scholarly journals Emotion recognition deficits as predictors of transition in individuals at clinical high risk for schizophrenia: a neurodevelopmental perspective

2015 ◽  
Vol 45 (14) ◽  
pp. 2959-2973 ◽  
Author(s):  
C. M. Corcoran ◽  
J. G. Keilp ◽  
J. Kayser ◽  
C. Klim ◽  
P. D. Butler ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Emotion Recognition ◽  
Negative Symptoms ◽  
Characteristic Curve ◽  
Classification Model ◽  
Developmental Study ◽  
Clinical High Risk ◽  
Risk Patients ◽  
Early Developmental

Background.Schizophrenia is characterized by profound and disabling deficits in the ability to recognize emotion in facial expression and tone of voice. Although these deficits are well documented in established schizophrenia using recently validated tasks, their predictive utility in at-risk populations has not been formally evaluated.Method.The Penn Emotion Recognition and Discrimination tasks, and recently developed measures of auditory emotion recognition, were administered to 49 clinical high-risk subjects prospectively followed for 2 years for schizophrenia outcome, and 31 healthy controls, and a developmental cohort of 43 individuals aged 7–26 years. Deficit in emotion recognition in at-risk subjects was compared with deficit in established schizophrenia, and with normal neurocognitive growth curves from childhood to early adulthood.Results.Deficits in emotion recognition significantly distinguished at-risk patients who transitioned to schizophrenia. By contrast, more general neurocognitive measures, such as attention vigilance or processing speed, were non-predictive. The best classification model for schizophrenia onset included both face emotion processing and negative symptoms, with accuracy of 96%, and area under the receiver-operating characteristic curve of 0.99. In a parallel developmental study, emotion recognition abilities were found to reach maturity prior to traditional age of risk for schizophrenia, suggesting they may serve as objective markers of early developmental insult.Conclusions.Profound deficits in emotion recognition exist in at-risk patients prior to schizophrenia onset. They may serve as an index of early developmental insult, and represent an effective target for early identification and remediation. Future studies investigating emotion recognition deficits at both mechanistic and predictive levels are strongly encouraged.

scholarly journals Longitudinal outcome of attenuated positive symptoms, negative symptoms, functioning and remission in people at clinical high risk for psychosis: a meta-analysis

2021 ◽  
Vol 36 ◽  
pp. 100909
Author(s):  
Gonzalo Salazar de Pablo ◽  
Filippo Besana ◽  
Vincenzo Arienti ◽  
Ana Catalan ◽  
Julio Vaquerizo-Serrano ◽  
...  
Keyword(s):  
High Risk ◽  
Negative Symptoms ◽  
Meta Analysis ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
Longitudinal Outcome

scholarly journals Secondary sources of negative symptoms in those meeting criteria for a clinical high-risk syndrome

2021 ◽  
Author(s):  
Tina Gupta ◽  
Gregory P. Strauss ◽  
Henry R. Cowan ◽  
Andrea Pelletier-Baldelli ◽  
Lauren M. Ellman ◽  
...  
Keyword(s):  
High Risk ◽  
Negative Symptoms ◽  
Clinical High Risk ◽  
Secondary Sources

scholarly journals Theory of mind, emotion recognition and social perception in individuals at clinical high risk for psychosis: Findings from the NAPLS-2 cohort

2015 ◽  
Vol 2 (3) ◽  
pp. 133-139 ◽  
Author(s):  
Mariapaola Barbato ◽  
Lu Liu ◽  
Kristin S. Cadenhead ◽  
Tyrone D. Cannon ◽  
Barbara A. Cornblatt ◽  
...  
Keyword(s):  
High Risk ◽  
Theory Of Mind ◽  
Emotion Recognition ◽  
Social Perception ◽  
Clinical High Risk

scholarly journals Association of baseline inflammatory markers and the development of negative symptoms in individuals at clinical high risk for psychosis

