scholarly journals The prognosis of functional limb weakness: a 14-year case-control study

Brain ◽  
2019 ◽  
Vol 142 (7) ◽  
pp. 2137-2148 ◽  
Author(s):  
Jeannette M Gelauff ◽  
Alan Carson ◽  
Lea Ludwig ◽  
Marina A J Tijssen ◽  
Jon Stone
Keyword(s):  
Psychiatric Symptoms ◽  
Illness Perception ◽  
Control Group ◽  
Motor Disorder ◽  
Limb Weakness ◽  
Control Subjects ◽  
Healthy Control ◽  
Baseline Factors ◽  
Functional Limb

Abstract Reliable data on the prognosis of functional motor disorder are scarce, as existing studies of the prognosis of functional motor disorder are nearly all retrospective, small and uncontrolled. In this study we used a prospectively recruited, controlled cohort design to assess misdiagnosis, mortality and symptomatic and health outcome in patients with functional limb weakness compared to neurological disease and healthy control subjects. We also carried out an exploratory analysis for baseline factors predicting outcome. One hundred and seven patients with functional limb weakness, 46 neurological and 38 healthy control subjects from our previously studied prospective cohort were traced for follow-up after an average of 14 years. Misdiagnosis was determined in a consensus meeting using information from records, patients and their GPs. Numbers and causes of death were collected via death certificates. Outcome of limb weakness, physical and psychiatric symptoms, disability/quality of life and illness perception were recorded with self-rated questionnaires. Outcome measures were compared within and between groups. Seventy-six patients (71%) with functional limb weakness, 31 (67%) neurological and 23 (61%) healthy controls were included in follow-up. Misdiagnosis was found in one patient in the functional limb weakness group (1%) and in one neurological control (2%). Eleven patients with functional limb weakness, eight neurological control subjects and one healthy control subject had died. Weakness had completely remitted in 20% of patients in the functional limb weakness group and in 18% of the neurological controls (P = 0.785) and improved in a larger proportion of functional limb weakness patients (P = 0.011). Outcomes were comparable between patient groups, and worse than the healthy control group. No baseline factors were independent predictors of outcome, although somatization disorder, general health, pain and total symptoms at baseline were univariably correlated to outcome. This study is the largest and longest follow-up study of functional limb weakness. Misdiagnosis in functional limb weakness is rare after long-term follow-up. The disorder is associated with a higher mortality rate than expected, and symptoms are persistent and disabling. It appears difficult to predict outcome based on common baseline variables. These data should help inform clinicians to provide a more realistic outlook of the outcome and emphasize the importance of active and targeted therapy.

scholarly journals Relational Memory in the Early Stage of Psychosis: A 2-Year Follow-up Study

2020 ◽  
Author(s):  
Suzanne N Avery ◽  
Kristan Armstrong ◽  
Maureen McHugo ◽  
Simon Vandekar ◽  
Jennifer Urbano Blackford ◽  
...  
Keyword(s):  
Early Stage ◽  
Chronic Schizophrenia ◽  
Early Psychosis ◽  
Control Group ◽  
Relational Memory ◽  
Course Of Illness ◽  
Memory Impairments ◽  
Control Subjects ◽  
Healthy Control

Abstract Background Relational memory, the ability to bind information into complex memories, is moderately impaired in early psychosis and severely impaired in chronic schizophrenia, suggesting relational memory may worsen throughout the course of illness. Methods We examined relational memory in 66 early psychosis patients and 64 healthy control subjects, with 59 patients and 52 control subjects assessed longitudinally at baseline and 2-year follow-up. Relational memory was assessed with 2 complementary tasks, to test how individuals learn relationships between items (face-scene binding task) and make inferences about trained relationships (associative inference task). Results The early psychosis group showed impaired relational memory in both tasks relative to the healthy control group. The ability to learn relationships between items remained impaired in early psychosis patients, while the ability to make inferences about trained relationships improved, although never reaching the level of healthy control performance. Early psychosis patients who did not progress to schizophrenia at follow-up had better relational memory than patients who did. Conclusions Relational memory impairments, some of which improve and are less severe in patients who do not progress to schizophrenia, are a target for intervention in early psychosis.

