◽

Epigastric Pain ◽

Serological Test ◽

Demographic Data ◽

Clinical Signs ◽

Signs And Symptoms ◽

Diagnosis And Management ◽

History Of ◽

Clinical Signs And Symptoms

Background: In the current study, we described the epidemiological features, clinical presentation, diagnosis and management of patients with suspicion of fascioliasis in Kohgiluyeh and Boyer-Ahmad Province in southwest of Iran. Methods: Overall, 56 patients with suspicion of fascioliasis, based on their clinical signs and symptoms that referred to Clinic of Internal Medicine in Yasuj city, from 2014 to 2016 were enrolled. Demographic data, history of eating aquatic local plants, the chief complains, and laboratory findings were recorded for each patient. Stool samples were obtained from each case for detection of Fasciola eggs. Moreover, blood samples were taken from each patient and evaluated for detection of anti-Fasciola antibodies by an indirect ELISA. Patients who defined as having fascioliasis were treated with triclabendazole and were followed for at least three months for clinical improvement. Results: Serological test was positive in 5 patients. Of these 5 cases, three cases had a history of ingesting raw aquatic vegetables. The main clinical signs and symptoms in positive cases were; abdominal pain (60%), epigastric pain (40%), anemia (60%), and dermal pruritus (20%). Hypereosinophilia was seen in all of 5 positive cases. No Fasciola egg was found in stool specimens of any of the patients. The fascioliasis cases were treated by triclabendazole and clinical symptoms disappeared in all of 5 cases. Conclusion: Our observation further confirmed Yasuj district as a human endemic area for fascioliasis in Iran. The study also highlighted the importance of clinical features together with eosinophilia, as key parameters, in the diagnosis of human fascioliasis. Clinicians need to be aware of this disease and should keep in mind fascioliasis when hypereosinophilia present in patients in such endemic areas.

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Diagnostic Model of Covid-19 for Resource-Limited Countries Based on The Combination Of Clinical Symptoms, Chest Radiography and Laboratory Test

10.21203/rs.3.rs-119024/v1 ◽

2020 ◽

Author(s):

Herikurniawan Herikurniawan ◽

Martin C Rumende ◽

Siti Setiati ◽

July Kumalawati ◽

Belinda Thania Deslanthy

Keyword(s):

Chest Radiography ◽

Clinical Symptoms ◽

Area Under The Curve ◽

Cross Sectional Study ◽

Diagnostic Process ◽

Morbidity Rate ◽

Diagnostic Model ◽

Cross Sectional ◽

Mortality And Morbidity ◽

History Of

Abstract Background: COVID-19 is an infection caused by SARS-CoV 2. RT-PCR test is the gold standard for COVID-19 diagnosis, detecting the virus nucleic acid. However, this test is not yet available in every healthcare center, thus making the diagnostic process lengthy. A prompt diagnosis and immediate management are important to decrease mortality and morbidity rate, as well as to prevent transmission. A simple and practical diagnostic model using determinant factors is needed to guide the physician for a quicker decision-making. Method: This study is a cross sectional study using consecutive sampling method. The study was conducted at RSUPN Cipto Mangunkusumo, Jakarta from March to June 2020. History of contact with COVID-19, clinical symptoms, laboratory examination, and chest radiographs data were taken from medical records. The steps of analysis were univariate, bivariate, and multivariate analyses, followed by ROC curve and Hosmer-Lemeshow calibration. Result: There were 187 patients with the majority of subjects in the age group < 60 years old (65,2%) and male sex (53,47%). The most frequent comorbidities were diabetes mellitus and hypertension. The selected variables in this scoring system were contact history, fever/history of fever, dyspnea with respiratory rate >20 breaths/minute, leucocyte ≤ 10.000 cells/mL and typical chest radiography. The area under the curve for this model was 0,777 (CI 95% (0,706-0,847), P<0,001). The probability was 82% with a cut-off point ≥ 4, PPV: 74%, NPV: 77%. Conclusion: Determinant model based on the combination of contact history, fever/history of fever, dyspnea, leucocyte ≤ 10.000 cells/mL and typical chest radiography provides a good accuracy to establish COVID-19 diagnosis.

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Clinical features and radiological characteristics of pulmonary cryptococcosis

Journal of International Medical Research ◽

10.1177/0300060518769541 ◽

2018 ◽

Vol 46 (7) ◽

pp. 2687-2695 ◽

Cited By ~ 5

Author(s):

Hui Deng ◽

Jie Zhang ◽

Jia Li ◽

Dongxu Wang ◽

Lei Pan ◽

...

