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1.
Background
Ictal electroencephalogram (EEG) source imaging has both advantages and disadvantages compared with source imaging of interictal epileptiform discharges. Ictal source imaging estimates the seizure onset zone directly. However, the rapid propagation of the ictal activity and the low signal-to-noise ratio impose additional challenges on ictal source imaging. Several methods have been developed to circumvent these challenges.Objectives
To summarize and explain in plain terms the methods of ictal EEG source imaging and to review the published evidence on its accuracy.Materials and methods
We systematically searched Medline for studies of ictal EEG source imaging. In addition, we summarize our clinical experience with ictal EEG source imaging and we present illustrative examples for the analysis process.Results
Pooled data from 77 operated patients, from four clinical studies, showed that ictal EEG source imaging had a sensitivity of 83.3% (95% confidence interval: 69.8–92.5%) and specificity of 72.4% (95% confidence interval: 52.8–87.3%).Conclusion
Ictal EEG source imaging is accurate and it should be added to the multimodal presurgical evaluation of patients with drug-resistant focal epilepsy.2.
Eloise Crush Louise Arseneault Helen L. Fisher 《Social psychiatry and psychiatric epidemiology》2018,53(12):1413-1417
Purpose
To investigate whether social support is protective for psychotic experiences similarly among poly-victimised adolescent girls and boys.Methods
We utilised data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative sample of 2232 UK-born twins. Participants were privately interviewed at age 18 about victimisation, psychotic experiences, and social support during adolescence.Results
Perceived social support (overall and from friends) was found to be protective against psychotic experiences amongst poly-victimised adolescent girls, but not boys. Though boys were similarly protected by family support.Conclusions
Social support-focused interventions targeting psychotic phenomena amongst poly-victimised adolescents may be more effective for girls.3.
Ming Wen Xingyou Zhang Carmen D. Harris James B. Holt Janet B. Croft 《Annals of behavioral medicine》2013,45(1):18-27
Background
Little national evidence is available on spatial disparities in distributions of parks and green spaces in the USA.Purpose
This study examines ecological associations of spatial access to parks and green spaces with percentages of black, Hispanic, and low-income residents across the urban–rural continuum in the conterminous USA.Methods
Census tract-level park and green space data were linked with data from the 2010 U.S. Census and 2006–2010 American Community Surveys. Linear mixed regression models were performed to examine these associations.Results
Poverty levels were negatively associated with distances to parks and percentages of green spaces in urban/suburban areas while positively associated in rural areas. Percentages of blacks and Hispanics were in general negatively linked to distances to parks and green space coverage along the urban–rural spectrum.Conclusions
Place-based race–ethnicity and poverty are important correlates of spatial access to parks and green spaces, but the associations vary across the urbanization levels.4.
Angela?Rosenbohm Mingsheng?Liu Gabriele?Nagel Raphael?S.?Peter Bo?Cui Xiaoguang?Li Jan?Kassubek Dietrich?Rothenbacher Dorothée?Lulé Liying?Cui
Objective
The aim of this study is to explore phenotypical differences of amyotrophic lateral sclerosis (ALS) between two cohorts from Germany and China.Methods
Registry-based studies of ALS were conducted in South-West Germany from 2010 to 2014 and an ALS clinic in Beijing from 2013 to 2016, respectively. Demographic and clinical features of 663 German and 276 Chinese ALS patients were collected and compared.Results
Mean age-at-onset was higher in German than in Chinese ALS patients [66.6 years (95% CI 65.7, 67.5) vs. 53.2 years (95% CI 52.0, 54.5)]. Age distribution of ALS patients peaked around 70–74 years in Germany and 50–54 years in China. Bulbar onset was more prevalent among German than among Chinese patients (35.9 vs. 22.8%). Diagnostic delay was higher in the Chinese than in the German study sample (12 vs. 5 months). Cognitive deficits were more pronounced in the Chinese cohort. Both cohorts differed in smoking habits, prevalence of diabetes and in body mass index (BMI).Conclusions
The apparent discrepancies between German and Chinese ALS patients (age at onset, gender distribution, bulbar forms, cognitive dysfunction, risk factors) reveal a quite different clinical phenotype in China, maybe due to socioeconomic status, environmental factors or genetic background. The observed differences in phenotype need to be pursued by further epidemiological studies on environmental and genetic risk factors.5.