2019 ◽  
Vol 76 ◽  
pp. 268-274 ◽  
Author(s):  
David R. Goldsmith ◽  
Ebrahim Haroon ◽  
Andrew H. Miller ◽  
Jean Addington ◽  
Carrie Bearden ◽  
...  
Keyword(s):  
High Risk ◽  
Inflammatory Markers ◽  
Negative Symptoms ◽  
Clinical High Risk

scholarly journals Description of a pharmacist-led clinical video telehealth group clinic for opioid overdose prevention and naloxone education

2019 ◽  
Vol 9 (4) ◽  
pp. 294-297
Author(s):  
Aimee N. Jensen ◽  
Candace M. Beam ◽  
Amber R. Douglass ◽  
Jennifer E. Brabson ◽  
Michelle Colvard ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Rural Areas ◽  
Urban Areas ◽  
Patient Specific ◽  
Opioid Overdose ◽  
Overdose Prevention ◽  
Innovative Practice ◽  
Risk Patients ◽  
Urban And Rural Areas

Abstract To achieve the nationwide goal of reducing opioid-related deaths, a clinical pharmacy specialist–led clinical video telehealth (CVT) clinic was created at a Veterans Affairs medical center (VAMC) to deliver opioid overdose prevention and naloxone education to at-risk patients. The purpose of this innovative practice was to improve access to this potentially life-saving intervention to patients across urban and rural areas. This study is a single-center, descriptive analysis of adult patients across 2 VAMC campuses and 4 community-based outpatient clinics from July 11, 2016, through December 31, 2016. The purpose of this innovative practice was to increase access to overdose education and naloxone distribution (OEND) to at-risk patients across urban and rural areas. Patient-specific factors were also examined among those receiving naloxone through the CVT clinic compared to other prescribers. During the first 6 months from the initiation of the clinic, 1 pharmacist prescribed 21% of the health care system's naloxone. These patients identified by the pharmacist-led CVT clinic were more likely to be considered high-risk due to concomitant use of opioids and benzodiazepines. In conclusion, the pharmacist-led CVT group clinic has been an efficient strategy to extend OEND services to high-risk patients beyond central, urban areas.

Guidelines for the Management of Pediatric and Adult Tumor Lysis Syndrome: An Evidence-Based Review

2008 ◽  
Vol 26 (16) ◽  
pp. 2767-2778 ◽  
Author(s):  
Bertrand Coiffier ◽  
Arnold Altman ◽  
Ching-Hon Pui ◽  
Anas Younes ◽  
Mitchell S. Cairo
Keyword(s):  
At Risk ◽  
High Risk ◽  
Tumor Lysis Syndrome ◽  
The United States ◽  
Standards Of Care ◽  
Close Monitoring ◽  
Tumor Lysis ◽  
High Risk Patients ◽  
Patients At Risk ◽  
Risk Patients

PurposeTumor lysis syndrome (TLS) has recently been subclassified into either laboratory TLS or clinical TLS, and a grading system has been established. Standardized guidelines, however, are needed to aid in the stratification of patients according to risk and to establish prophylaxis and treatment recommendations for patients at risk or with established TLS.MethodsA panel of experts in pediatric and adult hematologic malignancies and TLS was assembled to develop recommendations and guidelines for TLS based on clinical evidence and standards of care. A review of relevant literature was also used.ResultsNew guidelines are presented regarding the prevention and management of patients at risk of developing TLS. The best management of TLS is prevention. Prevention strategies include hydration and prophylactic rasburicase in high-risk patients, hydration plus allopurinol or rasburicase for intermediate-risk patients, and close monitoring for low-risk patients. Primary management of established TLS involves similar recommendations, with the addition of aggressive hydration and diuresis, plus allopurinol or rasburicase for hyperuricemia. Alkalinization is not recommended. Although guidelines for rasburicase use in adults are provided, this agent is currently only approved for use in pediatric patients in the United States.ConclusionThe potential severity of complications resulting from TLS requires measures for prevention in high-risk patients and prompts treatment in the event that symptoms arise. Recognition of risk factors, monitoring of at-risk patients, and appropriate interventions are the key to preventing or managing TLS. These guidelines should assist in the prevention of TLS and improve the management of patients with established TLS.

