Comparison of the Clinical and Treatment Characteristics of Patients Undergoing Electroconvulsive Therapy for Catatonia Indication in the Context of Gender

2021 ◽  
pp. 155005942110258
Author(s):  
Zozan Parsanoglu ◽  
Ozlem Devrim Balaban ◽  
Sakir Gica ◽  
Ozge Canbek Atay ◽  
Ozan Altin
Keyword(s):  
Clinical Data ◽  
Electroconvulsive Therapy ◽  
Response Rate ◽  
Signs And Symptoms ◽  
Response To Treatment ◽  
Global Improvement ◽  
Male And Female ◽  
Opposite Sex ◽  
The Mean

The aim of this study was to compare in the context of gender both clinical diagnosis and disease-related differences and electroconvulsive therapy (ECT)-related differences in data and efficacy in hospitalized patients with catatonic signs and symptoms. Data from 106 patients who received ECT with catatonia indication were retrospectively analyzed. Clinical data of male (n = 58) and female (n = 48) patients were compared. Hospitalization documents and outpatient files, sociodemographic and clinical data form, Clinical Global Improvement scores used by the ECT unit in the follow-up of patients who received ECT were used in the study. It was seen that the mean age of women at the onset of ECT was higher than in men and the presence of prolonged seizures was more common than men. In men, it was found out that the average number of sessions with the onset of clinical response to treatment was higher than the average of women. The distribution of diagnoses by gender showed that the presence of schizophrenia diagnosis in men and of bipolar disorder in women were significantly more frequent compared to the opposite sex. It was found out that there were no significant differences between genders in terms of response rate to ECT. Our study is important for being the first study in the literature investigating the gender differences in ECT used for catatonia. However, gender is not a distinctive factor in the effectiveness of treatment, there are some important differences between male and female patients showing signs and symptoms of catatonia and undergoing ECT.

scholarly journals Serum C-reactive protein metabolite (CRPM) is associated with incidence of contralateral knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anne-Christine Bay-Jensen ◽  
Asger Bihlet ◽  
Inger Byrjalsen ◽  
Jeppe Ragnar Andersen ◽  
Bente Juhl Riis ◽  
...  
Keyword(s):  
Phase Iii ◽  
Response To Treatment ◽  
C Reactive Protein ◽  
Two Phase ◽  
Knee Oa ◽  
Reactive Protein ◽  
Inflammatory Phenotype ◽  
The Mean ◽  
Using Data

AbstractThe heterogeneous nature of osteoarthritis (OA) and the need to subtype patients is widely accepted in the field. The biomarker CRPM, a metabolite of C-reactive protein (CRP), is released to the circulation during inflammation. Blood CRPM levels have shown to be associated with disease activity and response to treatment in rheumatoid arthritis (RA). We investigated the level of blood CRPM in OA compared to RA using data from two phase III knee OA and two RA studies (N = 1591). Moreover, the association between CRPM levels and radiographic progression was investigated. The mean CRPM levels were significantly lower in OA (8.5 [95% CI 8.3–8.8] ng/mL, n = 781) compared to the RA patients (12.8 [9.5–16.0] ng/mL, n = 60); however, a significant subset of OA patients (31%) had CRPM levels (≥ 9 ng/mL) comparable to RA. Furthermore, OA patients (n = 152) with CRPM levels ≥ 9 ng/mL were more likely to develop contra-lateral knee OA assessed by X-ray over a two-year follow-up period with an odds ratio of 2.2 [1.0–4.7]. These data suggest that CRPM is a blood-based biochemical marker for early identification OA patients with an inflammatory phenotype.

scholarly journals Spatz3 Adjustable Balloon: Weight Loss and Response Rates in Brazil

2018 ◽  
Vol 1 (1) ◽  
pp. 38-41
Author(s):  
Leonard Salles De Almeida
Keyword(s):  
Intragastric Balloon ◽  
Response Rate ◽  
Successful Outcome ◽  
Implantation Time ◽  
Duration Of Effect ◽  
The Mean ◽  
Total Body ◽  
Lost To Follow Up ◽  
Adjustable Balloon

