Treatment of residual symptoms of schizophrenia with cariprazine

2021 ◽  
Vol 22 (3) ◽  
pp. 167-171
Author(s):  
Pavel Knytl
Keyword(s):  
Residual Symptoms

Quick Reference: Chapter 3: The Musculoskeletal System and Chapter 4: The Nervous System

2000 ◽  
Vol 5 (3) ◽  
pp. 4-4
Keyword(s):  
Nervous System ◽  
Lower Extremity ◽  
Musculoskeletal System ◽  
Multistep Method ◽  
Manual Muscle Testing ◽  
Motor Deficits ◽  
Lower Extremity Weakness ◽  
Residual Symptoms ◽  
Muscle Testing ◽  
Almost All

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, divides PNS deficits into sensory and motor and includes pain in the former. This article, which regards rating sensory and motor deficits of the lower extremities, is continued from the March/April 2000 issue of The Guides Newsletter. Procedures for rating extremity neural deficits are described in Chapter 3, The Musculoskeletal System, section 3.1k for the upper extremity and sections 3.2k and 3.2l for the lower limb. Sensory deficits and dysesthesia are both disorders of sensation, but the former can be interpreted to mean diminished or absent sensation (hypesthesia or anesthesia) Dysesthesia implies abnormal sensation in the absence of a stimulus or unpleasant sensation elicited by normal touch. Sections 3.2k and 3.2d indicate that almost all partial motor loss in the lower extremity can be rated using Table 39. In addition, Section 4.4b and Table 21 indicate the multistep method used for spinal and some additional nerves and be used alternatively to rate lower extremity weakness in general. Partial motor loss in the lower extremity is rated by manual muscle testing, which is described in the AMA Guides in Section 3.2d.

Questions and Answers

2000 ◽  
Vol 5 (2) ◽  
pp. 3-3
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Spinal Nerve ◽  
Sensory Loss ◽  
Residual Symptoms ◽  
Additional Information ◽  
Questions And Answers ◽  
Motor Nerves ◽  
Symptoms And Signs ◽  
Limited Motion

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) describes procedures for rating upper extremity neural deficits in Chapter 3, The Musculoskeletal System, section 3.1k; Chapter 4, The Nervous System, section 4.4 provides additional information and an example. The AMA Guides also divides PNS deficits into sensory and motor and includes pain within the former. The impairment estimates take into account typical manifestations such as limited motion, atrophy, and reflex, trophic, and vasomotor deficits. Lesions of the peripheral nervous system may result in diminished sensation (anesthesia or hypesthesia), abnormal sensation (dysesthesia or paresthesia), or increased sensation (hyperesthesia). Lesions of motor nerves can result in weakness or paralysis of the muscles innervated. Spinal nerve deficits are identified by sensory loss or pain in the dermatome or weakness in the myotome supplied. The steps in estimating brachial plexus impairment are similar to those for spinal and peripheral nerves. Evaluators should take care not to rate the same impairment twice, eg, rating weakness resulting from a peripheral nerve injury and the joss of joint motion due to that weakness.

Hyperoxic myopia: a case series of four divers

2020 ◽  
pp. 261-265
Author(s):  
Jonathan W. Brügger ◽  
Glenn A. Rauscher ◽  
John P. Florian ◽  
Keyword(s):  
Hyperbaric Oxygen ◽  
Prolonged Exposure ◽  
Case Series ◽  
Oxygen Toxicity ◽  
Hyperbaric Oxygen Treatment ◽  
Subjective Data ◽  
Residual Symptoms ◽  
Oxygen Treatment ◽  
Blurry Vision ◽  
Record Review

