Early and late-onset nonconvulsive status epilepticus after stroke

ABSTRACT Background: Nonconvulsive status epilepticus (NCSE) is a condition that needs timely diagnosis and treatment. It has insignificant clinical features and presents high risk of misdiagnosis. Objective: To investigate NCSE among patients with stroke, given that stroke plays an important role in the etiology of NCSE. Methods: In this retrospective study, acute stroke patients who were admitted and followed up at a stroke outpatient clinic between January 2013 and March 2016 were included. Patients with previous histories of epilepsy, brain tumor, head trauma, hypertensive encephalopathy, arteriovenous malformation, subarachnoid hemorrhage or cerebral venous thrombosis were excluded. Demographic properties, stroke etiology, imaging method, EEG findings, stroke severity according to the NIHSS score, functional disability and modified Rankin Scale were recorded for all patients. Results: Thirty-nine out of 792 stoke patients experienced NCSE. The mean age of the study population was 70±1.2 years (min-max: 46‒90). The study population was composed of 28 females (71.8%) and 11 males (28.2%). NCSE had early onset in 23 patients (59%) and late onset in 16 (41%). The early-onset NCSE patients were older and this was statistically significant between the groups (early onset: 73.5±11.5; late onset: 65.9±12.1; p=0.04). A history of previous stroke was more frequent in the late-onset NCSE group (14; 87,5%) than in the early-onset group (11; 47.8%) (p=0.01). The prognosis was worse in the early-onset group, but without statistical significance. Conclusion: Changes in mental status in the early stages of stroke are mostly attributed to stroke itself, but NCSE should be suspected in the right clinical setting, such as in older patients with suspicious anatomical and clinical associations.

Download Full-text

Differences in Clinical and Dietary Characteristics, Serum Adipokine Levels, and Metabolomic Profiles between Early- and Late-Onset Gout

Metabolites ◽

10.3390/metabo11060399 ◽

2021 ◽

Vol 11 (6) ◽

pp. 399

Author(s):

Young Sun Suh ◽

Hae Sook Noh ◽

Hyun-Jin Kim ◽

Yun-Hong Cheon ◽

Mingyo Kim ◽

...

Keyword(s):

Early Onset ◽

Late Onset ◽

Clinical Information ◽

Plasminogen Activator Inhibitor ◽

Ultra Performance Liquid Chromatography ◽

Plasminogen Activator Inhibitor 1 ◽

Baseline Serum ◽

Onset Group ◽

Early Onset Group ◽

Pai 1

This study aimed to identify differences in clinical and dietary characteristics, serum adipokine levels, and metabolomic profiles between early- and late-onset gout. Eighty-three men with gout were divided into an early-onset group (n = 38, aged < 40 years) and a late-onset group (n = 45, aged ≥ 40 years). Dietary and clinical information was obtained at baseline. Serum adipokines, including adiponectin, resistin, leptin, and plasminogen activator inhibitor-1 (PAI-1), were quantified by a Luminex multiplex immunoassay. Metabolite expression levels in plasma were measured in 22 representative samples using metabolomics analysis based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Average body mass index, rate of consumption of sugar-sweetened beverages, and serum uric acid levels were significantly higher in the early-onset group (p < 0.05), as was the PAI-I concentration (105.01 ± 42.45 ng/mL vs. 83.76 ± 31.16 ng/mL, p = 0.013). Changes in levels of metabolites mostly involved those related to lipid metabolism. In the early-onset group, acylcarnitine analog and propylparaben levels were downregulated and negatively correlated with the PAI-1 concentration whereas LPC (22:6) and LPC (18:0) levels were upregulated and positively correlated with the PAI-1 concentration. Dietary and clinical features, serum adipokine concentrations, and metabolites differed according to whether the gout is early-onset or late-onset. The mechanisms of gout may differ between these groups and require different treatment approaches.

