Delirium and Right-Hemisphere Dysfunction in Cognitively Impaired Older Persons

1996 ◽  
Vol 8 (3) ◽  
pp. 373-382 ◽  
Author(s):  
John R. Mach ◽  
Vivian Kabat ◽  
Doug Olson ◽  
Michael Kuskowski
Keyword(s):  
Risk Factor ◽  
Right Hemisphere ◽  
Memory Loss ◽  
Depression Scale ◽  
Indirect Evidence ◽  
Controlled Study ◽  
Cognitively Impaired ◽  
Retrospective Case ◽  
Right Hemisphere Dysfunction ◽  
History Of

Cognitive impairment has been repeatedly shown to be a delirium risk factor. Much indirect evidence suggests that right-hemisphere dysfunction plays a particularly important role. This retrospective, case-controlled study, from a 148-patient memory loss clinic database, compared neuropsychological measures of hemispheric function in cognitively impaired elderly veterans with and without a history of delirium. Eleven study subjects had a history compatible with DSM-III-R criteria for delirium. Controls selected from the same database had no known history of delirium and were matched for Mini-Mental State Examination scores and Geriatric Depression Scale scores. Compared to the controls, subjects with a history of delirium had significantly lower scores on Object Assembly and Visual Reproduction (p < .05), tests that are predominantly right-hemisphere dependent. There were no significant differences in left-hemisphere measures. It is concluded that right-hemisphere dysfunction may prove to be an important risk factor for delirium.

scholarly journals Cognition, Depressive Symptoms and Vascular Factors among Southwest Tribal Elders

2016 ◽  
Vol 26 (2) ◽  
pp. 235 ◽  
Author(s):  
Francine Gachupin ◽  
Michael D. Romero ◽  
Willa J. Ortega ◽  
Rita Jojola-Dorame ◽  
Hugh Hendrie ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Geriatric Depression Scale ◽  
Memory Loss ◽  
Depression Scale ◽  
Vascular Risk ◽  
Tribal Community ◽  
Cross Sectional ◽  
Pilot Studies ◽  
Physical Measurements ◽  
History Of

<p><strong>Objectives</strong>: Few data exist on cognitive and depressive symptoms and vascular factors in American Indian (AI) elders. Since vascular risk factors increase risk for cognitive impairments, depression and dementia, and since AI elders are at high vascular risk, it is timely to assess the interplay of these factors in comprehensive studies of aging in this population. To begin, pilot studies must be conducted to show these types of data can be collected successfully.</p><p><strong>Design:</strong> A cross-sectional pilot study, the Southwest Heart Mind Study (SHMS). Setting: Tribal community in the Southwest United States. Participants: AI elders, aged ≥55 years.</p><p><strong>Main Outcome Measures:</strong> Cross-cultural demographic, social network and risk factor surveys; tests of cognition, depression and anxiety; physical measurements; blood biochemistries; and APOE genotyping.</p><p><strong>Results:</strong> SHMS elders were comparable to other rural elder populations on cognitive and depressive symptom scores. The average CogScore was 28.8 (out of 32), the average Geriatric Depression Scale (GDS) was 6.7 (of 30), and the average Hamilton Anxiety Scale was 1.2 (of 4). 32% possessed at least one APOEe4 allele. High vascular risk was evident: 76% were overweight or obese; 54% self-reported history of hypertension; 24% heart trouble; 32% type 2 diabetes; 35% depression; and 24% a family history of serious memory loss. More than 70% reported prescription medication use. 54% cared for someone besides self.</p><p><strong>Conclusions:</strong> A better understanding of the burden of vascular risk in relation to cognition and depression among Southwest Tribes is needed. <em>Ethn Dis.</em> 2016;26(2):235- 244; doi:10.18865/ed.26.2.235</p>

scholarly journals Pathological Significance and Prognostic Roles of Indirect Bilirubin/Albumin Ratio in Hepatic Encephalopathy

2021 ◽  
Vol 8 ◽  
Author(s):  
Yanling Li ◽  
Huiyuan Liu ◽  
Keng Chen ◽  
Xueheng Wu ◽  
Jiawen Wu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Hepatic Encephalopathy ◽  
Protoporphyrin Ix ◽  
Heme Oxygenase 1 ◽  
Retrospective Case ◽  
Albumin Ratio ◽  
Indirect Bilirubin ◽  
New Strategy ◽  
History Of ◽  
Cerebellum Development