Background: The degree of efficacy and duration of effect of Intragastric Balloons (IGBs) can be variable and unpredictable. The Spatz Adjustable Intragastric Balloon (AIGB) was developed to address these issues by extending implantation to 1 year, decreasing balloon volume for intolerance and increasing volume for decreased balloon effect.Aims: To determine the efficacy and response rate of the Spatz3 AIGB.Methods: Results of 379 consecutive patients (pts) implanted with the Spatz3 AIGB were retrospectively reviewed (3 lost to follow up). Mean BMI 35.5; mean weight (wt) 97.5 kg; mean excess wt 29.1 kg; mean balloon volume 600ml. Balloon volume adjustments were offered: Down adjustments for intolerance and up adjustments for decreased balloon effect.Results: The mean implantation time of 376 pts was 10.6 months yielding mean wt loss 14.9 kg; mean 15.1% Total Body Wt Loss (%TBL) and 58% Excess Wt Loss(%EWL). Response rate (> 25%EWL) was achieved in 79% (297/376) of pts. Down adjustments in 95 pts (mean 2.4 months; mean -152.4 ml) allowed 76/95 (80%) to continue IGB therapy for at least 6 months (mean 9.1 months). Up adjustments in 205/376 (54.5%) pts (mean 5.8 months; mean + 179.2 ml) yielded additional mean wt loss of 6.5 kg. There was 1 gastric ulcer (0.27%). One balloon deflated at 7.4 months and 4 others deflated after 1 year (13-23 months).Conclusions: In this retrospective review of 376 Spatz3 AIGB patients, up adjustments yielded a mean 6.5kg extra wt loss for those with wt loss plateau, and down adjustments alleviated early intolerance. These two adjustment functions may be instrumental in yielding a successful outcome (> 25% EWL) in 79% of pts.

scholarly journals Idiopathic retroperitoneal fibrosis: A report on 15 patients

2015 ◽  
Vol 72 (10) ◽  
pp. 928-931 ◽  
Author(s):  
Jovan Hadzi-Djokic ◽  
Tomislav Pejcic ◽  
Dragoslav Basic ◽  
Ivana Vukomanovic ◽  
Zoran Dzamic ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Retroperitoneal Fibrosis ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Omental Flap ◽  
Definitive Treatment ◽  
Pathological Examination ◽  
Idiopathic Retroperitoneal Fibrosis ◽  
The Mean

Background/Aim. Retroperitoneal fibrosis (RPF) represents a chronic pathological process characterized by fibrosis which entraps and compresses the ureters and the great blood vessels in the retroperitoneal space. A specific form of RPF is idiopathic RPF, an uncommon collagen vascular disease of unclear etiology. The series of 15 patients which underwent open surgical repair due to idiopathic RPF is presented herein. Methods. From 1989 to 2012, 11 male and 4 female patients underwent surgery due to primary RPF. The ureters were entrapped unilaterally (7 patients), or bilaterally (8 patients). Major symptoms included low back pain due to hydronephrosis (9 patients), uremia (4 patients), and urinary tract infection (2 patients). The diagnosis was based on intravenous urography (IVU), retrograde ureteropyelography and computed tomography (CT). Results. Surgical procedures included intraperitoneal ureteral displacement (8 patients) and ureteral wrapping with omental flap (6 patients). One patient underwent bilateral ureteral stenotic segments resection and oblique ureterography, followed by wrapping with omental flap. Pathological examination confirmed primary RPF in all patients. The mean operative time was 3.5 h (range 2.5-4.5 h). The average intrahospital stay was 21 days (range 16-26 days). The mean follow up was 32 months (6-46 months). During the follow up, 12 patients had improvement on IVU. Conclusion. Early recognition of signs and symptoms of RPF is of the utmost importance for the outcome. Surgical procedures, including ureteral wrapping with omental flap, or intraperitoneal ureteral displacement, usually represent definitive treatment.

scholarly journals The Weighed Core Symptom Scale and Prediction of ADHD in Adults – Objective Measures of Remission and Response to Treatment with Methylphenidate

2013 ◽  
Vol 9 (1) ◽  
pp. 171-179
Author(s):  
Hanna Edebol ◽  
Lars Helldin ◽  
Torsten Norlander
Keyword(s):  
Adult Adhd ◽  
Response Rate ◽  
Optimal Dose ◽  
Response To Treatment ◽  
Therapeutic Effects ◽  
Modified Release ◽  
Symptom Scale ◽  
Core Symptom ◽  
Two Measures