Download Full-text

The Evolution of Dementia in Idiopathic Parkinson's Disease: Neuropsychological and Clinical Evidence in Support of Subtypes

International Psychogeriatrics ◽

10.1017/s1041610292001248 ◽

1992 ◽

Vol 4 (4) ◽

pp. 147-160 ◽

Cited By ~ 13

Author(s):

Wayne G. J. Reid

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Early Onset ◽

Late Onset ◽

Age At Onset ◽

Critical Determinant ◽

Drug Study ◽

Baseline Phase ◽

Onset Group ◽

Early Onset Group

One hundred and seven newly diagnosed, untreated patients with Parkinson's disease (PD) were divided into two groups according to their age at reported onset of symptoms. Of these, 79 patients were under age 70 (early-onset) and 28 patients were age 70 and over (late-onset). The group of 50 control subjects comprised spouses, friends of the PD patients, and community volunteers. The patients were participants in a multicenter drug study of Parkinson's disease. Each had received a detailed neurological and neuropsychological assessment in the baseline placebo phases of the study. Thirty-4 patients with early-onset and 12 patients with late-onset were reassessed 3 years after treatment with low-dose levodopa, with bromocriptine, or with a combination of the two drugs. The results of the baseline phase of the study revealed that 8% of the early-onset group and 32% of the late-onset group were classified as demented. The 3-year follow-up revealed that the prevalence of dementia had increased to 17% in the early-onset group and to 83% in the late-onset group. This study confirms that at least two distinct subtypes of Parkinson's disease exist. The subtypes differ both clinically and neuropsychologically. The age at onset of symptoms is a critical determinant of the rate and type of cognitive decline in Parkinson's disease.

Download Full-text

Differences Ratio Level Soluble FMS-Like Tyrosine Kinase-1 and Placental Growth Factor Early And Late Onset on Preeclampsia and Normal Pregnancy

Journal of Midwifery ◽

10.25077/jom.1.1.83-92.2018 ◽

2018 ◽

Vol 3 (1) ◽

pp. 83

Author(s):

Ria Andina ◽

Yanwirasti Yanwirasti ◽

Defrin Defrin

Keyword(s):

Growth Factor ◽

Tyrosine Kinase ◽

Early Onset ◽

Late Onset ◽

Normal Pregnancy ◽

Elisa Test ◽

Placental Growth Factor ◽

Cross Sectional ◽

Onset Group ◽

Early Onset Group

Preeclampsia is a major maternal morbidity and mortality worldwide including in Indonesia. PIGF concentrations were found to be lower and sFlt-1 to be higher in patients with preeclampsia than normal pregnancy. Futher, this factor has been proposed as a parameter that can help identify women with potentially preeclampsia.This study aims todeterminethe differences ratio level soluble rate fms-like tyrosine kinase-1 and placental growth factor early and late onset on preeclampsia and normal pregnancy. The cross sectional study design was conducted in RSUP M.Djamil, Rasidin Hospital, Reksodiwiryo Hospital and Biomedical Laboratory of Andalas University from July 2017 until January 2018. The sample of this study was pregnant women>20-42 weeks pregnancy totalling 80 people by consecutive sampling.Sample was divided into 3 groups. SFlt-1 and PlGF levels tested using ELISA test. Test the normality of data by Kolmogrov-Smirnov test by using unpaired T test.The results showed median sFLT-1 levels in the early onset group with normal pregnancy with p= 0,88, median sFLT-1 levels in the late onset group with normal pregnancy with p= 0,01 and median levels of sFLT-1 in the early onset group with late onset with p= 0.34. Mean of PlGF in the early onset group with normal pregnancy with p=0,30, mean of PlGF in the late onset group with normal pregnancy with p= 0.63, and mean of PlGF in the early onset group with late onset with p = 0.27. The conclusion of this study was that there was a difference ratio level Soluble Fms-Like Tyrosine Kinase-1 late onset in preeclampsia and normal pregnancy.

