Current Issue : January - March Volume : 2017 Issue Number : 1 Articles : 7 Articles
Background and Objective. To determine the value of repeated brain CT in TBI cases for risk-stratified care management (RSCM)\nand to identify predicting factors which will change the neurosurgical management after repeated brain CTs. Methods. A 5-year\nretrospective study from January 2009 to August 2013 was conducted. The primary outcome was the value of repeated brain CT in\nTBI cases. The secondary outcome is to identify predicting factors which will change the neurosurgical management after repeated\nbrain CTs. Results.There were 145 consecutive patients with TBI and repeated brain CT after initial abnormal brain CT. Forty-two\npercent of all cases (...
Research on the implications of anxiety in Parkinsonââ?¬â?¢s disease (PD) has been neglected despite its prevalence in nearly 50% of\npatients and its negative impact on quality of life. Previous reports have noted that neuropsychiatric symptoms impair cognitive\nperformance in PD patients; however, to date, no study has directly compared PD patients with and without anxiety to examine\nthe impact of anxiety on cognitive impairments in PD. This study compared cognitive performance across 50 PD participants with\nand without anxiety (17 PDA+; 33 PDAâË?â??), who underwent neurological and neuropsychological assessment. Group performance\nwas compared across the following cognitive domains: simple attention/visuomotor processing speed, executive function (e.g., setshifting),\nworking memory, language, and memory/new verbal learning. Results showed that PDA+ performed significantly worse\non the Digit Span forward and backward test and Part B of the Trail Making Task (TMT-B) compared to the PDAâË?â?? group.There\nwere no group differences in verbal fluency, logical memory, or TMT-A performance. In conclusion, anxiety in PD has ameasurable\nimpact on working memory and attentional set-shifting....
Background. Undernutrition and major depressive disorder are frequently co-occurring. Patients with impaired mental health are\nstrongly vulnerable to the risks of having involuntary weight loss or deficiency of essential nutrients. However, there is no study\nwhich assesses undernutrition among major depressive patients in Ethiopia. Method. A total of 422 clients were included in the\nstudy. Structured questionnaires and anthropometric measurements were used for collecting the data. Bivariate and multivariate\nlogistic regression model was fitted to identify factors associated with undernutrition. Odds ratio with 95% confidence interval\nwas computed to determine the level of significance. Results. The prevalence of undernutrition was 31.4% [95% CI: 27.2ââ?¬â??36.0].\nBeing in a rural residence [AOR = 1.84, 95% CI (1.18ââ?¬â??2.85)], taking multiple medication [AOR = 1.77, 95% CI (1.03ââ?¬â??3.05)], taking\nprescribed diet [AOR = 1.90, 95% CI (1.06ââ?¬â??3.41)], and current use of alcohol [AOR = 2.96, 95% CI (1.34ââ?¬â??6.55)] were factors\nsignificantly associated with undernutrition among depressive patients. Conclusion. The prevalence of undernutrition among\nadults with major depressive disorder was found to be higher than the general population. Appropriate nutritional education and\nnutritional assessment are recommended during the course of major depressive disorder....
PEI is a clinical approach which aims at assessing the links between psycho-traumatic\nexperience and depressive disorder. In the present study, inspired by the\nEMDR (Eye Movement Desensitization and Reprocessing) protocol, the PEI approach\nis proposed to 30 patients with depressive disorder. The aim is to determine\nthe implication of negative cognitions and dysphoric emotions resulting from a\ntraumatic experience on their psychopathological disorder. Our analysis shows a\npredominance of memories linked to a lack of affective support during childhood.\nThe negative cognitions identified confirm a feeling of insecurity generated either by\na failure of affective bond or helplessness towards the event. An alteration of self-esteem\nalso emerges. Likewise, the present work also shows how psychotherapeutic\ncare should consider narrowing the focus on traumatic experiences....
Background: This study aimed to explore differences in links between negative symptoms and neurocognitive\ndeficits in adolescent and adult patients with first-episode schizophrenia. Schizophrenia is a mental disorder often\ncharacterized by positive and negative symptoms, reduced emotional expression, excitatory status, and poor\ncognitive ability. The severity of negative symptoms in patients with schizophrenia was reported to be more\nrelated to poor quality of life, weak functional ability, and heavy burden from families than with the severity\nof positive symptoms. Previous studies suggested correlations between the severity of negative symptoms in\npatients with schizophrenia and neurocognitive deficits.\nMethods: This study included 92 patients (33 adolescents and 59 adults) with first-episode schizophrenia and\n57 healthy people matched by age and education level. Neurocognitive functions and clinical symptoms were\nassessed using a standardized questionnaire.\nResults: Patients with first-episode schizophrenia showed neurocognitive deficits in most neuropsychological\nassessments compared with healthy people. With the variable of education level controlled, the negative factor\nscore of adolescent patients with first-episode schizophrenia was strongly correlated with more time spent in\npart 1 (r = .646) and part 2 (r = .663) of the trail making test, and moderately correlated to more perseverative\nerrors (r = .425) of the Wisconsin card sorting test and fewer correct trials 2 (r = âË?â??.425) of the continuous performance\ntest. However, no such correlations were found in adult patients.\nConclusions: This study indicated significant correlations between negative symptoms and most neurocognitive\nfunctions in patients with first-episode schizophrenia, with a stronger correlation in adolescent patients....