Hopelessness and Psychiatric Symptomatology in Hospitalized Physically Ill Adolescents

1996 ◽  
Vol 26 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Anthony L. Pillay ◽  
Douglas R. Wassenaar
Keyword(s):  
Psychiatric Symptoms ◽  
The Other ◽  
Psychiatric Disturbance ◽  
Psychiatric Symptomatology ◽  
Healthy Group ◽  
Matched Group ◽  
Control Subjects ◽  
Healthy Control ◽  
The One

This study compares scores on psychiatric disturbance and hopelessness in two adolescent samples. The one sample was a physically ill hospitalized group, and the other was a matched group of healthy control subjects. It was found that the hospitalized physically ill group scored significantly higher on both psychiatric disturbance and hopelessness than the healthy group. At six-month follow-up, the physically ill group's scores on psychiatric disturbance had declined significantly, but hopelessness scores remained significantly high. In line with other findings, this study suggests that insufficient clinical attention is paid to psychiatric symptoms in hospitalized physically ill patients, and that the high hopelessness scores after six months warrant clinical psychological evaluation.

scholarly journals Circulating tumour DNA methylation in hepatocellular carcinoma diagnosis using digital droplet PCR

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199296
Author(s):  
Juan Wang ◽  
Liu Yang ◽  
Yanjun Diao ◽  
Jiayun Liu ◽  
Jinjie Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Dna Methylation ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Control Group ◽  
Control Subjects ◽  
Droplet Pcr ◽  
Healthy Control

Objective To evaluate the performance of a DNA methylation-based digital droplet polymerase chain reaction (ddPCR) assay to detect aberrant DNA methylation in cell-free DNA (cfDNA) and to determine its application in the detection of hepatocellular carcinoma (HCC). Methods The present study recruited patients with liver-related diseases and healthy control subjects. Blood samples were used for the extraction of cfDNA, which was then bisulfite converted and the extent of DNA methylation quantified using a ddPCR platform. Results A total of 97 patients with HCC, 80 healthy control subjects and 46 patients with chronic hepatitis B/C virus infection were enrolled in the study. The level of cfDNA in the HCC group was significantly higher than that in the healthy control group. For the detection of HCC, based on a cut-off value of 15.7% for the cfDNA methylation ratio, the sensitivity and specificity were 78.57% and 89.38%, respectively. The diagnostic accuracy was 85.27%, the positive predictive value was 81.91% and the negative predictive value was 87.20%. The positive likelihood ratio of 15.7% in HCC diagnosis was 7.40, while the negative likelihood ratio was 0.24. Conclusions A sensitive methylation-based assay might serve as a liquid biopsy test for diagnosing HCC.

scholarly journals Nrf2 Dysregulation in Major Depressive and Bipolar Disorders

2021 ◽  
Vol 10 ◽  
pp. e2074
Author(s):  
Maryam Ghanbarirad ◽  
Mehrdad Hashemi ◽  
Seyed Mehdi Saberi ◽  
Ahmad Majd
Keyword(s):  
Mental Disorders ◽  
Defense Mechanisms ◽  
Bipolar Disorders ◽  
Expression Level ◽  
Control Group ◽  
Roc Curve Analysis ◽  
Major Depressive ◽  
Control Subjects ◽  
Healthy Control ◽  
Nrf2 Expression

Background: Major depressive disorder (MDD) and bipolar disorder (BPD) are two of the most important mental disorders that greatly impact different aspects of life. These conditions imply heavy health and economic burden and are heterogeneous in nature. Inflammation is reported as the etiology of mental disorders. Nrf2 transcription factor plays a key role in the defense mechanisms against inflammation and oxidative stress. So, this study aimed to evaluate the expression level of Nrf2 in MDD and BPD patients and compared it with healthy control subjects. Materials and Methods: In this study, real-time PCR was conducted to evaluate the expression level of Nrf2 in 100 MDD and 100 BPD patients compared to 100 healthy control subjects. Statistical analysis conducted on GraphPad Prism 8 and SPSS21 included ANOVA, Tukey’s test, receiver operating characteristic (ROC), and odds ratio. Results: Results suggest a significant downregulation of Nrf2 in these conditions compared to the control group. ROC curve analysis demonstrates Nrf2 as a biomarker of these psychiatric disorders. Conclusion: The elevated levels of reactive oxygen species and downregulation of detoxifying enzymes were observed in MDD and BPD, which can be associated with the downregulation of Nrf2. Concerning its role in inflammatory response pathways, alternation of Nrf2 expression can be associated with the pathology of these conditions.

