scholarly journals 0961 Comparison of Clinical Characteristics of Children With Narcolepsy With and Without Sleep Related Movement Disorders

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A365-A365
Author(s):  
E A McIntyre ◽  
S K Oles ◽  
A Bandyopadhyay ◽  
A Daftary

Abstract Introduction Narcolepsy is known to be associated with sleep related movement disorders (SRMD) including periodic limb movement and restless leg syndrome. However, there is paucity of data comparing the clinical characteristics of children with narcolepsy with and without SRMD. Methods Retrospective chart review of all children presenting to the sleep clinic for sleep problems between March 2016 to June 2017 was performed. Demographics, sleep intake patient questionnaires and ICD-10 codes for comorbidities and sleep diagnoses were collected. Children with diagnosis of narcolepsy (ICD-10 G47.4) were included in this study. Cohort was divided into 2 groups- with and without co-existing diagnoses of sleep related movement disorders (ICD-10 G47.6). Demographics, presenting symptoms, Epworth sleepiness scores and prevalence of sleep comorbidities were compared using T-test (continuous) and Chi square (categorical). Unadjusted odds ratio was calculated for demographics and presence of SRMD. P value of <0.05 was considered significant. Results 28 (F=14,50%) children with narcolepsy were included. 25% children were diagnosed with SRMD. Mean (SD) age of children with SRMD presenting to the sleep clinic was 11.14 (5.08) years while mean age (SD) of children without SRMD was 9.52 (3.87) years. Age and race of children with and without SRMD were not statistically different. There was an increased prevalence of females in the group with narcolepsy and SRMD compared to the group without SRMD (86%vs38%, p=0.029). Epworth sleepiness score was not statistically different between the 2 groups. Female gender increased the odds of SRMD in children with narcolepsy (OR:9.75, 0.98- 96.56). Conclusion Children with narcolepsy can present with comorbid sleep related movement disorder. Females were more likely to present with associated SRMD compared to males. Support None

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A367-A367
Author(s):  
E McIntyre ◽  
S K Oles ◽  
K Walsh ◽  
A Bandyopadhyay

Abstract Introduction Anxiety and Attention Deficit Hyperactive Disorder (ADHD) are common psychiatric comorbidities in children with sleep disorders. It is known that comorbid psychiatric disorders increase the risk of sleep problems. However, no study has compared the clinical characteristics of children presenting with sleep problems and various common psychiatric disorders. Methods Retrospective chart review of all children presenting to the sleep clinic for sleep problems between March 2016 to June 2017 was performed. Demographics, sleep intake patient questionnaires, polysomnograms and ICD-9/10 codes for comorbidities and sleep diagnoses were collected. In children with diagnoses of anxiety (ICD-9 300/ICD-10 F41) and ADHD (ICD-9 314/ICD-10 F90), demographics, presenting symptoms, Epworth sleepiness scores and prevalence of sleep comorbidities were compared. T-test (continuous) and Chi Square (categorical) were used. Unadjusted odds ratio was calculated for presenting symptoms and sleep comorbidities. P value of <0.05 was considered significant. Results 250 (F=145, 58%) children were evaluated. 71.2% children were diagnosed with anxiety and 28.8% diagnosed with ADHD. Mean age at presentation was 8.53 ± 4.2 years. Age, gender and race of children presenting with sleep problems and comorbid anxiety/ADHD were statistically similar. Children with anxiety spent less time in stage N3 sleep (25.2% ± 9.1 versus 28.6% ± 9.2) and had lower arousal indices (7.19 ± 3.8 versus 8.86 ± 5.5) compared to children with ADHD. Children with anxiety were more likely to present with chief complaint of “feeling tired or sleepy during the day” (OR:2.38, 1.32-4.37) and were more likely to have a diagnosis of hypersomnia (OR: 11.67, 3.19-42.75) versus children with ADHD. Conclusion Children with psychiatric comorbidities have distinct polysomnographic characteristics. Children with anxiety are more likely to present with daytime sleepiness and have a significantly higher prevalence of hypersomnia compared to children with ADHD. Support None


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S330-S330
Author(s):  
Jocelyn Y Ang ◽  
Nirupama Kannikeswaran ◽  
Basim Asmar