Keyword(s):

Computed Tomography ◽

Clinical Features ◽

Clinical Symptoms ◽

Ground Glass Opacity ◽

Mediastinal Lymph Nodes ◽

Pulmonary Cryptococcosis ◽

Radiological Features ◽

Computed Tomography Images ◽

Tertiary Hospitals ◽

History Of

Objective Diagnosis of pulmonary cryptococcosis is difficult. In this study, we examined the clinical and radiological features that increase the diagnostic accuracy for pulmonary cryptococcosis. Methods This retrospective study included clinical data from 68 patients with pulmonary cryptococcosis from 2012 to 2016 in 3 tertiary hospitals. Results Among the 68 patients, 39 (57.35%) had no complications, 39 (57.35%) had clinical symptoms, 6 (8.82%) had a history of occupational exposure, 27 (39.71%) had a single nodule/mass (the most common type of pulmonary cryptococcosis) on chest computed tomography images, 21 (30.88%) had multiple nodules/masses, 16 (23.53%) had ground glass opacity with or without nodules, 2 (2.94%) had miliary nodules, and 2 (2.94%) had enlarged mediastinal lymph nodes. Fifty-three (77.94%) patients had lesions with irregular margins, 33 (48.53%) had spiculated lesions, 32 (47.06%) had air bronchograms, 9 (13.24%) had cavities, and 4 (5.88%) had calcifications. Twenty-four patients underwent surgery, 35 received antifungal treatment, and 9 received both treatments. Conclusion The clinical features and computed tomography signs found in this study are not specific for a diagnosis of pulmonary cryptococcosis. Therefore, an increased awareness of pulmonary cryptococcosis is needed among clinicians.

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Investigating the Dynamics of Suicidal Ideation

Crisis ◽

10.1027/0227-5910/a000464 ◽

2018 ◽

Vol 39 (1) ◽

pp. 65-69 ◽

Cited By ~ 22

Author(s):

Nina Hallensleben ◽

Lena Spangenberg ◽

Thomas Forkmann ◽

Dajana Rath ◽

Ulrich Hegerl ◽

...

Keyword(s):

Suicidal Ideation ◽

Small Sample Size ◽

Unipolar Depression ◽

Small Sample ◽

History Of ◽

Severity Of Depression ◽

Ecological Momentary ◽

Depressive Episodes ◽

Ema Method ◽

Shed Light

Abstract. Background: Although the fluctuating nature of suicidal ideation (SI) has been described previously, longitudinal studies investigating the dynamics of SI are scarce. Aim: To demonstrate the fluctuation of SI across 6 days and up to 60 measurement points using smartphone-based ecological momentary assessments (EMA). Method: Twenty inpatients with unipolar depression and current and/or lifetime suicidal ideation rated their momentary SI 10 times per day over a 6-day period. Mean squared successive difference (MSSD) was calculated as a measure of variability. Correlations of MSSD with severity of depression, number of previous depressive episodes, and history of suicidal behavior were examined. Results: Individual trajectories of SI are shown to illustrate fluctuation. MSSD values ranged from 0.2 to 21.7. No significant correlations of MSSD with several clinical parameters were found, but there are hints of associations between fluctuation of SI and severity of depression and suicidality. Limitations: Main limitation of this study is the small sample size leading to low power and probably missing potential effects. Further research with larger samples is necessary to shed light on the dynamics of SI. Conclusion: The results illustrate the dynamic nature and the diversity of trajectories of SI across 6 days in psychiatric inpatients with unipolar depression. Prediction of the fluctuation of SI might be of high clinical relevance. Further research using EMA and sophisticated analyses with larger samples is necessary to shed light on the dynamics of SI.