Background and Aim: Hepatic encephalopathy (HE) is a neurological disease caused by severe liver disease. Early identification of the risk factor is beneficial to the prevention and treatment of HE. Free bilirubin has always been considered to be the culprit of neonatal kernicterus, but there is no research to explore its role in HE. In this study, we aim to study the clinical significance of the indirect bilirubin-albumin ratio in HE.Methods: A retrospective case-control study of 204 patients with liver failure was conducted. Human serum albumin (HSA) or heme oxygenase-1 (HO-1) inhibitor SnPP (Tin protoporphyrin IX dichloride) was injected intraperitoneally into Ugt1−/− mice to establish a treatment model for endogenous hyperbilirubinemia.Results: IBil/albumin ratio (OR = 1.626, 95% CI1.323–2.000, P &lt; 0.001), white blood cell (WBC) (OR = 1.128, 95% CI 1.009–1.262, P = 0.035), ammonia (OR = 1.010, 95% CI 1.001–1.019, P = 0.027), platelet (OR=1.008, 95% CI 1.001–1.016, P = 0.022), Hb (OR = 0.977, 95% CI 0.961–0.994, P = 0.007), and PTA (OR = 0.960, 95% CI 0.933–0.987, P = 0.005) were independent factors of HE. Patients with a history of liver cirrhosis and severe HE (OR = 12.323, 95% CI 3.278–47.076, P &lt; 0.001) were more likely to die during hospitalization. HSA or SnPP treatment improved cerebellum development and reduced apoptosis of cerebellum cells.Conclusion: The IBil/albumin ratio constitutes the most powerful risk factor in the occurrence of HE, and reducing free bilirubin may be a new strategy for HE treatment.

scholarly journals SCHIZOPHRENIA AND DRUG NON-COMPLIANCE

2006 ◽  
Vol 13 (03) ◽  
pp. 423-430
Author(s):  
WAJID ALI ◽  
WAJEH UR REHMAN ◽  
NIAZ MAQSOOD
Keyword(s):  
Previous History ◽  
Controlled Study ◽  
Control Group ◽  
P Value ◽  
Test Results ◽  
Retrospective Case ◽  
Chi Square ◽  
Chi Square Test ◽  
History Of ◽  
Compliance To Treatment

Objectives: To determine the different levels of drug non-compliance inpatients with schizophrenia and to find out its relationship to relapses of the disorder and admission to the hospital.Design: A randomized, retrospective, case- controlled study. Place and Duration of Study: Conducted at GovernmentMental Hospital Peshawar, from April 2001 to December 2002. Patients and Method: 50-Cases were randomly (eachfifth patient) selected from all the admissions with the DSM-IV diagnosis of Schizophrenia, 50- matched controls wererandomly (each fifth patient) selected from the outdoor patients. Both sexes were included. The basicsociodemographic characteristics and the clinical profile of all the patients were collected. The level of drug noncompliancewith previous history of admissions to hospital and total number of relapses. SPSS version 10 was usedfor statistical analysis. The applied method for group comparison was the Chi-square test. Results: The mean age ofstudy group was 33.54 ± 8.15 years as compare to 32.56 ± 9.02 years of control group, most participants were men,and a predominant proportion of participants were married. Majority of the patients were from the lower socio-economicclass. Scores on the drug non- compliance were statistically significant with a p value of (0.027). The differencebetween the two groups, regarding the previous number of relapses was statistically significant with a p value (0.002).The number of previous admission was also statistically significant and the p value was (0.017). 74.1% of the patientswith poor drug compliance relapsed, while 71% of patients with poor compliance needed admission. Conclusion: Animportant measure of out come is compliance with treatment. A substantial proportion of patients with schizophreniacontinues to relapse and are readmitted to the hospital as a result of non-compliance to treatment.

Suicidal Behavior in German Adolescents

2015 ◽  
Vol 43 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Joana Straub ◽  
Ferdinand Keller ◽  
Nina Sproeber ◽  
Michael G. Koelch ◽  
Paul L. Plener
Keyword(s):  
Suicidal Behavior ◽  
Suicide Attempts ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Present Sample ◽  
Manic Symptoms ◽  
Symptoms Of Depression ◽  
Adolescent Sample ◽  
History Of ◽  
Sum Scores

Objective: Research in adults has identified an association between bipolar disorder and suicidal behavior. This relationship, however, has been insufficiently investigated in adolescents to date. Methods: 1,117 adolescents from 13 German schools (mean age = 14.83, SD = .63; 52.7% females) completed an extended German version of the Center for Epidemiological Studies Depression Scale (CES-D), which assesses depressive and manic symptoms during the last week, as well as the Self-Harm Behavior Questionnaire (SHBQ) for the assessment of lifetime suicidal behavior. Results: In the present sample 39.4% of the girls and 23.1% of the boys reported lifetime suicidal thoughts and 7.1% of the girls as well as 3.9% of the boys a lifetime history of suicide attempts. 18.7% of the adolescent sample revealed elevated symptoms of depression and 9% elevated levels of mania symptoms. Elevated sum scores of depression and mania were associated with a higher number of suicidal ideations and suicide attempts. A block-wise regression analysis revealed that sum scores of depression and mania predicted suicidal ideations best. Concerning suicide attempts, the best predictors were age as well as depression and mania sum scores. Conclusions: Suicidal behavior was reported more often when adolescents demonstrate symptoms of mania as well as symptoms of depression than when they demonstrate only depressive symptoms. The presence of bipolar symptoms in adolescents should alert clinicians to the heightened possibility of suicidal behavior.