Abstract Background There is limited data regarding the presenting clinical characteristics of COVID-19 in children. Our objective is to describe the clinical presentations and outcomes of COVID-19 infection early in the pandemic at our institution. Methods We performed a retrospective chart review of children up to 18 years who underwent testing for SARS CoV-2 from March 1st to May 10th 2020 at our pediatric emergency department. We abstracted patient’s demographics, clinical presentation, diagnostic studies and patient disposition. We classified the severity of clinical illness based on published criteria. We excluded patients diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19. Results SARS CoV-2 testing was performed on 481 patients of whom 43 (8.9%) tested positive. Of these, 4 were diagnosed with MIS-C. Data of 39 patients were analyzed. Patients’ demographics, co-morbidities, presenting signs and symptoms and disposition are shown in Table 1. Age range was 47 days – 18 years. Infants representing one third (14/39; 35.9%) of our study cohort. There was equal sex distribution. Asthma or obesity was present in 17 (44%). The most common presenting symptoms included fever, cough, shortness of breath and diarrhea. Chest radiograph showed pneumonia in 12 (30.8%) patients. Two thirds (27/39; 69.2%) were asymptomatic or had mild disease; six patients (15.4%) had severe or critical illness (Figure 1). Nineteen (48%) patients were admitted to the general pediatric service. Eleven (28%) were admitted to the Intensive Care Units (ICU). The characteristics, presenting symptoms and interventions performed in the PICU cohort are shown in Table 2. Half of these patients required mechanical ventilation. There was one death in a 3 month old infant unrelated to SARS CoV-2. Majority of the infants required hospitalization (12/14; 85.7%), including 4 to the PICU (one each for non accidental trauma, ingestion, seizure and pneumonia). Table 1. Patient demographics, signs and symptoms of COVID-19 infection in Children Table 2: PICU patients: Characteristics, Interventions and pharmacotherapy Figure 1: Severity of Ill ness in the study cohort Conclusion Majority (17; 43%) of our children with COVID-19 had a mild disease. Eleven (28%) including 4 infants required critical care; 5 required mechanical ventilation. There was no COVID-19 related mortality. Larger studies are needed to further define the spectrum of COVID- 19 and risk factors associated with severe disease in children. Disclosures All Authors: No reported disclosures


2017 ◽  
Vol 28 (12) ◽  
pp. 1164-1168 ◽  
Author(s):  
JeeYoon Park ◽  
Lindsay Zimmerman ◽  
Kelly Stempinski ◽  
Rebecca Bridge ◽  
Alicia Roston ◽  
...  

This study is a follow-up observational study to assess the prevalence of chlamydia (CT) and gonorrhea (GC) among women who undergo a first-trimester surgical termination in a large public, urban hospital-based termination clinic, and to compare the rates to previously published data. We conducted a retrospective chart review on 4197 patients who underwent CT and GC testing before an elective, first-trimester surgical termination between 1 June 2014 and 31 May 2015. The prevalence rates were calculated and compared by chi square tests to previously published data from 1 January 2006 to 30 June 2006 from the same publicly-funded pregnancy termination clinic. Our study population comprised mostly of African Americans (86.8%), and more than half were aged less than 25 years. The overall prevalence of CT in our population was 9.6%, which was significantly different to the prevalence of 11.4% in 2006 ( p value = 0.03). The overall prevalence of GC in our population was 1.9%, which was not significantly different to the prevalence of 2.6% in 2006. To conclude, this study demonstrates the high prevalence rate of CT-positive and GC-positive patients in our publicly-funded pregnancy termination clinic. The prevalence of infection with CT and GC in our study is higher than in other family planning clinics. Regular screening of all patients who undergo induced termination in pregnancy termination clinics can provide a valuable opportunity for physicians to counsel patients about sexually transmitted infection prevention and treatment prior to the procedure or distribution of medications.


Author(s):  
Shahid Bilal ◽  
Jaiperkash Dayaram ◽  
Ali Nawaz Bijarani ◽  
Mariam Muneer ◽  
Saba Arshad ◽  
...  