Download Full-text

Timing of chemotherapy-induced neutropenia is a prognostic factor in patients with diffuse large B-cell lymphoma: a retrospective study

10.21203/rs.3.rs-285196/v1 ◽

2021 ◽

Author(s):

Juan Qiu ◽

Baoxuan Zhang ◽

Bing Bu ◽

Shu Fang ◽

Lihua Song

Keyword(s):

Early Onset ◽

Cell Lymphoma ◽

Late Onset ◽

Independent Predictor ◽

B Cell Lymphoma ◽

Short Term ◽

Term Efficacy ◽

Large B Cell Lymphoma ◽

Onset Group ◽

Early Onset Group

Abstract Background Chemotherapy-induced neutropenia (CIN) has been shown to be associated with improved clinical outcomes in patients with various solid tumors. The aim of this study was to investigate the relationship between the timing and degree of chemo-induced neutropenia (CIN) and short-term efficacy and survival in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL).Methods A retrospective study was conducted on 236 newly diagnosed DLBCL patients who received at least 6 cycles of R-CHOP (like) or CHOP (like) between January 2012 and December 2018. According to the occurrence time of CIN, subjects were divided into CIN-absent group, early-onset CIN group and late-onset CIN group. According to the degree of CIN, they were divided into CIN-absent group, mild (grade 1-2) CIN group, and severe (grade 3-4) CIN group. Short-term efficacy was evaluated after 4 cycles of treatment. The Kaplan-Meier method was used to draw the survival curve, and the Cox proportional hazards model was applied to determine the correlation between the timing and extent of CIN and clinical features, short-term efficacy, progression-free survival (PFS) and overall survival (OS).Results After 4 treatment cycles, the objective response rate (ORR) of the early-onset group was higher than that of in the late-onset group and CIN absent group (95.7% VS 88.4% VS 81.0%). Multivariate analysis, Ann Arbor staging, choice of treatment plan and CIN timing were the independent prognostic factors for OS and PFS. OS and PFS in the early-onset group were longer than those of in the absent group [OS (HR:0.241; 95%CI: 0.110-0.530; P < 0.001), PFS (HR: 0.313; 95%CI: 0.169-0.579; P < 0.001)] and late-onset group [OS (HR: 0.332; 95%CI: 0.161- 0.685; P = 0.003), PFS (HR: 0.376; 95%CI: 0.204-0.693; P = 0.002)].Conclusions The timing of CIN is an independent predictor of prognosis in DLBCL patients treated with R-CHOP (like) or CHOP (like) regimens, and patients with early-onset CIN have longer survival times. The degree of CIN is not an independent predictor of prognosis in patients with DLBCL.

Download Full-text

Age trajectories of disability in instrumental activities of daily living and disability-free life expectancy among middle-aged and older adults in Taiwan: an 11-year longitudinal study

10.21203/rs.3.rs-42679/v2 ◽

2020 ◽

Author(s):

Wen-Ling Liao ◽

Yu-Hung Chang

Keyword(s):

Older Adults ◽

Longitudinal Study ◽

Life Expectancy ◽

Early Onset ◽

Late Onset ◽

Remaining Life ◽

Iadl Disability ◽

Disability Free Life Expectancy ◽

Onset Group ◽

Early Onset Group

Abstract Objectives: This study aims to identify the age trajectories of disability in instrumental activities of daily life (IADLs) over 11 years and their correlates, and to estimate disability-free life expectancy for identified trajectory groups in middle-aged and older adults.Methods: We included 3,118 participants aged 50 and over without IADL limitations at baseline from the Taiwan Longitudinal Study in Aging, followed across 1996-2007. We used group-based trajectory models to identify age trajectories of IADL disability, and multiple logistic regressions to examine their correlates. Sullivan method was used to compute IADL disability-free life expectancy for trajectory groups at different ages.Results: We identified two trajectories groups: 67.7% of participants classified as the late-onset group and 32.3% as the early-onset group. Female (adjusted odds ratio [aOR]: 1.93, 95% confidence interval [95% CI]: 1.54, 2.41), not being employed (aOR: 1.30, 95% CI: 1,08, 1,56), poor/fair self-rated health (aOR: 1.31, 95% CI:1.09, 1.58), hypertension (aOR: 1.32, 95% CI: 1.07, 1.63) , diabetes mellitus (aOR: 2.29, 95% CI: 1.72, 3.07), arthritis (aOR: 1.42, 95% CI: 1.11, 1.81), stroke (aOR: 2.21, 95% CI: 1.04, 4.70), and one-point increase in a 10-item depression scale (aOR: 1.04, 95% CI: 1.02, 1.06) were associated with early-onset of disability, whereas higher education (aOR: 0.59, 95% CI: 0.42, 0.81), regular exercise (aOR: 0.76, 95% CI: 0.62, 0.93), and participating voluntary or club activities (aOR: 0.78, 95% CI: 0.65, 0.93) related to the late-onset. IADL disability-free life expectancies at 65 years old in the late-onset group were 15.6 years for women and 14.4 for men, respectively, comprising 56.6% and 64.2% of their remaining life, whereas those of the early-onset group were 4.8 and 4.6 years for women and men respectively, comprising 22.5% and 27.2% of remaining life.Conclusions: Early-onset of IADLs disability may correlate to chronic conditions, and engagement in employment, exercise, and social participation were associated with a reduced risk of early disability in IADLs.