scholarly journals Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Patients with RetinalArtery Occlusion

2020 ◽  
Author(s):  
Mahmut Atum ◽  
Gürsoy Alagöz
Keyword(s):  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Control Group ◽  
Retrospective Case ◽  
Control Subjects ◽  
Gender And Age ◽  
Significant Difference ◽  
Healthy Control ◽  
Retinal Artery ◽  
The Relationship

Purpose: This study aimed to compare the neutrophil-to-lymphocyte (NLR) and plateletto- lymphocyte (PLR) ratios in patients with retinal artery occlusion (RAO) with those from a healthy control population and to identify the relationship between them. Methods: Forty-six patients with RAO and fifty-one healthy control subjects were included in this retrospective case-control study. RAO was diagnosed following an ophthalmic examination and fluorescein angiography (FA). Blood neutrophil, lymphocyte, and platelet counts were recorded for each of the 97 subjects, from which NLR and PLR values were calculated. Results: There were 46 patients (28 male [M], 18 female [F]) in the RAO group and 51 patients (27 M, 24 F) in the control group. No significant differences were found between patients with RAO and the control subjects in terms of gender and age (P > 0.05). Patients with RAO had significantly increased NLR values (2.85 ± 1.70) than the control subjects (1.63 ± 0.59, P < 0.001). The mean PLR in patients with RAO was 123.69 ± 64.98, while that in control subjects was 103.08 ± 36.95; there was no significant difference between the two groups (P = 0.055). A logistic regression analysis revealed that NLRs were 3.8 times higher in patients with RAO than in control subjects (odds ratio = 3.880; 95% confidence interval = 1.94 to 7.74; P < 0.001). Conclusion: NLRs were significantly increased in patients with RAO compared to the control subjects.

Stereopsis Deficits in Parkinson’s Disease and Their Clinical Implications

2020 ◽  
Author(s):  
Fang Ba ◽  
Tina T. Sang ◽  
Jaleh Fatehi ◽  
Wenjing He ◽  
Emanuel Mostofi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Severity ◽  
Rating Scale ◽  
Disease Status ◽  
Cognitive Status ◽  
Control Group ◽  
Motor Disorder ◽  
Healthy Control ◽  
Stereo Acuity

Abstract Background: Parkinson's disease (PD) is not exclusively a motor disorder. Among non-motor features, PD patients possess sensory visual dysfunctions. Stereopsis deficit can significantly impact patients' motor performance. However, it is not routinely tested, and its significance is under-investigated. Studying stereopsis using reliable 3D stimuli may help determine its implications in disease status in PD.The objective of the study is to investigate stereopsis abnormalities in PD with reliable and more physiological tools, and their correlation with indicators of PD severity. Methods: Twenty-four healthy control and 20 PD participants were first evaluated for visual acuity, visual field, contrast acuity, and stereoperception with 2D and Titmus stereotests, followed by the assessment with the 3D active shutter system. The correlation between stereopsis and disease severity, Unified Parkinson’s disease rating scale motor scores (UPDRS-III), levodopa equivalent daily dose (LEDD), course of disease and cognitive status were evaluated using univariate regression models. Results: Screening visual tests did not reveal any differences between PD and control group. With the 3D active shutter system, PD patients demonstrated significantly worse stereopsis (i.e p=0.002, 26 seconds of arc). There was a trend that UPDRS-III and LEDD negatively correlate with the stereo acuity, suggesting poorer stereoperception is related to disease severity. Preserved cognitive function correlated with more intact stereo acuity. Conclusion: With more reliable and physiological tools, PD patients exhibit poorer stereopsis. These deficits reflected PD motor and cognitive status. How stereopsis relates to gait, fall risks and navigation warrants more investigations in the future.