Aims: The aim of current study is to find out the prevalence of depression in doctors in different hospitals of Karachi and its association with lifestyle, the field of specialty and coping mechanisms. Place and Duration of Study: The sample was collected from 10 different hospitals of Karachi, in a period of one Year i.e., March 2019 to February 2020. Methodology: A descriptive cross-sectional study design using non-probability consecutive type of sampling technique was used. Sample size was calculated at 95% confidence interval and was found to be 368. The sample was classified in two broader categories Surgery & Allied and Medicine & Allied. For identification of depression level, Public Health Questionnaire (PHQ-9) was used. A 28-item questionnaire Brief COPE was used to asses coping mechanisms. Results: In total 400 forms were used for data analysis. The mean age of doctors was 35 ± 4 years, 65% were males while 35% were females, there was a statistically significant association of female gender with depression. Chi-Square was applied to determine the association of depression and departments and it was found to be highly significant with a P < .001. Highest level of depression was found in Orthopedics and Psychiatry departments followed by Surgery and Gynecology. While Otolaryngology was the least depressed department. Chi-square was applied and a statistically significant association of low monthly income and depression with a p-value of 0.02. In Surgery and allied there was a statistically significant association of depression with extensive working hours and lack of facilities with a p-value of 0.01 and 0.04. While in Medicine and allied there was a statistically significant association of depression with a harsh attitude of seniors and an uncomfortable working environment with a p-value of 0.02 and 0.03. A linear regression model comparing depression and its associations with coping strategies was applied. Conclusion: Our study shows that depression is present in a vast majority of doctors from multiple specialties. Various risk factors for depression have also been identified so appropriate coping strategies should be formulated to deal with it.


Geriatrics ◽  
2020 ◽  
Vol 5 (3) ◽  
pp. 54
Author(s):  
Joy Antonelle de Marcaida ◽  
Jeffrey Lahrmann ◽  
Duarte Machado ◽  
Lawrence Bluth ◽  
Michelle Dagostine ◽  
...  

It is not established whether SARS-CoV-2 (COVID-19) patients with movement disorders, are at greater risk for more serious outcomes than the larger COVID-19 population beyond the susceptibility associated with greater age. We reviewed electronic health records and conducted telephone interviews to collect the demographics and clinical outcomes of patients seen at our Movement Disorders Center who tested positive for COVID-19 from 8 March 2020 through 6 June 2020. Thirty-six patients were identified, 23 men and 13 women, median age of 74.5 years. They primarily carried diagnoses of idiopathic Parkinson disease (n = 22; 61%) and atypical parkinsonism (n = 7; 19%) with the balance having other diagnoses. Twenty-seven patients (75%) exhibited alteration in mental status and fifteen (42%) had abnormalities of movement as common manifestations of COVID-19; in 61% and 31%, respectively, these were the presenting symptoms of the disease. Sixty-seven percent of patients in our cohort required hospitalization, and the mortality rate was 36%. These data demonstrate that in patients with movement disorders, the likelihood of hospitalization and death after contracting COVID-19 was greater than in the general population. Patients with movement disorders frequently presented with altered mental status, generalized weakness, or worsening mobility but not anosmia.


Author(s):  
Emmanuel A. Adelusi

Introduction: Though changing patterns of tooth extraction have been reported in the literature which included the age, gender, tooth type and indications for extraction, there is still paucity of studies that have examined the variation and changes in the pattern of tooth extraction over a period of time in a given nation. We therefore accessed the pattern and indications of tooth loss in the patients who presented at oral surgery clinic for intra-alveolar tooth extraction over a twelve month period. Methods: This is a prospective cohort study of adult patients tooth extraction between September 2015 and August 2016. Patients’ demographic and clinical data were collected with a structured questionnaire. Data were analyzed using statistical package for social sciences (SPSS) version 23.0. Variables were subjected to Pearson’s chi-square test and P <0.05 was considered statistically significant. Results: A total of 240 adults age range between 18 to 75 years of age with mean age of 36.64 years were included in the analysis. Maxillary teeth (231) and mandibular teeth (326) were extracted in 203 and 263 patients respectively. Caries and its sequelae, 223(93%) were the predominant indication for tooth extractions. Lower second molar (25%), and upper third molar (20%) had the highest frequencies. More female (126, 52.5%) than male (114, 47.5%) had extraction done, the difference is however not statistically significant (X2 =1.67, P Value = 0.195) Conclusions: Dental caries and its sequelae are the most frequent cause of tooth extraction. Tooth extraction was more in Patients in the fourth decade as well as in the Female gender, even though the difference between male and female is not statistically significant. And there is increased in number of male who had extraction done compared to what obtained in the past decades. Left side of the mouth appeared to be more affected.


2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 508-508
Author(s):  
Kareem Rayn ◽  
Michael Daniel Weintraub ◽  
Gustavo R Pena-La Grave ◽  
Graham R. Hale ◽  
Samuel Gold ◽  
...  

