Iopanoic Acid to Treat Acute Psychiatric Crisis Associated With Thyrotoxicosis

2015 ◽  
Vol 35 (6) ◽  
pp. 743-745
Author(s):  
Jennifer S. Way ◽  
Yang Shen ◽  
Dorothy S. Martinez
Keyword(s):  
Iopanoic Acid ◽  
Psychiatric Crisis

scholarly journals The effects of intensive home treatment on self-efficacy in patients recovering from a psychiatric crisis

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ansam Barakat ◽  
Matthijs Blankers ◽  
Jurgen E Cornelis ◽  
Nick M Lommerse ◽  
Aartjan T F Beekman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Disorders ◽  
Self Efficacy ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Small Sample ◽  
Home Treatment ◽  
Differential Effects ◽  
Psychiatric Crisis

Abstract Background This study evaluated whether providing intensive home treatment (IHT) to patients experiencing a psychiatric crisis has more effect on self-efficacy when compared to care as usual (CAU). Self-efficacy is a psychological concept closely related to one of the aims of IHT. Additionally, differential effects on self-efficacy among patients with different mental disorders and associations between self-efficacy and symptomatic recovery or quality of life were examined. Methods Data stem from a Zelen double consent randomised controlled trial (RCT), which assesses the effects of IHT compared to CAU on patients who experienced a psychiatric crisis. Data were collected at baseline, 6 and 26 weeks follow-up. Self-efficacy was measured using the Mental Health Confidence Scale. The 5-dimensional EuroQol instrument and the Brief Psychiatric Rating Scale (BPRS) were used to measure quality of life and symptomatic recovery, respectively. We used linear mixed modelling to estimate the associations with self-efficacy. Results Data of 142 participants were used. Overall, no difference between IHT and CAU was found with respect to self-efficacy (B = − 0.08, SE = 0.15, p = 0.57), and self-efficacy did not change over the period of 26 weeks (B = − 0.01, SE = 0.12, t (103.95) = − 0.06, p = 0.95). However, differential effects on self-efficacy over time were found for patients with different mental disorders (F(8, 219.33) = 3.75, p < 0.001). Additionally, self-efficacy was strongly associated with symptomatic recovery (total BPRS B = − 0.10, SE = 0.02, p < 0.00) and quality of life (B = 0.14, SE = 0.01, p < 0.001). Conclusions Although self-efficacy was associated with symptomatic recovery and quality of life, IHT does not have a supplementary effect on self-efficacy when compared to CAU. This result raises the question whether, and how, crisis care could be adapted to enhance self-efficacy, keeping in mind the development of self-efficacy in depressive, bipolar, personality, and schizophrenia spectrum and other psychotic disorders. The findings should be considered with some caution. This study lacked sufficient power to test small changes in self-efficacy and some mental disorders had a small sample size. Trial registration This trial is registered at Trialregister.nl, number NL6020.

Comparison of non-suicidal self-injurious behavior and suicide attempts in patients admitted to a psychiatric crisis unit

2010 ◽  
Vol 48 (1) ◽  
pp. 83-87 ◽  
Author(s):  
Laurence Claes ◽  
Jennifer Muehlenkamp ◽  
Walter Vandereycken ◽  
Luc Hamelinck ◽  
Helga Martens ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Psychiatric Crisis

Relationship of Bile Salts and Bile Flow to Biliary Excretion of Iopanoic Acid

1972 ◽  
Vol 7 (1) ◽  
pp. 11-15
Author(s):  
Albert A. Moss ◽  
John R. Amberg ◽  
Scott R. Jones
Keyword(s):  
Biliary Excretion ◽  
Bile Flow ◽  
Bile Salts ◽  
Iopanoic Acid ◽  
Relationship Of

Treatment Costs for Youths Receiving Multisystemic Therapy or Hospitalization After a Psychiatric Crisis

2004 ◽  
Vol 55 (5) ◽  
pp. 548-554 ◽  
Author(s):  
Ashli J. Sheidow ◽  
W. David Bradford ◽  
Scott W. Henggeler ◽  
Melisa D. Rowland ◽  
Colleen Halliday-Boykins ◽  
...  
Keyword(s):  
Multisystemic Therapy ◽  
Treatment Costs ◽  
Psychiatric Crisis

scholarly journals A novel melanoma therapy stirs up a storm: ipilimumab-induced thyrotoxicosis

2015 ◽  
Vol 2015 ◽  
Author(s):  
Christine Yu ◽  
Inder J Chopra ◽  
Edward Ha
Keyword(s):  
Adverse Effects ◽  
T Lymphocyte ◽  
Autoimmune Thyroiditis ◽  
Cytotoxic T Lymphocyte ◽  
Alternative Therapy ◽  
Thyroid Storm ◽  
Iopanoic Acid ◽  
Immune Mediated ◽  
Thyroid Function Testing ◽  
Function Testing