scholarly journals Cervical proprioception and its relationship with neck pain intensity in subjects with cervical spondylosis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ravi Shankar Reddy ◽  
Jaya Shanker Tedla ◽  
Snehil Dixit ◽  
Mohammed Abohashrh
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Cervical Spondylosis ◽  
Target Position ◽  
Absolute Error ◽  
Healthy Control Group ◽  
Control Group ◽  
Cross Sectional ◽  
Control Subjects ◽  
Healthy Control

Abstract Background Cervical proprioception is critical in the maintenance of posture and movements, so its assessment in different cervical conditions has gained importance in recent clinical practice. Studies reporting this assessment in subjects with cervical spondylosis (CS) have not previously been investigated. The goals of the study are (1) comparison of joint position error (JPE) in subjects with CS to healthy control group. (2) Correlation of neck pain intensity to cervical proprioception in patients with CS. Methods In a Cross-sectional study, 132 subjects with CS and 132 healthy age-matched control subjects were evaluated for cervical JPE with the cervical range of motion device. The subjects were blindfolded and repositioned their heads to a target position, which was determined by the examiner previously and their repositioning accuracy (absolute error in degrees) was measured in the frontal (flexion and extension) and transverse planes (left rotation and right rotation). The CS subjects resting neck pain intensity was assessed using visual analog scale (VAS). Results CS subjects showed statistically significantly larger JPEs compared to healthy control subjects in all the directions tested (flexion - 95% CI = 2.38–3.55, p < 0.001, extension - 95% CI =3.26–4.33, p < 0.001, left rotation - 95% CI = 2.64 - 3.83, p < 0.001, right rotation − 95% CI = 3.77–4.76, p < 0.001). The mean JPE errors in the CS group ranged from 6.27° to 8.28° and in the control group ranged from 2.36° to 4.48°. Pearson’s correlation coefficient showed a significant and positive relationship between neck pain intensity and cervical proprioception (p ≤ 0.001). Conclusions Proprioception is impaired in subjects with CS when compared to healthy control group. Higher pain intensity was associated with greater cervical JPE in patients with CS.

scholarly journals Silent hypoxia: higher NO in red blood cells of COVID-19 patients

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Esmaeil Mortaz ◽  
Majid Malkmohammad ◽  
Hamidreza Jamaati ◽  
Parisa Adimi Naghan ◽  
Seyed MohamadReza Hashemian ◽  
...  
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Diffuse Alveolar Damage ◽  
Serum Levels ◽  
Pulmonary Involvement ◽  
Clinical Feature ◽  
Control Group ◽  
Small Vessels ◽  
Control Subjects ◽  
Healthy Control

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has spread to almost 100 countries, infected over 31 M patients and resulted in 961 K deaths worldwide as of 21st September 2020. The major clinical feature of severe COVID-19 requiring ventilation is acute respiratory distress syndrome (ARDS) with multi-functional failure as a result of a cytokine storm with increased serum levels of cytokines. The pathogenesis of the respiratory failure in COVID-19 is yet unknown, but diffuse alveolar damage with interstitial thickening leading to compromised gas exchange is a plausible mechanism. Hypoxia is seen in the COVID-19 patients, however, patients present with a distinct phenotype. Intracellular levels of nitric oxide (NO) play an important role in the vasodilation of small vessels. To elucidate the intracellular levels of NO inside of RBCs in COVID-19 patients compared with that of healthy control subjects. Methods We recruited 14 COVID-19 infected cases who had pulmonary involvement of their disease, 4 non-COVID-19 healthy controls (without pulmonary involvement and were not hypoxic) and 2 hypoxic non-COVID-19 patients subjects who presented at the Masih Daneshvari Hospital of Tehran, Iran between March–May 2020. Whole blood samples were harvested from patients and intracellular NO levels in 1 × 106 red blood cells (RBC) was measured by DAF staining using flow cytometry (FACS Calibour, BD, CA, USA). Results The Mean florescent of intensity for NO was significantly enhanced in COVID-19 patients compared with healthy control subjects (P ≤ 0.05). As a further control for whether hypoxia induced this higher intracellular NO, we evaluated the levels of NO inside RBC of hypoxic patients. No significant differences in NO levels were seen between the hypoxic and non-hypoxic control group. Conclusions This pilot study demonstrates increased levels of intracellular NO in RBCs from COVID-19 patients. Future multi-centre studies should examine whether this is seen in a larger number of COVID-19 patients and whether NO therapy may be of use in these severe COVID-19 patients.