Hyperoxic myopia is a phenomenon reported in individuals who have prolonged exposure to an increased partial pressure of oxygen (PO2) and subsequently have a myopic (nearsighted) change in their vision. To date, there are numerous accounts of hyperoxic myopia in dry hyperbaric oxygen treatment patients; however, there have been only three confirmed cases reported in wet divers. This case series adds four confirmed cases of hyperoxic myopia in wet divers using 1.35 atmospheres (ATM) PO2 at the Navy Experimental Diving Unit (NEDU). The four divers involved were the first author’s patients at NEDU. Conditions for two divers were confirmed via record review, whereas the other two divers were diagnosed by the first author. All subjects were interviewed to correlate subjective data with objective findings. Each subject completed five consecutive six-hour hyperoxic (PO2 of 1.35 ATM) dives with 18-hour surface intervals. Each individual was within the U. S. Navy Dive Manual’s standards for general health. Visual acuity was measured prior to diving. Within three to four days after diving, the individuals reported blurry vision with an associated myopic refraction shift. Each diver had spontaneous resolution of his myopia over the next two to three weeks, with no significant residual symptoms. The divers in this case series were exposed to an increased PO2 (1.35 ATM for 30 hours over five days), a lesser exposure than that in other reports of hyperoxic myopia in wet divers diagnosed with hyperoxic myopia (1.3-1.6 ATM for 45-85 hours in 12-18 days). Furthermore, this pulse of exposure was more concentrated than typically seen with traditional hyperbaric oxygen therapy. Hyperoxic myopia continues to be a risk for those conducting intensive diving with a PO2 between 1.3-1.6 ATM. Additional investigation is warranted to better define risk factors and PO2 limits regarding ocular oxygen toxicity.

Prodromal Symptoms in Depression: A Systematic Review

2021 ◽  
pp. 1-8
Author(s):  
Giada Benasi ◽  
Giovanni A. Fava ◽  
Jenny Guidi
Keyword(s):  
Systematic Review ◽  
Unipolar Depression ◽  
Prodromal Phase ◽  
Cross Sectional ◽  
Prodromal Symptoms ◽  
Clinical Issue ◽  
Residual Symptoms ◽  
Close Relationship ◽  
Staging Model ◽  
Depressive Episodes

<b><i>Introduction</i></b>: Appraisal of prodromal symptoms of unipolar depression may complement the traditional cross-sectional approach and provide a longitudinal perspective, according to a staging model of the illness. <b><i>Objective:</i></b> To provide an updated systematic review of clinical studies concerned with prodromal symptoms of unipolar depression, according to PRISMA guidelines. <b><i>Methods:</i></b> Keyword searches were conducted in PubMed, Scopus, and Web of Science. Longitudinal studies on prodromal symptoms and signs in adult patients primarily diagnosed with unipolar depression were selected. Findings were examined separately according to study design (i.e., retrospective or prospective). <b><i>Results:</i></b> Twenty-five studies met the criteria for inclusion in this systematic review. Findings indicate that a distinct prodromal symptomatology – commonly characterized by anxiety, tension, irritability, and somatic complaints – exists before the onset of unipolar depression. The duration of the prodromal phase was highly variable across studies, ranging from less than a month to several years. Prodromal symptoms profile and duration were consistent within individuals across depressive episodes. There was a close relationship between prodromal and residual symptoms of the same depressive episode. <b><i>Conclusions:</i></b> The present systematic review addresses an important, and yet relatively neglected, clinical issue that deserves further investigation and may be of immediate practical value. The findings provide challenging insights into the pathogenesis and course of unipolar depression, which may result in more timely and effective treatment of recurrences. The definition of a prodromal phase in depression would benefit from the joint use of symptom identification, biomarkers, and neuroimaging.

scholarly journals AB0132 THE STUDY OF SUBCLINICAL SYNOVITIS DETECTED BY ULTRASONOGRAPHY AND MRI IN RA PATIENTS AFTER REACHING CLINICAL REMISSION ON PATIENT’S SUBJECTIVE SYMPTOMS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1094.2-1094
Author(s):  
M. Nawata ◽  
K. Someya ◽  
T. Aritomi ◽  
M. Funada ◽  
K. Nakamura ◽  
...  
Keyword(s):  
Clinical Remission ◽  
Research Funding ◽  
Morning Stiffness ◽  
Univariate Analysis ◽  
P Value ◽  
Research Support ◽  
Residual Symptoms ◽  
Logistic Analysis ◽  
Significant Difference ◽  
Multivariate Logistic Analysis