Download Full-text

Clinical characteristics of patients under 40 years old with early-onset hyperuricaemia: a retrospective monocentric study in China

BMJ Open ◽

10.1136/bmjopen-2018-025528 ◽

2019 ◽

Vol 9 (8) ◽

pp. e025528

Author(s):

Yi Zhang ◽

Yong Yang ◽

Leixi Xue ◽

Jian Wen ◽

Lin Bo ◽

...

Keyword(s):

Fatty Liver ◽

Early Onset ◽

Clinical Characteristics ◽

Liver Enzymes ◽

Late Onset ◽

Density Lipoprotein ◽

Control Group ◽

And Control ◽

Onset Group ◽

Early Onset Group

ObjectiveTo investigate the clinical characteristics of patients with early-onset hyperuricaemia (HUC).MethodsA retrospective study using data from the Second Affiliated Hospital of Soochow University was conducted. 623 patients with HUC were divided into early-onset group and late-onset group. Another 201 healthy subjects ≤40 years old were regarded as control group. The data of physical measurements and biochemistry test were collected. Clinical data of early-onset group were compared with late-onset group and control group by analysis of variance (ANOVA) and χ2test. Principal component analysis (PCA) was applied. Logistic regression was used to identify the clinical factors correlated with patients with early-onset HUC.ResultsThe patients of early-onset group had different body mass index (BMI), serum albumin, alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AKP), gamma-glutamyltransferase (GGT), creatinine (Cr), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), TG/high density lipoprotein (HDL) ratio, HDL and percentage of males, hypertension (HBP) as well as fatty liver compared with healthy people in the control group. Early-onset group patients had different albumin, ALT, fasting blood glucose, Cr, percentage of males and HBP compared with late-onset group patients. PCA identified four significant patterns including PC1 (labelled ‘TG and HDL’), PC2 (labelled ‘fatty liver and liver enzymes’), PC3 (labelled ‘TC and LDL’) and PC4 (labelled ‘AKP’). The results of univariate and multivariate logistic regression analysis showed that BMI, HBP and albumin were correlative factors for early onset of HUC when the patients with early-onset and late-onset HUC were involved, while gender, BMI, PC1, PC2 and PC4 were correlative factors for early-onset HUC when the early-onset and control groups were involved.ConclusionThis study described a group of patients with early-onset HUC with distinct clinical features. Gender, BMI, ‘TG and HDL’, ‘fatty liver and liver enzymes’ and ‘AKP’ have higher values than HBP, type 2 diabetes mellitus and ‘TC and LDL’ in patients under 40 years old with early-onset HUC.

Download Full-text

Clinical and Laboratory Differences Between Early-Onset and Late-Onset Adult Atopic Dermatitis

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475420921385 ◽

2020 ◽

Vol 24 (4) ◽

pp. 360-366

Author(s):

Dae-Lyong Ha ◽

Geun-Hwi Park ◽

Hoon-Soo Kim ◽

Hyun-Chang Ko ◽

Moon-Bum Kim ◽

...