Objective: Two measures of the response rate and the optimal treatment response for adult ADHD were evaluated using methylphenidate. The hypotheses were that Prediction of ADHD (PADHD) defines remission, the Weighed Core Symptom (WCS) scale registers direct effects of medication and that WCS may indicate the optimal dose level during titration. Design: PADHD and WCS were analyzed at baseline and after intake of low doses of either short-acting or modified-release formulations of methylphenidate, MPH (Study I), during titration with modified-release formulations of MPH (18/27, 36, 54, 72 mg) and at three months follow-up (Study II). Patients: Study I consisted of 63 participants (32 females) and Study II consisted of 10 participants (6 females) diagnosed with ADHD and who was to start with treatment. Outcome measures: Prediction of ADHD (PADHD) indicates the occurrence of ADHD (No, Yes) and the Weighed Core Symptom scale (WCS) quantifies ADHD from 0 to 100 (max-min). Results: The number of clinical cases of ADHD decreased after methylphenidate treatment according to PADHD. WCS increased (p < 0.001) from 9.75 (SD = 12.27) to 47.50 (SD = 29.75) with about 10 mg of methylphenidate (N = 63). During titration, symptoms improved after 18/27 mg and 36 mg of methylphenidate and baseline-follow up comparisons showed WCS increments (p = 0.005) from 31.00 (N = 10, SD = 26.85) to 69.00 (N = 10, SD = 22.34). Conclusions: PADHD defined remission and WCS measured therapeutic effects of methylphenidate in adult ADHD.

Neurogenic claudication associated with posterior vertebral rim fractures in children

2012 ◽  
Vol 10 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Jonathan G. Thomas ◽  
Jerome Boatey ◽  
Alison Brayton ◽  
Andrew Jea
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Leg Pain ◽  
Neurogenic Claudication ◽  
Pediatric Age Group ◽  
Fractures In Children ◽  
The Mean

Object Outside of the patient population with achondroplasia, neurogenic claudication is rare in the pediatric age group. Neurogenic claudication associated with posterior vertebral rim fracture is even more uncommon but nonetheless causes pain and disability in affected children and adolescents. The purpose of this study was to describe the surgical results of 3 adolescents presenting with neurogenic claudication and posterior vertebral rim fracture when treated with laminectomy alone. Methods The medical and operative records of the 3 pediatric patients were retrospectively reviewed. Presenting signs and symptoms and CT findings, such as the interpedicular distances between T-12 and L-5, were obtained. Perioperative results were assessed, including operative time, blood loss, length of hospital stay, and complications. Findings at latest follow-up were also recorded, including a patient satisfaction survey. Results The 3 patients (1 girl and 2 boys) had a mean age of 14.7 years (range 14–15 years) and underwent follow-up for a mean of 11.3 months (range 5–18 months). Notable preoperative signs and symptoms included back pain (all patients), leg pain (all patients), leg numbness (1 patient), and leg weakness (1 patient). No patient presented with bowel and/or bladder dysfunction. The mean blood loss during laminectomy was 123 ml (range 20–300 ml), and the mean length of hospital stay was 4.3 days (range 3–6 days). On average, decompression was performed at 2.2 levels (range 2–2.5 levels). All 3 patients reported at most recent follow-up that they were “satisfied” with the surgery. There was 1 complication of instability from an iatrogenic pars fracture, which required reoperation and posterior instrumented fusion. Conclusions To the best of the authors' knowledge, this report represents the first surgical series of pediatric neurogenic claudication associated with posterior vertebral rim fractures. Pediatric neurosurgeons may infrequently encounter neurogenic claudication associated with a posterior vertebral rim fracture in children. To treat children with neurogenic claudication associated with posterior vertebral rim fractures, a simple laminectomy may be a safe and efficacious alternative to discectomy and removal of fracture fragments.

Parapharyngeal space tumours: an 18 year review

2002 ◽  
Vol 116 (3) ◽  
pp. 170-175 ◽  
Author(s):  
Kenny Peter Pang ◽  
Christopher H. K. Goh ◽  
How Ming Tan
Keyword(s):  
Parapharyngeal Space ◽  
Signs And Symptoms ◽  
Incision And Drainage ◽  
Delay In Diagnosis ◽  
Parotid Tumour ◽  
Singapore General Hospital ◽  
Correct Sequence ◽  
Unnecessary Procedures ◽  
The Mean

Parapharyngeal space tumours account for only 0.5 per cent of all head and neck tumours. Due to their inherent location, they present with varied non-specific signs and symptoms, resulting in a delay in diagnosis and unnecessary procedures, such as a ‘tonsillectomy’ or ‘incision and drainage’ of a ‘quinsy’. Thirty-one patients, operated on over an 18-year period (1981 to 1998), in the Department of Otolaryngology, Singapore General Hospital, are presented. Their ages ranged from 21 to 86 years, with a mean of 52 years, with equal sex distribution. The commonest aetiology was a deep lobe of parotid tumour (44 per cent), followed by neurilemmomas (18 per cent), there was only one paraganglioma. The transcervical and transparotid approaches were the commonest used. The mean surgical time was three hours, mean hospital stay was 5.3 days and post-operative complications were minimal. The average follow-up time was 5.6 years. Although parapharyngeal space tumours are uncommon, recognizing them would enable the correct sequence of investigations, instead of unnecessary procedures resulting in an increased morbidity for the patient.