Background:The goal of treatment in rheumatoid arthritis (RA) is to achieve remission. There is the patient with residual symptoms in the Japanese RA patient who achieved clinical remission. There are not many studies to examine the relation between everyday life, social activity and evaluation of disease activities using high-sensitivity image examinations (musculoskeletal ultrasound (MSKUS) and MRI).Objectives:To examine the relationship between subjective residual symptoms and imaging examinations in RA patients who have achieved clinical remission.Methods:30 RA patients who achieved SDAI remission during RA treatment. Age, sex, disease duration, physical findings, serological markers, disease activity, HAQ, EQ-5D-5L, FACIT-F, Patient Reported Outcomes (PROs), EGA and medications were evaluated. 44 joints were assessed by MSKUS with gray scale (GS) and power doppler (PD) and contrast-enhanced bilateral joint MRI scoring with OMERACT-RAMRIS scoring.Results:1. The mean SDAI of the 30 RA patients was 1.3. 2.In the analysis of the presence or absence of subjective residual symptoms that led to remission of SDAI (Table 1).Table 1.Subjective residual symptoms/presence (N=17)Subjective residual symptoms/absence (N=13)Univariate analysisp valueMultivariate logistic analysisp valueTJC0.0±0.00.3±0.50.0173HAQ0.4±0.40.05±0.10.00950.00181EQ5D-5L0.8±0.10.9±0.00.0001FACIT-F14.5±9.84.6±4.30.0233Morning stiffness (min)256.5±564.80.0±0.00.0210Pain (VAS) (mm)9.2±9.50.9±1.50.00440.0455PGA (mm)7.7±9.00.5±1.10.0013(1). In the univariate analysis, the number of tender joints, HAQ, EQ-5D-5L, FACIT-F, morning stiffness, and pain VAS were extracted with significant differences.(2). In multivariate logistic analysis, HAQ and pain VAS were extracted as independent factors with significant differences. 3.In univariate analysis of the association between HAQ and pain VAS extracted in multivariate logistic analysis and imaging examinations (MSKUS/MRI), MRI-synovitis was extracted with a significant difference in HAQ.Conclusion:1. It was suggested that Pain VAS and HAQ due to RA could be identified in patients reaching SDAI remission. 2. In patients reaching SDAI remission, Pain VAS ≤10 or HAQ ≤0.5 suggested that subjective residual symptoms may be eliminated. 3. HAQ ≤ 0.5 suggests that synovitis is less likely to be detected on MRI. 4. In patients who have reached SDAI remission, little residual inflammation was observed on US, suggesting that induction of remission is important not only to prevent joint destruction, but also to improve and maintain long-term QoL.Disclosure of Interests:MASAO NAWATA Grant/research support from: I have received research funding from Eli Lilly Japan K.K., Kazuki Someya: None declared, Takafumi Aritomi: None declared, Masashi funada: None declared, Katsumi Nakamura: None declared, SAITO KAZUYOSHI Grant/research support from: I have received research funding from Eli Lilly Japan K.K., Yoshiya Tanaka Speakers bureau: I have received speaking fees from Abbvie, Daiichi-Sankyo, Chugai, Takeda, Mitsubishi-Tanabe, Bristol-Myers, Astellas, Eisai, Janssen, Pfizer, Asahi-kasei, Eli Lilly, GlaxoSmithKline, UCB, Teijin, MSD, and Santen, Consultant of: I have received consulting fees from Abbvie, Daiichi-Sankyo, Chugai, Takeda, Mitsubishi-Tanabe, Bristol-Myers, Astellas, Eisai, Janssen, Pfizer, Asahi-kasei, Eli Lilly, GlaxoSmithKline, UCB, Teijin, MSD, and Santen, Grant/research support from: I have received research grants from Mitsubishi-Tanabe, Takeda, Chugai, Astellas, Eisai, Taisho-Toyama, Kyowa-Kirin, Abbvie, and Bristol-Myers

RESIDUAL SYMPTOMS IN GRAVES'S DISEASE AFTER THYROIDECTOMY

The Lancet ◽  
1948 ◽  
Vol 251 (6510) ◽  
pp. 858-860 ◽  
Author(s):  
Laurence Martin
Keyword(s):  
Residual Symptoms

scholarly journals Presence of individual (residual) symptoms during depressive episodes and periods of remission: a 3-year prospective study

2010 ◽  
Vol 41 (6) ◽  
pp. 1165-1174 ◽  
Author(s):  
H. J. Conradi ◽  
J. Ormel ◽  
P. de Jonge
Keyword(s):  
Prospective Study ◽  
Depressive Symptomatology ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Residual Symptoms ◽  
Full Remission ◽  
Sleeping Problems ◽  
The Individual ◽  
Major Depressive Episodes ◽  
Depressive Episodes