Differential expression of hepatocyte growth factor in patients with systemic sclerosis-associated pulmonary arterial hypertension

2017 ◽  
Vol 2 (3) ◽  
pp. 225-230
Author(s):  
Yon K. Sung ◽  
Roham T. Zamanian ◽  
Catriona A. Wagner ◽  
William Robinson ◽  
Virginia Steen ◽  
...  
Keyword(s):  
At Risk ◽  
Systemic Sclerosis ◽  
Growth Factor ◽  
Pulmonary Arterial Hypertension ◽  
High Risk ◽  
Hepatocyte Growth Factor ◽  
Arterial Hypertension ◽  
Risk Patients ◽  
Pulmonary Arterial ◽  
Hepatocyte Growth

Introduction Non-invasive biomarkers are needed to identify pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) patients who may benefit from early intervention. We sought to identify novel cytokines that differentiate patients with incident SSc-PAH from those at high risk for PAH. Methods The Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma (PHAROS) Registry is a multicenter registry of SSc patients at high risk for PAH (at-risk) or with incident right-heart catheterization-confirmed PAH (definite PAH). Serum from 10 at-risk and 9 definite PAH patients were profiled with Bio-PlexTM bead arrays for 48 cytokines and chemokines. We also evaluated the longitudinal change in cytokine profiles from 3 at-risk patients who subsequently developed definite PAH. Results Clinical features of at-risk versus definite PAH patients were not significantly different except for right-ventricular systolic pressure on echocardiogram (34 ± 7 vs. 45 ± 8 mmHg, p = 0.006), left atrial diameter (2.9 ± 0.5 vs. 3.7 ± 0.4 cm, p = 0.02), 6-minute walk distance (508 ± 115 vs. 393 ± 70 m, p = 0.02), mean pulmonary artery pressure (18 ± 4 vs. 32 ± 6 mmHg, p = 0.01), and pulmonary vascular resistance (111 ± 48 vs. 272 ± 109 dyn/s/cm5, p = 0.009). Serum cytokine profiling identified hepatocyte growth factor (HGF) as the only cytokine significantly different between the at-risk and definite PAH groups (225.8 ± 55.0 vs. 361.6 ± 164.5 pg/mL, q<0.1%). Profiling of longitudinal samples of at-risk to definite PAH patients did not identify any significant changes in HGF or other cytokines over time. Conclusions Definite PAH patients expressed higher levels of HGF than at-risk patients. Further studies are needed to clarify the utility of HGF as a predictive biomarker for SSc-PAH.

scholarly journals Negative symptoms in individuals at clinical high risk of psychosis

2012 ◽  
Vol 196 (2-3) ◽  
pp. 220-224 ◽  
Author(s):  
Danijela Piskulic ◽  
Jean Addington ◽  
Kristin S. Cadenhead ◽  
Tyrone D. Cannon ◽  
Barbara A. Cornblatt ◽  
...  
Keyword(s):  
High Risk ◽  
Negative Symptoms ◽  
Clinical High Risk

scholarly journals Clinical subtypes that predict conversion to psychosis: A canonical correlation analysis study from the ShangHai At Risk for Psychosis program

2019 ◽  
Vol 54 (5) ◽  
pp. 482-495 ◽  
Author(s):  
TianHong Zhang ◽  
XiaoChen Tang ◽  
HuiJun Li ◽  
Kristen A Woodberry ◽  
Emily R Kline ◽  
...  
Keyword(s):  
At Risk ◽  
Cluster Analysis ◽  
High Risk ◽  
Correlation Analysis ◽  
Canonical Correlation Analysis ◽  
Canonical Correlation ◽  
Clinical Symptoms ◽  
Structured Interview ◽  
Two Dimensions ◽  
Clinical High Risk