scholarly journals The Effectiveness of Non-clozapine Antipsychotics Combined with Electroconvulsive Therapy versus Clozapine Combined with Electroconvulsive Therapy for Treatment-resistant Schizophrenia

2021 ◽  
Vol 16 (2) ◽  
pp. 263-273
Author(s):  
Pichai Ittasakul ◽  
Keyword(s):  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Mmse Score ◽  
Subscale Score ◽  
Mean Difference ◽  
Response To Treatment ◽  
Treatment Resistant ◽  
Mini Mental Status Exam ◽  
The Mean ◽  
Safe Treatment Option

The study aimed to compare the effectiveness and safety of other atypical antipsychotics (non-clozapine) plus electroconvulsive therapy (ECT) (NC+ECT) versus clozapine plus ECT (C+ECT) for treating treatment-resistant schizophrenia (TRS). Data of 32 patients with TRS who was receiving ECT were analysed. We compared clinical characteristics, response to treatment [defined as an improvement of 40% in the Brief Psychotic Rating Scale (BPRS) psychotic symptom subscale from pretreatment scores], change of Mini-mental Status Exam (MMSE) scores, and other adverse effects between the NC+ECT group (N= 16) and C+ECT group (N =16). We found that the overall response rate was 65.6% (75.8% for the NC+ECT group and 56.3% for the C+ECT group, p=0.26). The overall BPRS score in both groups decreased significantly. The mean difference in total BPRS psychotic subscale score between pre-ECT and after last ECT was 10.4 + 5.8 (p<0.001) for the NC+ECT group and 6.6 + 7.3 (p = 0.002) for the C+ECT group. When comparing the NC+ECT group to the C+ECT group, the mean difference in total BPRS psychotic subscale score was not significant. (p = 0.104). The mean difference in MMSE score between pre-ECT and after the last ECT was -1.1 + 5.1 (p =0.45) for the NC+ECT group and 0.2 + 4.3 (p=0.855) for the C+ECT group. The change of MMSE score in the NC+ECT group was not significant different compare to the C+ECT group (p = 0.461). We concluded the combination of antipsychotics and ECT is an effective and safe treatment option for patients with TRS. Other NC+ECT groups’ efficacy may be comparable to that of clozapine plus ECT.

scholarly journals Towards the development of a reciprocal liaison service

2000 ◽  
Vol 24 (10) ◽  
pp. 379-381 ◽  
Author(s):  
Mark Davies
Keyword(s):  
Response Rate ◽  
Psychiatric Patients ◽  
Surgical Patients ◽  
Clinical Implications ◽  
Total Response ◽  
District Health ◽  
Total Response Rate ◽  
The Mean ◽  
Equity Of Access

Aims and MethodThe aim of this survey was to determine attitudes among consultants in different specialities towards the development of a reciprocal liaison service providing access for psychiatric patients to medical and surgical liaison services equal to the access of medical and surgical patients to psychiatric liaison services. All medical, surgical and psychiatric consultants in a district health service were surveyed, with a total response rate of 48%.ResultsThe mean number of medical and surgical patients requiring a psychiatric liaison service was 6%. The mean number of psychiatric patients requiring medical and surgical liaison services was 11%. Ratings overall for various components of the two types of liaison service were generally similar, with acute assessments and follow-up being given a high priority for both types.Clinical ImplicationsAs liaison services are developed, the notion of equity of access for all patients is paramount. Commissioning of such services should thereby specify the reciprocal nature of development. This survey shows that generally there is a positive attitude to the development of such a service.

scholarly journals Assessment of Neopterin Serum Level for Monitoring Therapy of Patients with Mycobacterium Tuberculosis

2021 ◽  
Vol 13 (3) ◽  
Author(s):  
Shokrollah Salmanzadeh ◽  
Razieh Mombeini ◽  
Seyed Mohammad Alavi ◽  
Morteza Abdullatif Khafaie
Keyword(s):  
Serum Levels ◽  
Response To Treatment ◽  
Sputum Smear ◽  
Major Health Problem ◽  
Tb Treatment ◽  
Monitoring Therapy ◽  
Significant Difference ◽  
The Mean ◽  
First Time