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Organization of restrictive quarantine measures to prevent especially dangerous infections

Spravočnik vrača obŝej praktiki (Journal of Family Medicine) ◽

10.33920/med-10-2005-01 ◽

2020 ◽

pp. 6-11

Author(s):

Petr Ilyin

Keyword(s):

Infectious Diseases ◽

Clinical Symptoms ◽

International Health ◽

World Health ◽

The World ◽

History Of ◽

Entire History ◽

Health Organization ◽

Former Ussr ◽

Health Regulations

Especially dangerous infections (EDIs) belong to the conditionally labelled group of infectious diseases that pose an exceptional epidemic threat. They are highly contagious, rapidly spreading and capable of affecting wide sections of the population in the shortest possible time, they are characterized by the severity of clinical symptoms and high mortality rates. At the present stage, the term "especially dangerous infections" is used only in the territory of the countries of the former USSR, all over the world this concept is defined as "infectious diseases that pose an extreme threat to public health on an international scale." Over the entire history of human development, more people have died as a result of epidemics and pandemics than in all wars combined. The list of especially dangerous infections and measures to prevent their spread were fixed in the International Health Regulations (IHR), adopted at the 22nd session of the WHO's World Health Assembly on July 26, 1969. In 1970, at the 23rd session of the WHO's Assembly, typhus and relapsing fever were excluded from the list of quarantine infections. As amended in 1981, the list included only three diseases represented by plague, cholera and anthrax. However, now annual additions of new infections endemic to different parts of the earth to this list take place. To date, the World Health Organization (WHO) has already included more than 100 diseases in the list of especially dangerous infections.

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CASE REPORT: RARE FORM OF HIRSCHPRUNG’S DISEASE

10.35988/sm-hs.2020.118 ◽

2020 ◽

Vol 30 (5) ◽

pp. 82-84

Author(s):

Ilja Skalskis

Keyword(s):

Down Syndrome ◽

Case Report ◽

Clinical Symptoms ◽

Hirschsprung Disease ◽

Distal Colon ◽

Total Colonic Aganglionosis ◽

Sphincter Function ◽

Anal Sphincter Function ◽

History Of ◽

High Index Of Suspicion

Hirschsprung disease (HD) is a developmental disorder characterized by the absence of ganglia in the distal colon, resulting in a functional obstruction. Incidence of total colonic aganglionosis (TCA) is 1 in 500 000 and it accounts for 5-10% of all cases of HD. HD should be suspected in patients with typical clinical symptoms and a high index of suspicion is appropriate for infants with a predisposing condition such as Down Syndrome (DS), or for those with a family history of HD. The treatment of choice for HD is surgical, such as Swenson, Soave, and Duhamel procedures. The goals are to resect the affected segment of the colon, bring the normal ganglionic bowel down close to the anus, and preserve internal anal sphincter function. We present a clinical case report of TCA in a child with Down syndrome (DS) and review of literature.

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Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

Infectious Disorders - Drug Targets ◽

10.2174/1871526520666200218115400 ◽

2020 ◽

Vol 20 ◽

Cited By ~ 1

Author(s):

Sara Abolghasemi ◽

Mohammad Alizadeh ◽

Ali Hashemi ◽

Shabnam Tehrani

Keyword(s):

Chlamydia Trachomatis ◽

Clinical Symptoms ◽

Urine Culture ◽

Clinical Manifestations ◽

Urinary Frequency ◽

Serological Tests ◽

Duration Of Symptoms ◽

Two Samples ◽

History Of ◽

Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

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Prediction of unconventional protein secretion by exosomes

BMC Bioinformatics ◽

10.1186/s12859-021-04219-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Alvaro Ras-Carmona ◽

Marta Gomez-Perosanz ◽

Pedro A. Reche

Keyword(s):

Protein Secretion ◽

Random Forests ◽

Signal Peptide ◽

Area Under The Curve ◽

Dipeptide Composition ◽

Web Based ◽

Independent Dataset ◽

Link Type ◽

Tenfold Cross Validation ◽

Dependent Pathway

Abstract Motivation In eukaryotes, proteins targeted for secretion contain a signal peptide, which allows them to proceed through the conventional ER/Golgi-dependent pathway. However, an important number of proteins lacking a signal peptide can be secreted through unconventional routes, including that mediated by exosomes. Currently, no method is available to predict protein secretion via exosomes. Results Here, we first assembled a dataset including the sequences of 2992 proteins secreted by exosomes and 2961 proteins that are not secreted by exosomes. Subsequently, we trained different random forests models on feature vectors derived from the sequences in this dataset. In tenfold cross-validation, the best model was trained on dipeptide composition, reaching an accuracy of 69.88% ± 2.08 and an area under the curve (AUC) of 0.76 ± 0.03. In an independent dataset, this model reached an accuracy of 75.73% and an AUC of 0.840. After these results, we developed ExoPred, a web-based tool that uses random forests to predict protein secretion by exosomes. Conclusion ExoPred is available for free public use at http://imath.med.ucm.es/exopred/. Datasets are available at http://imath.med.ucm.es/exopred/datasets/.

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