Management of Frequently Encountered Causes of Unconsciousness

2019 ◽  
pp. 326-378
Author(s):  
Jerome B. Posner ◽  
Clifford B. Saper ◽  
Nicholas D. Schiff ◽  
Jan Claassen
Keyword(s):  
Clinical Diagnoses ◽  
Underlying Disorder

This chapter presents a diagnostic and management outline to approach commonly encountered conditions associated unconsciousness. Once the specific cause is identified, attention should turn to dealing with the set of problems inherent to the underlying disorder. As it is not possible to cover all aspects of treatment of all possible causes of stupor and coma comprehensively, this chapter focuses instead on the management of frequently encountered pathologies within each of the main categorical clinical diagnoses: supratentorial or infratentorial compressive lesions; supratentorial or infratentorial destructive lesions; metabolic, diffuse, or multifocal coma. Management of psychogenic coma is discussed in Chapter 6.

Substance Abuse in Older Psychiatric Inpatients

2017 ◽  
Vol 63 (2) ◽  
pp. 115-121 ◽  
Author(s):  
Tilman Wetterling ◽  
Klaus Junghanns
Keyword(s):  
Substance Abuse ◽  
Substance Abusers ◽  
Psychiatric Inpatient ◽  
Psychiatric Inpatients ◽  
Severe Withdrawal ◽  
Psychiatric Inpatient Treatment ◽  
Clinical Diagnoses ◽  
Multiple Substance ◽  
Icd 10 ◽  
Substance Abuse Disorders

Abstract. Aim: This study investigates the characteristics of older patients with substance abuse disorders admitted to a psychiatric department serving about 250.000 inhabitants. Methods: The clinical diagnoses were made according to ICD-10. The data of the patients with substance abuse were compared to a matched sample of psychiatric inpatients without substance abuse as well as to a group of former substance abusers with long-term abstinence. Results: 19.3 % of the 941 patients aged > 65 years showed current substance abuse, 9.4 % consumed alcohol, 7.9 % took benzodiazepines or z-drugs (zolpidem and zopiclone), and 7.0 % smoked tobacco. Multiple substance abuse was rather common (30.8 %). About 85 % of the substance abusers had psychiatric comorbidity, and about 30 % showed severe withdrawal symptoms. As with the rest of the patients, somatic multimorbidity was present in about 70 % of the substance abusers. Remarkable was the lower rate of dementia in current substance abusers. Conclusion: These results underscore that substance abuse is still a challenge in the psychiatric inpatient treatment of older people.

scholarly journals Dental Pulp-Derived Mesenchymal Stem Cells for Modeling Genetic Disorders

2021 ◽  
Vol 22 (5) ◽  
pp. 2269
Author(s):  
Keiji Masuda ◽  
Xu Han ◽  
Hiroki Kato ◽  
Hiroshi Sato ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Dental Pulp ◽  
Genetic Disorders ◽  
In Vitro Models ◽  
High Plasticity ◽  
Human Teeth ◽  
Clinical Diagnoses ◽  
Models Of Disease

A subpopulation of mesenchymal stem cells, developmentally derived from multipotent neural crest cells that form multiple facial tissues, resides within the dental pulp of human teeth. These stem cells show high proliferative capacity in vitro and are multipotent, including adipogenic, myogenic, osteogenic, chondrogenic, and neurogenic potential. Teeth containing viable cells are harvested via minimally invasive procedures, based on various clinical diagnoses, but then usually discarded as medical waste, indicating the relatively low ethical considerations to reuse these cells for medical applications. Previous studies have demonstrated that stem cells derived from healthy subjects are an excellent source for cell-based medicine, tissue regeneration, and bioengineering. Furthermore, stem cells donated by patients affected by genetic disorders can serve as in vitro models of disease-specific genetic variants, indicating additional applications of these stem cells with high plasticity. This review discusses the benefits, limitations, and perspectives of patient-derived dental pulp stem cells as alternatives that may complement other excellent, yet incomplete stem cell models, such as induced pluripotent stem cells, together with our recent data.

scholarly journals Robust diagnostic classification via Q-learning

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Victor Ardulov ◽  
Victor R. Martinez ◽  
Krishna Somandepalli ◽  
Shuting Zheng ◽  
Emma Salzman ◽  
...  
Keyword(s):  
Autism Spectrum ◽  
Decision Function ◽  
Diagnostic Classification ◽  
Decision Making Process ◽  
Domain Experts ◽  
Q Learning ◽  
School Aged Children ◽  
Hyperactivity Disorder ◽  
Clinical Diagnoses ◽  
Learning Frameworks