Summary Ipilimumab, a novel therapy for metastatic melanoma, inhibits cytotoxic T-lymphocyte apoptosis, causing both antitumor activity and significant autoimmunity, including autoimmune thyroiditis. Steroids are frequently used in treatment of immune-related adverse events; however, a concern regarding the property of steroids to reduce therapeutic antitumor response exists. This study describes the first reported case of ipilimumab-associated thyroid storm and implicates iopanoic acid as an alternative therapy for immune-mediated adverse effects. An 88-year-old woman with metastatic melanoma presented with fatigue, anorexia, decreased functional status, and intermittent diarrhea for several months, shortly after initiation of ipilimumab – a recombinant human monoclonal antibody to the cytotoxic T-lymphocyte-associated antigen 4 (CTLA4). On arrival, she was febrile, tachycardic, and hypertensive with a wide pulse pressure, yet non-toxic appearing. She had diffuse, non-tender thyromegaly. An electrocardiogram (EKG) revealed supraventricular tachycardia. Blood, urine, and stool cultures were collected, and empiric antibiotics were started. A computed tomography (CT) angiogram of the chest was negative for pulmonary embolism or pneumonia, but confirmed a diffusely enlarged thyroid gland, which prompted thyroid function testing. TSH was decreased at 0.16 μIU/ml (normal 0.3–4.7); free tri-iodothyronine (T3) was markedly elevated at 1031 pg/dl (normal 249–405), as was free thyroxine (T4) at 5.6 ng/dl (normal 0.8–1.6). With iopanoic acid and methimazole therapy, she markedly improved within 48 h, which could be attributed to lowering of serum T3 with iopanoic acid rather than to any effect of the methimazole. Ipilimumab is a cause of overt thyrotoxicosis and its immune-mediated adverse effects can be treated with iopanoic acid, a potent inhibitor of T4-to-T3 conversion. Learning points While ipilimumab more commonly causes autoimmune thyroiditis, it can also cause thyroid storm and clinicians should include thyroid storm in their differential diagnosis for patients who present with systemic inflammatory response syndrome. Immune-related adverse reactions usually occur after 1–3 months of ipilimumab and baseline thyroid function testing should be completed before initiation with ipilimumab. Conflicting data exist on the use of prednisone for treatment of CTLA4 adverse effects and its attenuation of ipilimumab's antitumor effect. Iopanoic acid may be considered as an alternative therapy in this setting.

scholarly journals Predicting Hospitalization following Psychiatric Crisis Care using Machine Learning

2019 ◽  
Author(s):  
Matthijs Blankers ◽  
Louk F. M. van der Post ◽  
Jack J. M. Dekker
Keyword(s):  
Machine Learning ◽  
Logistic Regression ◽  
Learning Algorithms ◽  
Nearest Neighbors ◽  
Machine Learning Algorithms ◽  
Predictor Variables ◽  
Gradient Boosting ◽  
K Nearest Neighbors ◽  
Psychiatric Crisis ◽  
Crisis Care

Abstract Background: It is difficult to accurately predict whether a patient on the verge of a potential psychiatric crisis will need to be hospitalized. Machine learning may be helpful to improve the accuracy of psychiatric hospitalization prediction models. In this paper we evaluate and compare the accuracy of ten machine learning algorithms including the commonly used generalized linear model (GLM/logistic regression) to predict psychiatric hospitalization in the first 12 months after a psychiatric crisis care contact, and explore the most important predictor variables of hospitalization. Methods: Data from 2,084 patients with at least one reported psychiatric crisis care contact included in the longitudinal Amsterdam Study of Acute Psychiatry were used. The accuracy and area under the receiver operating characteristic curve (AUC) of the machine learning algorithms were compared. We also estimated the relative importance of each predictor variable. The best and least performing algorithms were compared with GLM/logistic regression using net reclassification improvement analysis. Target variable for the prediction models was whether or not the patient was hospitalized in the 12 months following inclusion in the study. The 39 predictor variables were related to patients’ socio-demographics, clinical characteristics and previous mental health care contacts. Results: We found Gradient Boosting to perform the best (AUC=0.774) and K-Nearest Neighbors performing the least (AUC=0.702). The performance of GLM/logistic regression (AUC=0.76) was above average among the tested algorithms. Gradient Boosting outperformed GLM/logistic regression and K-Nearest Neighbors, and GLM outperformed K-Nearest Neighbors in a Net Reclassification Improvement analysis, although the differences between Gradient Boosting and GLM/logistic regression were small. Nine of the top-10 most important predictor variables were related to previous mental health care use. Conclusions: Gradient Boosting led to the highest predictive accuracy and AUC while GLM/logistic regression performed average among the tested algorithms. Although statistically significant, the magnitude of the differences between the machine learning algorithms was modest. Future studies may consider to combine multiple algorithms in an ensemble model for optimal performance and to mitigate the risk of choosing suboptimal performing algorithms.

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