BackgroundResidual depressive symptomatology constitutes a substantial risk for relapse in depression. Treatment until full remission is achieved is therefore implicated. However, there is a lack of knowledge about the prevalence of (1) residual symptoms in general and (2) the individual residual symptoms in particular.MethodIn a 3-year prospective study of 267 initially depressed primary care patients we established per week the presence/absence of the individual DSM-IV depressive symptoms during subsequent major depressive episodes (MDEs) and episodes of (partial) remission. This was accomplished by means of 12 assessments at 3-monthly intervals with the Composite International Diagnostic Interview (CIDI).ResultsIn general, residual depressive symptomatology was substantial, with on average two symptoms present during remissions. Three individual symptoms (cognitive problems, lack of energy and sleeping problems) dominated the course of depression and were present 85–94% of the time during depressive episodes and 39–44% of the time during remissions.ConclusionsResidual symptoms are prevalent, with some symptoms being present for almost half of the time during periods of remission. Treatment until full remission is achieved is not common practice, yet there is a clear need to do so to prevent relapse. Several treatment suggestions are made.

Bipolar disorder and comorbid obsessive-compulsive disorder is associated with higher rates of anxiety and impulse control disorders

2010 ◽  
Vol 22 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Cilly Klüger Issler ◽  
Emel Serap Monkul ◽  
José Antonio de Mello Siqueira Amaral ◽  
Renata Sayuri Tamada ◽  
Roseli Gedanke Shavitt ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Obsessive Compulsive Disorder ◽  
Impulse Control ◽  
Severe Form ◽  
Impulse Control Disorders ◽  
Tic Disorders ◽  
Obsessive Compulsive ◽  
Residual Symptoms ◽  
Compulsive Disorder ◽  
Depressive Episodes

Issler CK, Monkul ES, Amaral JAMS, Tamada RS, Shavitt RG, Miguel EC, Lafer B. Bipolar disorder and comorbid obsessive-compulsive disorder is associated with higher rates of anxiety and impulse control disorders.Objective:Although bipolar disorder (BD) with comorbid obsessive-compulsive disorder (OCD) is highly prevalent, few controlled studies have assessed this comorbidity. The objective of this study was to investigate the clinical characteristics and expression of comorbid disorders in female BD patients with OCD.Method:We assessed clinically stable female outpatients with BD: 15 with comorbid OCD (BD+OCD group) and 15 without (BD/no-OCD group). All were submitted to the Structured Clinical Interview for DSM-IV, with additional modules for the diagnosis of kleptomania, trichotillomania, pathological gambling, onychophagia and skin picking.Results:The BD+OCD patients presented more chronic episodes, residual symptoms and previous depressive episodes than the BD/no-OCD patients. Of the BD+OCD patients, 86% had a history of treatment-emergent mania, compared with only 40% of the BD/no-OCD patients. The following were more prevalent in the BD+OCD patients than the BD/no-OCD patients: any anxiety disorder other than OCD; impulse control disorders; eating disorders; and tic disorders.Conclusion:Female BD patients with OCD may represent a more severe form of disorder than those without OCD, having more depressive episodes and residual symptoms, and being at a higher risk for treatment-emergent mania, as well as presenting a greater anxiety and impulse control disorder burden.

Isolated symptomatic cervical spinous process fracture requiring surgery

1991 ◽  
Vol 75 (1) ◽  
pp. 131-133 ◽  
Author(s):  
Leonard F. Hirsh ◽  
Luis E. Duarte ◽  
Eric H. Wolfson ◽  
Wilhelm Gerhard
Keyword(s):  
Medical Condition ◽  
Spinous Process ◽  
Complete Recovery ◽  
Neurological Injury ◽  
Pertinent Literature ◽  
Content Type ◽  
Residual Symptoms ◽  
Economic Forces ◽  
Spinous Process Fracture ◽  
Fine Print

✓ Isolated cervical spinous process fractures are common, but are usually considered to be inconsequential. Although such fractures may produce pain, complete recovery without residual symptoms is expected after conservative treatment, and neurological injury does not usually occur. The case of a patient with a persistently symptomatic C-2 spinous process fracture that required surgical treatment for pain relief is reported. A review of the pertinent literature illustrates with unusual clarity the interactions of social, political, and economic forces associated with this medical condition.

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