Objective: Since only 30% or fewer of individuals at clinical high risk convert to psychosis within 2 years, efforts are underway to refine risk identification strategies to increase their predictive power. The clinical high risk is a heterogeneous syndrome presenting with highly variable clinical symptoms and cognitive dysfunctions. This study investigated whether subtypes defined by baseline clinical and cognitive features improve the prediction of psychosis. Method: Four hundred clinical high-risk subjects from the ongoing ShangHai At Risk for Psychosis program were enrolled in a prospective cohort study. Canonical correlation analysis was applied to 289 clinical high-risk subjects with completed Structured Interview for Prodromal Syndromes and cognitive battery tests at baseline, and at least 1-year follow-up. Canonical variates were generated by canonical correlation analysis and then used for hierarchical cluster analysis to produce subtypes. Kaplan–Meier survival curves were constructed from the three subtypes to test their utility further in predicting psychosis. Results: Canonical correlation analysis determined two linear combinations: (1) negative symptom and functional deterioration-related cognitive features, and (2) Positive symptoms and emotional disorganization-related cognitive features. Cluster analysis revealed three subtypes defined by distinct and relatively homogeneous patterns along two dimensions, comprising 14.2% (subtype 1, n = 41), 37.4% (subtype 2, n = 108) and 48.4% (subtype 3, n = 140) of the sample, and each with distinctive features of clinical and cognitive performance. Those with subtype 1, which is characterized by extensive negative symptoms and cognitive deficits, appear to have the highest risk for psychosis. The conversion risk for subtypes 1–3 are 39.0%, 11.1% and 18.6%, respectively. Conclusion: Our results define important subtypes within clinical high-risk syndromes that highlight clinical symptoms and cognitive features that transcend current diagnostic boundaries. The three different subtypes reflect significant differences in clinical and cognitive characteristics as well as in the risk of conversion to psychosis.

Identifying patients at risk of futile resuscitation: palliative care indicators in out-of-hospital cardiac arrest

2019 ◽  
pp. bmjspcare-2019-001828
Author(s):  
Mia Cokljat ◽  
Adam Lloyd ◽  
Scott Clarke ◽  
Anna Crawford ◽  
Gareth Clegg
Keyword(s):  
At Risk ◽  
Palliative Care ◽  
Cardiac Arrest ◽  
High Risk ◽  
Low Risk ◽  
Intermediate Risk ◽  
Patients At Risk ◽  
Risk Patients ◽  
Record Review ◽  
Hospital Cardiac Arrest

ObjectivesPatients with indicators for palliative care, such as those with advanced life-limiting conditions, are at risk of futile cardiopulmonary resuscitation (CPR) if they suffer out-of-hospital cardiac arrest (OHCA). Patients at risk of futile CPR could benefit from anticipatory care planning (ACP); however, the proportion of OHCA patients with indicators for palliative care is unknown. This study quantifies the extent of palliative care indicators and risk of CPR futility in OHCA patients.MethodsA retrospective medical record review was performed on all OHCA patients presenting to an emergency department (ED) in Edinburgh, Scotland in 2015. The risk of CPR futility was stratified using the Supportive and Palliative Care Indicators Tool. Patients with 0–2 indicators had a ‘low risk’ of futile CPR; 3–4 indicators had an ‘intermediate risk’; 5+ indicators had a ‘high risk’.ResultsOf the 283 OHCA patients, 12.4% (35) had a high risk of futile CPR, while 16.3% (46) had an intermediate risk and 71.4% (202) had a low risk. 84.0% (68) of intermediate-to-high risk patients were pronounced dead in the ED or ED step-down ward; only 2.5% (2) of these patients survived to discharge.ConclusionsUp to 30% of OHCA patients are being subjected to advanced resuscitation despite having at least three indicators for palliative care. More than 80% of patients with an intermediate-to-high risk of CPR futility are dying soon after conveyance to hospital, suggesting that ACP can benefit some OHCA patients. This study recommends optimising emergency treatment planning to help reduce inappropriate CPR attempts.

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