508 Background: Data on the genetic characteristics of patients with urinary bladder paragangliomas (UBPGLs) is extremely limited. The primary goal of this study is to examine the clinical characteristics of a series of patients with UBPGLs, focusing particularly on their genetic profiles. Methods: We analyzed the medical records of patients who presented with UBPGLs from 2000 to 2017 to determine their presenting symptoms, clinical characteristics and outcomes. In addition, patients were stratified by the presence or absence of metastasis and the presence or absence of multiple paragangliomas (PGLs). Groups were compared using chi-square test and t-test (Stata) statistical analyses. Results: 18 of the 28 patients (64.2%) with UBPGLs had underlying genetic mutations: 15 (53.5%) in the succinate dehydrogenase subunit B gene (SDHB) and 3 (10.7%) in the von Hippel-Lindau gene (VHL). The average age at first symptoms was significantly younger in patients with germline mutations compared to those without mutations (22.3 ± 2.52 vs 37.3 ± 5.95, p = 0.01). 7 patients (38.9%) with germline mutations developed metastasis, at either first presentation or on follow-up, compared to 7 patients (70%) without germline mutations, p = 0.15. 10 patients (58.8%) with germline mutations had multiple PGLs compared to 1 patient (11.1%) without germline mutations, p = 0.02. On average, patients with germline mutations had larger lesions than patients without germline mutations based on the means of the largest diameter (3.7 ± 2.6 vs 3.1 ± 2.2, p = 0.51). Conclusions: Patients presenting with UBPGLs should be screened for underlying germline mutations as they are frequently associated. Patients with UBPGLs and underlying germline mutations present at a significantly younger age than patients without these mutations. Even though patients with UBPGLs and underlying mutations are significantly more likely to develop multiple PGLs, the risk of metastasis is not greater compared to patients without germline mutations. Therefore, all patients with UBPGLs should be followed closely for metastatic development. This research was supported by the Intramural Research Program of the National Cancer Institute, NIH and NIH Medical Research Scholars Program.


2018 ◽  
Vol 12 (1) ◽  
pp. 68-74
Author(s):  
Ketlin Helenise dos Santos Ribas ◽  
Valdenilson Ribeiro Ribas ◽  
Silano Souto Mendes Barros ◽  
Valéria Ribeiro Ribas ◽  
Maria da Glória Nogueira Filizola ◽  
...  

ABSTRACT Young's early maladaptive schemas questionnaire (YSQ-S3) is used to understand psychological aspects. Objective: EMSs were evaluated in patients with migraine. Methods: Sixty-five subjects were evaluated using the YSQ-S3 under standard conditions in a room with air conditioning at 22 ± 2°C. The subjects were stratified by morbidity (migraine), gender (male/female) and age (18-29 / 30-39 / 40-55). Controls (without migraine), n = 27 and patients (with migraine), n = 38, men (n = 19) and women (n = 46); participants aged 18-29 years, n = 34, aged 30-39 years, n = 14 and aged 40-55 years, n = 17. Data were analyzed using the Chi-square test, with p-values <0.05. Results were expressed as percentages in contingency tables. Results: There was a significant association between migraine and female gender (84.21%; p-value <0.05, Table 1), between hypervigilance and inhibition, and unrelenting standards (56.52%; p-value <0.0.014, Table 2) and female gender with migraine. Moreover, there was a significant association between hypervigilance and inhibition, and unrelenting standards (73.68%; p-value <0.0001) and self-punishment (84.21%; p-value <0.0001) in patients with migraine of both genders (Table 3). Conclusion: The individuals with migraine had a psychological profile of being overly demanding with themselves and others and self-punishing, where this was more frequent in women.


2006 ◽  
Vol 13 (02) ◽  
pp. 303-309
Author(s):  
NIAZ MAQSOOD ◽  
ISHTIAQ AHMAD ◽  
WAJID ALI ◽  
Wajeh ur Rehman ◽  
Naima Niaz