Keyword(s):

Atopic Dermatitis ◽

Early Onset ◽

Age Of Onset ◽

Late Onset ◽

Severity Index ◽

Total Serum ◽

Significant Difference ◽

First Onset ◽

Onset Group ◽

Early Onset Group

Background Atopic dermatitis (AD) in adults is not uncommon, and its prevalence has been increasing in the recent decades. However, there is a paucity of data about the differences between early-onset and late-onset adult AD. Objective The objective of this study is to investigate the clinical and laboratory characteristics of adult AD, focusing on the differences between early-onset and late-onset adult AD. Methods We retrospectively reviewed the medical records and clinical photos of 214 adult AD patients (≥18 years of age) over a 3-year period. We classified the patients into 2 groups: early-onset (first onset of AD before 12 years of age) and late-onset (first onset of AD at 12 years of age or later). Results Among 214 patients, 151 patients (70.6%) belonged to the early-onset group (mean age 24.5 years), while 63 patients belonged to the late-onset group (mean age 29.5 years). An association with allergic asthma or rhinitis, a family history of atopic disease, elevated total serum IgE, and sensitivity to food allergens were more commonly seen in the early-onset group. The late-onset group had a significant likelihood of nonflexural involvement (38.1% vs 13.2%). There was no significant difference in the mean eczema area severity index score, eosinophil count, and sensitivity to aeroallergens between 2 groups. Conclusion Adult AD shows different clinical and laboratory characteristics depending on the age of onset. This study could help to create awareness about the heterogeneity of AD in adulthood and encourage further studies on clinical outcomes and different therapeutic methods depending on the age of onset.

Download Full-text

Predictors of Childhood Intractable Epilepsy- A Retrospective Study in A Tertiary Care Hospital

Bangladesh Journal of Child Health ◽

10.3329/bjch.v33i1.5669 ◽

1970 ◽

Vol 33 (1) ◽

pp. 6-15

Author(s):

AKM Moinuddin ◽

MM Rahman ◽

S Akhter ◽

CA Kawser

Keyword(s):

Early Onset ◽

Late Onset ◽

Intractable Epilepsy ◽

Childhood Epilepsy ◽

Care Hospital ◽

Predictors Of Outcome ◽

Myoclonic Seizure ◽

One Year ◽

Onset Group ◽

Early Onset Group

Objective: To study the predictors of intractable childhood epilepsy and to comparethe predictors of outcome in early and late onset childhood epilepsy.Design: Retrospective study.Study place: Child Development and Neurology Unit in the Department of Paediatricsof Bangabandhu Sheikh Mujib Medical University (BSMMU).Study period: January 2004 to December 2005.Subjects: Children with epilepsy of 1 month to 15 years of age who attended theepilepsy clinic.Results: The predictors of outcome of childhood epilepsy were analyzed. Accordingto outcome there were two groups, well- controlled group (seizure free for more than 6months) and intractable epilepsy ( one or more seizures per month over a period of 6months). The predictors of early and late onset childhood epilepsy were also compared.Total 73 cases were studied. Out of them 38 patients had early onset epilepsy (lessthan one year) and 35 had late onset epilepsy (more than one year). Median age ofonset of early and late onset of childhood epilepsy group was 3.5 months and 60months respectively. Male and female ratio was 1.53:1 and 0.94:1 in early and lateonset group respectively. Major seizure type was tonic-clonic seizure in 57.9% and77.1% patients of early and late onset group respectively. In this study, 27 (77.1%)patients of late onset and 5(13.2%) patients of early onset group achieved seizureremission. Independent predictors of intractable childhood epilepsy were finally found.Conclusion: In this study symptomatic epilepsy, myoclonic seizure, initial highfrequency of seizure, infantile spasm, neonatal seizures and birth asphyxia weresignificantly higher among early onset group than in late onset group. Early onset ofseizure, myoclonic seizure, initial high frequency of seizure (≥1 seizure/day),symptomatic etiology, neonatal seizure and microcephaly were found independentpredictors of intractable epilepsy.Key words: Early onset; late onset; intractable seizures.DOI: 10.3329/bjch.v33i1.5669Bangladesh Journal of Child Health 2009; Vol.33(1): 6-15

Download Full-text

Cannabis use before age 15 and subsequent executive functioning

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.077479 ◽

2011 ◽

Vol 198 (6) ◽

pp. 442-447 ◽

Cited By ~ 148

Author(s):

Maria Alice Fontes ◽

Karen I. Bolla ◽

Paulo Jannuzzi Cunha ◽

Priscila Previato Almeida ◽

Flávia Jungerman ◽

...