AbstractMachine learning (ML) models have demonstrated the power of utilizing clinical instruments to provide tools for domain experts in gaining additional insights toward complex clinical diagnoses. In this context these tools desire two additional properties: interpretability, being able to audit and understand the decision function, and robustness, being able to assign the correct label in spite of missing or noisy inputs. This work formulates diagnostic classification as a decision-making process and utilizes Q-learning to build classifiers that meet the aforementioned desired criteria. As an exemplary task, we simulate the process of differentiating Autism Spectrum Disorder from Attention Deficit-Hyperactivity Disorder in verbal school aged children. This application highlights how reinforcement learning frameworks can be utilized to train more robust classifiers by jointly learning to maximize diagnostic accuracy while minimizing the amount of information required.

scholarly journals Gait Patterns and Mood in Everyday Life: A Comparison Between Depressed Patients and Non-depressed Controls

2021 ◽  
Author(s):  
Dirk Adolph ◽  
Wolfgang Tschacher ◽  
Helen Niemeyer ◽  
Johannes Michalak
Keyword(s):  
Everyday Life ◽  
Walking Speed ◽  
Laboratory Findings ◽  
Gait Patterns ◽  
Gait Characteristics ◽  
Clinical Diagnoses ◽  
Current Mood ◽  
General Movement ◽  
And Gender ◽  
Vertical Up

Abstract Background Previous laboratory findings suggest deviant gait characteristics in depressed individuals (i.e., reduced walking speed and vertical up-and-down movements, larger lateral swaying movements, slumped posture). However, since most studies to date assessed gait in the laboratory, it is largely an open question whether this association also holds in more naturalistic, everyday life settings. Thus, within the current study we (1) aimed at replicating these results in an everyday life and (2) investigated whether gait characteristics could predict change in current mood. Methods We recruited a sample of patients (n = 35) suffering from major depressive disorder and a sample of age and gender matched non-depressed controls (n = 36). During a 2-day assessment we continuously recorded gait patterns, general movement intensity and repetitively assessed the participant’s current mood. Results We replicated previous laboratory results and found that patients as compared to non-depressed controls showed reduced walking speed and reduced vertical up-and-down movements, as well as a slumped posture during everyday life episodes of walking. Moreover, independent of clinical diagnoses, higher walking speed, and more vertical up-and-down movements significantly predicted more subsequent positive mood, while changes in mood did not predict subsequent changes in gait patterns. Conclusion In sum, our results support expectations that embodiment (i.e., the relationship between bodily expression of emotion and emotion processing itself) in depression is also observable in naturalistic settings, and that depression is bodily manifested in the way people walk. The data further suggest that motor displays affect mood in everyday life.

scholarly journals Cognitive behaviour therapy meets psychopharmacotherapy

2010 ◽  
Vol 3 (4) ◽  
pp. 117-131
Author(s):  
David Veale ◽  
Anna Stout
Keyword(s):  
Bipolar Disorder ◽  
Side Effects ◽  
Emotional Disorders ◽  
Cognitive Behaviour Therapy ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Underlying Disorder

AbstractThis article provides an overview of the role of psychopharmacotherapy in common emotional disorders for cognitive behaviour therapists. We consider some of the philosophical difference between CBT and medication, when medication might interfere with CBT, when it may enhance outcome and when it might be safely discontinued. We highlight how to differentiate side-effects and symptoms of discontinuation of antidepressants from that of the underlying disorder. The scope of this article is confined to common emotional disorders and does not discuss the interaction of CBT with medication in, e.g. schizophrenia, bipolar disorder or dementia.

Diagnostic criteria for temporomandibular disorders (DC/TMD): interexaminer reliability of the Finnish version of Axis I clinical diagnoses

2017 ◽  
Vol 44 (7) ◽  
pp. 493-499 ◽  
Author(s):  
J. Leskinen ◽  
T. Suvinen ◽  
T. Teerijoki-Oksa ◽  
P. Kemppainen ◽  
R. Näpänkangas ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Temporomandibular Disorders ◽  
Clinical Diagnoses ◽  
Interexaminer Reliability ◽  
Axis I

scholarly journals CLINICAL DIAGNOSES AND AUTOPSY FINDINGS AFTER HEART TRANSPLANTATION: DISCREPANCIES AFFECTING MANAGEMENT AND SURVIVAL – NEHTS STUDY (NECROPSY HEART TRANSPLANTATION STUDY)

2012 ◽  
Vol 59 (13) ◽  
pp. E929
Author(s):  
Edimar Alcides Bocchi ◽  
Thiago Ninck Valette ◽  
Silvia Moreira Ayub-Ferreira ◽  
Victor Issa ◽  
Luiz Alberto Benvenuti ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Autopsy Findings ◽  
Clinical Diagnoses ◽  
Transplantation Study
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