Background: Tuberculosis (TB) is a major health problem worldwide. To date, the standard diagnostic method for TB is still the direct observation of Mycobacterium TB in a sputum smear or culture. Objectives: There is an urgent need for a method to detect the disease in a shorter time with acceptable sensitivity and specificity and help monitor the treatment. Methods: A panel of 34 adults newly diagnosed with smear-positive pulmonary TB was followed during their treatment period of five months. Neopterin (NPT) serum levels were measured three times (before treatment and two and five months after treatment) using the Brahms ELItest Neopterin kit, and the results were analyzed using descriptive and graphical methods. Results: The mean NPT for the first time before treatment was 27.47 ± 20.7 nmol/L. NPT was measured two months after the anti-TB treatment, and the associated mean was 16.97 ± 14.14 nmol/L. At the end of the fifth month, the mean NPT concentration reached 11.3 ± 10.5 nmol/L. The mean serum NPT before treatment had a statistically significant difference with the mean NPT at the end of the second and fifth months of the treatment (P = 0.001). Conclusions: According to the national protocol for treating TB, a sputum smear is still necessary for patients’ follow-up. It seems that the serum NPT level should be measured to monitor response to treatment in patients that, for any reason are not able to give sputum in TB treatment follow-up.

P3808iBox-CRT: Better response, less complicated, equally fast

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
I Aguiar Ricardo ◽  
A Nunes-Ferreira ◽  
J Rigueira ◽  
J Agostinho ◽  
R Santos ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Response Rate ◽  
Control Group ◽  
Conduction Delay ◽  
Study Group ◽  
Automatic Assessment ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
The Mean

Abstract Introduction The optimization of the left ventricle (LV) pacing site guided by the electrical delay increases CRT response rate (RR), however it's necessary to develop technology that allows its universal use. Purpose The aim is automatically, and operator-independent, access the conduction delay between the right ventricular (RV) stimulus and the LV available veins in order to select the LV pacing site. It is further intended to compare the total procedure and radiation times in relation to an historical control group. Methods Prospective, single-center study that included patients undergoing CRT implant according to the current ESC Guidelines. All patients were submitted to a clinical, electrocardiographic and echocardiographic basal evaluation prior to CRT implantation and at 6 months of follow-up. To evaluate conduction delays between the RV lead and the LV available veins (RV-LV delay), an external interface - intelligent Box for CRT (iBox-CRT) was used. Four measurements in at least two different tributary veins were made. The implant of all the LV leads was guided by the longest measured delay. A positive response to CRT was defined as an improvement of >10% in left ventricle ejection fraction (LVEF) or a reduction of end-systolic volume (ESV)>15%. The results were compared to a control group (CG) of pts submitted to CRT implantation in the conventional way. Results 60 patients were included (68.3% males, 38% ischemic, mean age 67.4±10.2 years) and submitted to CRT implant (37 CRT-P; 23 CRT-D). At basal evaluation, LVEF was 28±7%, end-diastolic volume (EDV) was 200±73ml and ESV 145±64ml. CG (n=51) had similar characteristics. The RR was 85.7%, significantly higher compared to the CG (55.9%, p=0.003). The ESV reduced 38.2±3% in responders vs 5.7±2% in non-responders (NR) (p=0,005), EDV reduced 33.3±16% in responders vs 13.6±10% in NR (p=0.002), the mean LVEF improved 11% in responders vs −1% in NR (p=0.02). At follow-up, the mean ESV in the study group (SG) was 89±44 ml vs 132±75ml in the CG (p=0.002) and the EDV 136±51 vs 190±78 (p=0.007). In addition to a much better response rate, the responders in the study group had significantly higher mean LVEF at follow-up (39±11% vs 37±7%, p=0.032). The mean intra-procedure RV-LV delay was 187±34mseg. In the responder group the baseline delay was usually higher (190±35 msec) vs NR group RV-LV delay (165±23 msec; p=NS). Compared with CG, the automatic assessment of RV-LV delay with iBox-CRT did not increase fluoroscopy time (15±16min vs 18±16; p=NS) and shortened procedure time (65±34 vs 108±83min, p<0.005). Conclusions The iBox-CRT use enabled an automatic and operator independent RV-LV delays measurement, in order to implant the LV lead at the most delayed site. This technique translated into a major increase in CTR response rate, not compromising the procedure duration nor increasing the radiation exposure.

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