Objectives: To find out the sociodemographic characteristics ofconversion disorders and to find if there is any difference between the presenting symptoms of rural and urbanpopulation. Design: A non-probability, purposive, hospital based sample. Place and Duration of Study: Psychiatrydepartment of Victoria Hospital Bahawalpur, from February 2004 to April 2005. Patients and Method: A sample of 100-patients was collected. Both sexes were included. DSM-IV criteria for conversion disorder were applied for diagnosisof all these patients. Informed consent was taken for inclusion in the study. Patients suffering from concurrent physicaldisorders were excluded. The first author (NM.) using a semi-structured pro-forma interviewed all these patients. Thesociodemographic characteristics and the clinical profile were collected. Statistical analysis was made with the statisticalpackage for windows, SPSS (version –10). The applied method for group comparison was chi square- test. Results:The mean age of patients from the urban area was 24.26±7.25 years, as compared to 22.15±7.49 years for thepatients from the rural area. Most of the patients were females and were married. Majority of the patients from the urbanas well as from the rural area were uneducated and from the lower socio-economic class. The onset of illness wastypically acute and sudden, with precipitating life event. Majority of the patients had family history of the illness and comorbidpsychiatric disorders. The presenting symptoms were either sensory, motor, mixed symptoms and psuedoseizures.The presenting symptoms of patient from both urban (p value of 0.008), and rural area (P value =0.013), werestatistically significant. There were no statistically significant association between the presenting symptoms and thearea of living. The p values of the entire chi square tests were greater than (0.05). Conclusion: Prompt elimination ofthe symptoms of conversion disorder is important to prevent secondary gains from reinforcing it and causing it to persistor reoccur. Psychiatric services need to be developed and updated for the provision of prompt and efficient treatment,for the patients with these chronic and sometimes disabling conversion disorders.


2018 ◽  
Vol 3 (2) ◽  
pp. 51-54
Author(s):  
Fitria Dewi Yunitasari ◽  
Ilil Maidatuz Zulfa

ABSTRAKSkizofrenia merupakan gangguan atau kumpulan gangguan mental yang mempengaruhi pemikiran, persepsi, dan perilaku sosial dan penyebabnya sebagian besar masih belum diketahui. Pengobatan farmakologis skizofrenia menggunakan obat-obat golongan antipsikotik terutama dalam jangka waktu lima tahun setelah episode akut pertama muncul. Penggunaan antipsikotik berpotensi menimbulkan kejadian hospitalisasi yang dapat menurunkan kualitas hidup pasien terkait penurunan fungsi sosial pasien skizofrenia. Penelitian ini bertujuan menganalisis potensi jenis kelamin dan jenis pengobatan antipsikotik sebagai faktor prediktor hospitalisasi pasien skizofrenia. Analisis cross sectional jenis kelamin dan penggunaan antipsikotik dilakukan pada rekam medis pasien rawat inap di Rumah Sakit Jiwa Menur Surabaya Bulan Oktober 2017 yang didiagnosis skizofrenia (ICD-10 F20). Faktor prediktor hospitalisasi pasien  dianalisis menggunakan uji Chi-square for goodness of fit yang membandingkan perbedaan jumlah frekuensi antar kategori pada masing-masing faktor prediktor. Faktor jenis terapi antipsikotik digolongkan menjadi tipikal, atipikal, dan kombinasi. Hasil menunjukan terdapat perbedaan jumlah pasien pada tiga jenis terapi yang berbeda (p-value 0,000) dimana sebagian besar pasien yang dirawat dirumah sakit menerima antipsikotik tipikal (47,41%). Perbandingan jenis kelamin tidak menunjukkan perbedaan yang signifikan pada pasien yang dirawat. Dapat disimpulkan jenis antipsikotik tipikal kemungkinan dapat mempengaruhi kejadian hospitalisasi pada pasien skizofrenia. Kata kunci: Skizofrenia, antipsikotik tipikal, antipsikotik atipikal, hospitalisasi.ABSTRACTSchizophrenia is a mental disorder that affect thought, perception, and social behaviours. Most of causes of schizophrenia are unknown. Pharmacological treatments of schizophrenia use antipsychotics especially during  five years after first acute episode observed. The use of antipsychotics potentially lead to hospitalization that can affect to patients’ quality of life. This study was aimed to analyze the potential of gender and types of antipsychotic treatments as predictor factors in hospitalization of schizophrenia patients. Cross sectional analysis in gender and types of antipsycotics was conducted to medical records of inpatients at Rumah Sakit Jiwa Menur Surabaya diagnozed with Schizophrenia (ICD-10 Code F20) in October 2017. Chi-square for goodness of fit test was used to determine the difference amount of patients among different gender and different types of antipsychotics used as predictor factors. Types of antipsychotics used was classified into three categories which were patients who received typical antipsychotic, atypical antipsycotic and combination. The results showed that there was a significant difference in amount of hospitalized patients who received typical antipsychotic, atypical antipsycotic and combination (p-value 0,000) which most of hospitalized patients received atypical antipsychotics (47,41%).On the other hand, the proportion of gender among hospitalized patients was found have no significant difference. In conclusion, types of antipsychotics used might related to the hospitalization of schizophrenia patients.Keywords: Schizophrenia, Typical antipsychotic, Atypical antipsychotic, Hospitalization.


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