Background: Recent studies have reported that peripheral neuropathy (PN) is common in patients with Parkinsonâ��s\ndisease (PD) and raised the possibility that levodopa neurotoxicity is the main culprit.\nMethods: We evaluated the presence of large & small (autonomic) fiber PN in 54 consecutive patients with PD or\nparkinsonism in a tertiary outpatient clinic from Brazil. Initial PN screening consisted of history/neurological exam\nand skin wrinkling test (SWT). In addition, we also performed Nerve conduction studies/Electromyography (NCS/EMG)\nin all patients with PN signs/symptoms and/or abnormal SWT.\nResults: Thirty eight patients with PD (10 women, mean age: 63 �± 2.1 years, P < 0.05 versus parkinsonism, mean disease\nduration: 8 �± 0.8 years) and 16 patients with other forms of parkinsonism [7 women, mean age: 50.1 �± 3.9 years, mean\ndisease duration: 6.9 �± 1.1 years] completed clinical neuromuscular evaluation. SWT was performed in 48 patients\n(33 PD, 15 parkinsonism). In the PD group, SWT was abnormal in 57.6 % of the tested patients (comprising 50 %\nof all PD patients). In the parkinsonism group, SWT was abnormal in 37.5 % (comprising 35.3 % of all parkinsonism\npatients). NCS/EMG was performed in 39 patients (26 PD and 13 parkinsonism). Twelve out of the 26 PD (34.2 % of\nall PD) and 4 out of the 13 parkinsonism (23.5 % of all parkinsonism) had abnormal NCS/EMG results. Neuropathy\nprevalence was similar in PD and parkinsonism groups as detected either by NCS/EMG or SWT.\nConclusions: Large fiber and small (autonomic) fiber PN are common in patients with PD and parkinsonism.\nThe etiology for the neuropathy was likely to be multifactorial and may be secondary to PD itself.\nKeywords: Neuromuscular disorders, Parkinsonâ��s disease, Parkinsonism, Skin Wrinkling test, Peripheral neuropathy\nAbbreviations: CMAP, Compound muscle action potential; DM, Diabetes mellitus; EMG, Electromyography; NCS, Nerve\nconduction studies; PD, Parkinsonâ��s disease; PN, Peripheral neuropathy; SFN, Small fiber neuropathy; SNAP, Sensory nerve\naction potential; SWT, Skin winkling test...
Background: Parkinsonââ?¬â?¢s disease (PD) is the second commonest neurodegenerative disease in developed countries.\nCurrent treatment for PD is pharmacologically focused and can have significant side-effects. There is increasing\ninterest in holistic approaches including mindfulness to help manage the challenges associated with living with\nPD. We hypothesised that there would be an improvement in PD associated function and wellbeing in participants\nafter participating in a 6-week mindfulness-based lifestyle program, and that these improvements would be sustainable\nat 6 months. Our primary objective was to determine changes in function and wellbeing associated with PD.\nMethods: An exploratory prospective, mixed-method, randomised control trial incorporating a before and after design\nwith a waitlist control, with an embedded qualitative component was conducted in 2012ââ?¬â??2013. Participants included\ncommunity living adults with disability congruent to H&Y Stage 2 PD, aged 18ââ?¬â??75, fluent in spoken and written\nEnglish and able to attend at least four of six sessions of the program. Participants were randomised to the\nintervention or wait-list control groups at two locations. All participants in the wait-list control group eventually\nreceived the intervention. Two randomisation codes were created for each location. Allocation to the intervention or\nwait-list control was by random number generation. The program facilitator and participants were blinded to\nparticipant data.\nResults: Group 1 included 35 participants and group 2 (the waitlist control), 37. Data was analysed from 24\n(group 1) and 33 (group 2) participants. The intervention group, compared to the waitlist control, showed a\nsmall improvement in function and wellbeing associated with PD immediately after the program (t-score = âË?â??0.\n59) and at 6-month post intervention (t-score = âË?â??1.42) as reported by the PDQ-39 SI. However this finding\nwas not significant (p = 0.56 and 0.16 respectively). A small yet significant effect size (Ã?² = 0.23) in PDQ-39 ADL\nwas reported in group 1 after 6-months post-intervention. This showed a positive improvement in the ADL as\nreported by group 1 after 6-months (t-score âË?â??1.8, p = 0.04). Four secondary measures are reported. Conclusions: Our findings suggest mindfulness-based lifestyle programs have potential to assist participants in\nmanaging the ongoing difficulties associated with a neurological condition such as Parkinsonââ?¬â?¢s disease. Importantly,\nour study shows promise for the long term benefits of such programs. Improvements to participant activities in daily\nliving and mindfulness were retained at 6-months post intervention. A more definitive study should be conducted in\na larger sample of PD patients to further explore these findings and their impact on reducing stress and anxiety\nin PD patients....
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