scholarly journals A Prospective Psychological Study of Patients with Undiagnosed Episodes of Disturbed Consciousness

1992 ◽  
Vol 5 (3) ◽  
pp. 173-182
Author(s):  
L. D. Blumhardt ◽  
D. Barnes ◽  
S. J. Howell ◽  
E. Ghadiali
Keyword(s):  
Psychological Disorder ◽  
Control Group ◽  
Personality Profiles ◽  
Psychological Disturbance ◽  
Psychological Study ◽  
Healthy Control ◽  
Unexplained Symptoms ◽  
Patients With Epilepsy ◽  
The Relationship

We have carried out a prospective psychological and clinical study of neurological out-patients with episodes of disturbed consciousness that were mostly unexplained after clinical assessments and prolonged follow up. When compared with matched healthy subjects, both the undiagnosed patients and a control group with chronic epilepsy, had evidence of abnormal personality and psychological disturbance. However, in the undiagnosed patients there were significant differences between two subgroups defined by the results of clinical follow up. Patients whose symptoms resolved spontaneously were psychologically indistinguishable from healthy control subjects, whereas patients whose unexplained symptoms continued, with or without empirical treatment trials, had highly abnormal personality profiles. Although the basic psychological tests we used cannot reliably separate individual patients with epilepsy from those with non-epilepsy, they do have some predictive value with respect to the prognosis of unexplained symptoms. Further detailed prospective studies may help to establish the relationship between psychological disorder and unexplained symptoms and perhaps reduce the need for repeated, expensive investigations.

Identical Effects of Indomethacin on Renal Function in Healthy Uninephrectomized Subjects and in Healthy Control Subjects

1994 ◽  
Vol 86 (6) ◽  
pp. 715-721 ◽  
Author(s):  
C. B. Nielsen ◽  
S. S. Sørensen ◽  
E. B. Pedersen
Keyword(s):  
Renal Function ◽  
Urinary Excretion ◽  
Prostaglandin E2 ◽  
Excretion Rate ◽  
Control Group ◽  
Urinary Excretion Rate ◽  
Control Subjects ◽  
Time Control ◽  
Healthy Control ◽  
Remnant Kidney

1. Animal studies have shown that prostaglandins are important for renal function after unilateral nephrectomy. In order to investigate the importance of prostaglandins for renal function in the fully adapted remnant kidney in healthy uninephrectomized subjects, the acute effects of indomethacin on renal haemodynamics, lithium clearance, urinary excretion rates of prostaglandin E2, sodium and water, and plasma levels of angiotensin II, aldosterone, atrial natriuretic peptide and arginine vasopressin were measured in 14 healthy uninephrectomized subjects (median time after nephrectomy 1.7 years) and in 14 matched healthy control subjects. In addition, nine healthy control subjects were studied without indomethacin and served as a time-control group. 2. Before indomethacin ingestion there was a significantly higher single-kidney urinary excretion rate of prostaglandin E2 in the uninephrectomized group (uninephrectomized group, 349.2 fmol/min; control group, 76.6 fmol/min; time-control group, 96.3 fmol/min). 3. Indomethacin ingestion resulted in equal changes in all parameters in both groups. These were significant decreases in glomerular filtration rate (−11.3% versus −14.6%), renal plasma flow (−6.5% versus −13.0%), urinary flow rate (−49.8% versus −49.4%), fractional sodium excretion (−44.5% versus −47.4%), lithium clearance (−33.2% versus −23.8%) and urinary excretion rate of prostaglandin E2 (−93.8% versus −86.7%) (uninephrectomized versus control subjects, values are medians). In the time-control group no changes were observed in these parameters. 4. It is concluded that healthy uninephrectomized subjects with a fully adapted remnant kidney have a normal renal response to acute indomethacin-induced inhibition of prostaglandin synthesis.

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