Premorbid migraine history as a risk factor for vestibular and oculomotor baseline concussion assessment in pediatric athletes

2019 ◽  
Vol 23 (4) ◽  
pp. 465-470 ◽  
Author(s):  
Ryan N. Moran ◽  
Tracey Covassin ◽  
Jessica Wallace
Keyword(s):  
Risk Factor ◽  
Smooth Pursuit ◽  
Migraine Headache ◽  
Visual Motion ◽  
Assessment Tools ◽  
Motion Sensitivity ◽  
Ocular Reflex ◽  
Migraine Headaches ◽  
Vestibular Ocular Reflex ◽  
History Of

OBJECTIVEMigraine history has recently been identified as a risk factor for concussion and recovery. The authors performed a cross-sectional study examining baseline outcome measures on newly developed and implemented concussion assessment tools in pediatrics. The purpose of this study was to examine the effects of premorbid, diagnosed migraine headaches as a risk factor on vestibular and oculomotor baseline assessment in pediatric athletes.METHODSPediatric athletes between the ages of 8 and 14 years with a diagnosed history of migraine headache (n = 28) and matched controls without a history of diagnosed migraine headache (n = 28) were administered a baseline concussion assessment battery, consisting of the Vestibular/Ocular Motor Screening (VOMS), near point of convergence (NPC), and the King-Devick (K-D) tests. Between-groups comparisons were performed for vestibular symptoms and provocation scores on the VOMS (smooth pursuit, saccades, convergence, vestibular/ocular reflex, visual motion sensitivity), NPC (average distance), and K-D (time).RESULTSIndividuals diagnosed with migraine headaches reported greater VOMS smooth pursuit scores (p = 0.02), convergence scores (p = 0.04), vestibular ocular reflex scores (p value range 0.002–0.04), and visual motion sensitivity scores (p = 0.009). Differences were also observed on K-D oculomotor performance with worse times in those diagnosed with migraine headache (p = 0.02). No differences were reported on NPC distance (p = 0.06) or headache symptom reporting (p = 0.07) prior to the VOMS assessment.CONCLUSIONSPediatric athletes diagnosed with migraine headaches reported higher baseline symptom provocation scores on the VOMS. Athletes with migraine headaches also performed worse on the K-D test, further illustrating the influence of premorbid migraine headaches as a risk factor for elevated concussion assessment outcomes at baseline. Special consideration may be warranted for post-concussion assessment in athletes with migraine headaches.

PREVALENCE AND RELATED FACTORS OF POSTNATAL DEPRESSION IN HIV INFECTED WOMEN

2014 ◽  
pp. 140-152
Author(s):  
Manh Hoan Nguyen ◽  
Ngoc Thanh Cao
Keyword(s):  
Regression Analysis ◽  
Postpartum Depression ◽  
Hiv Infection ◽  
Postnatal Depression ◽  
Past History ◽  
Depression Scale ◽  
Multivariate Regression Analysis ◽  
Related Factors ◽  
History Of ◽  
History Of Depression

Background and Objective: HIV infection is also a cause of postpartum depression, however, in Vietnam, there has not yet the prevalence of postpartum depression in HIV infected women. The objective is to determine prevalence and related factors of postpartum depression in HIV infected women. Materials and Methods: From November 30th, 2012 to March 30th, 2014, a prospective cohort study is done at Dong Nai and Binh Duong province. The sample includes135 HIV infected women and 405 non infected women (ratio 1/3) who accepted to participate to the research. We used “Edinburgh Postnatal Depression Scale (EPDS) as a screening test when women hospitalized for delivery and 1 week, 6weeks postpartum. Mother who score EPDS ≥ 13 are likely to be suffering from depression. We exclude women who have EPDS ≥ 13 since just hospitalize. Data are collected by a structural questionaire. Results: At 6 weeks postpartum, prevalence of depression in HIV infected women is 61%, in the HIV non infected women is 8.7% (p < 0.001). There are statistical significant differences (p<0.05) between two groups for some factors: education, profession, income, past history of depression, child’s health, breast feeding. Logistical regression analysis determine these factors are related with depression: late diagnosis of HIV infection, child infected of HIV, feeling guilty of HIV infected and feeling guilty with their family. Multivariate regression analysis showed 4 factors are related with depression: HIV infection, living in the province, child’s health, past history of depression. Conclusion: Prevalence of postpartum depression in HIV infected women is 61.2%; risk of depression of postnatal HIV infected women is 6.4 times the risk of postnatal HIV non infected women, RR=6.4 (95% CI:4.3 – 9.4). Domestic women have lower risk than immigrant women from other province, RR=0.72 (95% CI:0.5 – 0.9). Past history of depression is a risk factor with RR=1.7 (95% CI:1.02 – 0.9. Women whose child is weak or die, RR=1.7(95% CI:0.9 – 3.1). Keywords: Postpartum depression, HIV-positive postpartum women

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