Keyword(s):

Executive Functioning ◽

Cognitive Performance ◽

Early Onset ◽

Impulse Control ◽

Late Onset ◽

Cannabis Use ◽

Neuropsychological Measures ◽

Neuropsychological Tasks ◽

Onset Group ◽

Early Onset Group

BackgroundMany studies have suggested that adolescence is a period of particular vulnerability to neurocognitive effects associated with substance misuse. However, few large studies have measured differences in cognitive performance between chronic cannabis users who started in early adolescence (before age 15) with those who started later.AimsTo examine the executive functioning of individuals who started chronic cannabis use before age 15 compared with those who started chronic cannabis use after 15 and controls.MethodWe evaluated the performance of 104 chronic cannabis users (49 early-onset users and 55 late-onset users) and 44 controls who undertook neuropsychological tasks, with a focus on executive functioning. Comparisons involving neuropsychological measures were performed using generalised linear model analysis of variance (ANOVA).ResultsThe early-onset group showed significantly poorer performance compared with the controls and the late-onset group on tasks assessing sustained attention, impulse control and executive functioning.ConclusionsEarly-onset chronic cannabis users exhibited poorer cognitive performance than controls and late-onset users in executive functioning. Chronic cannabis use, when started before age 15, may have more deleterious effects on neurocognitive functioning.

Download Full-text

Hemodynamic Profile and Cardiac Morphometry in Normotension and Severe Preeclamptic Pregnant Women

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v7i1.826 ◽

2019 ◽

pp. 27

Author(s):

Noroyono Wibowo ◽

Peby M Lestari

Keyword(s):

Pregnant Women ◽

Early Onset ◽

Late Onset ◽

Left Ventricular ◽

Severe Preeclampsia ◽

The Other ◽

Control Group ◽

Hemodynamic Profile ◽

Onset Group ◽

Early Onset Group

Abstract Objective: To identify the differences of hemodynamic profile and morphometric changes of maternal heart in normotensive and severe preeclampsia (early-onset and late-onset) pregnant women. Method: Cross-sectional study on consecutively selected 34 pregnant women which divided into three groups: normotensive group (n = 12), early-onset group (n = 11), and the late-onset group (n = 11). Conducted in the ER and inpatient care unit of Obstetrics and Gynecology Department, Faculty of Medicine Sriwijaya University / Dr. Moh. Hoesin Hospital Palembang, from April 2015 - June 2015. Results: There are significant differences in CO and SVR among three groups. In early onset groups, CO values are lower (3.4 + 0:27, p <0.001) with higher SVR (3100.2 + 261.3, p <0.001) compared the other two groups. There is increased of SVR in preeclamptic group compared to control, where SVR is higher in the early onset compared to late-onset group (3100.2 + 261.3 vs 2217.1 + 407.8, p <0.001), as well as differences between groups in cardiac index variables, except in the early onset group and controls (p = 0.045). In blood pressure and MAP variable, we only notice difference between the early onset group and control (p <0.001) as well as late-onset group and controls (p <0.001). There are significant differences in LVMi, LVID and LVPWT among three groups, in which the control group was lower than the other two groups (p <0.001; p = 0.049; p = 0.009), but similar in early and late-onset groups (98.7 (86.5-203) vs 132 (77.7-17.6); 4.7 (0.4) vs 4.8 (0.5); 1.1 (0.7-1.3) vs. 1.1 (0.8-1.6)). While RWT relatively similar among the three study groups (p = 0.264). A post hoc analysis showed no differences in maternal heart morphometry in early onset and late-onset group (p> 0.05). Conclusions: In severe preeclampsia there are changes in hemodynamic, ventricular morphometry, and left ventricular function. But the changes that occurred seems to be more evident in the early onset preeclampsia group of compared than late-onset preeclampsia. Keywords: Normotensive, early onset PEB, PEB late-onset, hemodynamic profile, cardiac morphometry.

Download Full-text