Background
The anticonvulsant eslicarbazepine acetate (ESL) is licensed as adjunctive therapy for adults with partial-onset seizures (POS).Objectives
To gather information on the use of ESL in current clinical practice in Germany and to assess its efficacy and tolerability.Methods
Clinical data from consecutive patients with POS who started adjunctive treatment with ESL after 1 January 2012 was retrospectively collected from 18 neurological centres in Germany. Data on utilisation, efficacy, and tolerability of ESL were documented on a standardised electronic documentation sheet.Results
Included in the analysis were 125 patients (median age: 48 years (range 20–83 years), 59.2?% male). The most common primary treatment goals were improvement of seizure control (70.4?% of patients) and improvement of tolerability (20.8?%). A median dose of 800 mg (range 400–2,400 mg) was both the initial target and last treatment dose. The responder rate, defined as proportion of patients achieving a reduction in seizure frequency by ≥50?% versus baseline, was 46.7?%, 53.3?%, and 55.3?% after 3, 6, and 12 months, respectively. At the last documented visit, 38.8?% of patients were seizure-free for ≥3 months. The last documented visit occurred after a mean treatment period of 397 ± 246 days. The physician’s rating of ESL efficacy was very good or good in 61.6?% of treated patients, while tolerability was rated very good or good in 70.4?% of patients. Due to adverse events (AEs), 12.0?% of patients discontinued treatment with ESL. More frequently (≥5?%) reported AEs were fatigue, dizziness, and hyponatremia. Overall, 77?% of patients continued ESL therapy for at least 12 months.Conclusions
In this retrospective collection of current real-life data in Germany, adjunctive anticonvulsant treatment with ESL was effective and well-tolerated.6.
Christopher P. Salas-Wright Michael G. Vaughn Trenette Clark Goings 《Social psychiatry and psychiatric epidemiology》2017,52(10):1325-1328
Purpose
To examine the prevalence of self-reported criminal and violent behavior, substance use disorders, and mental disorders among Mexican immigrants vis-à-vis the US born.Methods
Study findings are based on national data collected between 2012 and 2013. Binomial logistic regression was employed to examine the relationship between immigrant status and behavioral/psychiatric outcomes.Results
Mexican immigrants report substantially lower levels of criminal and violent behaviors, substance use disorders, and mental disorders compared to US-born individuals.Conclusion
While some immigrants from Mexico have serious behavioral and psychiatric problems, Mexican immigrants in general experience such problems at far lower rates than US-born individuals.7.
Laura Strada Jonathan Y. Streifler Bruno Del Sette Matteo Puntoni Antonio Castaldi Daria Bianchini Massimo Del Sette 《Neurological sciences》2017,38(10):1771-1777
Background
Intravenous tPA is the standard treatment for acute ischemic stroke within 4.5 hours of symptom onset. Neuroradiological selection is currently based upon non-contrast- brain CT scan (NCCT).Aims
To verify, in an “expert-opinion setting”, the possible usefulness of CT perfusion (CTP) in decision-making toward i.v. thrombolysis.Patients and method
One hundred and three consecutive patients with acute ischemic stroke who underwent NCCT and CTP were re-evaluated by an expert in cerebrovascular disease, to verify if adding CTP information would have changed expert’s opinion.Results
After CTP, a definitive decision was made for 20 more patients, changing the proportion of patients candidate to i.v. tPA from 44% to 51%, and reducing uncertainty from 29% to 10%. CTP results were useful inmilder stroke (p = 0.01).Conclusions
In a “real world” setting, CT perfusion could be useful for clinical decision, in particular for milder stroke.8.
9.
Background
Currently, there are clear indications that due to their exposed occupational position psychiatrists and psychotherapists are at a higher risk than the general public to become the victim of stalking by patients.Objectives
This study investigated the frequency of stalking and its psychosocial impact among psychiatrists and psychotherapists in the Federal Republic of Germany.Methods
Analysis of an online survey among members of the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) from 23 September 2015 until 22 October 2015.Results
Of the respondents 26.5% reported having been the victim of stalking. In more than a third of the reported cases the stalking was described as severely or very severely debilitating. The majority of the perpetrators suffered from psychotic or personality disorders. Male victims were significantly more frequently stalked by a female perpetrator. Approximately 1 in 10 stalking victims continued the treatment of the perpetrator. The majority of the stalking victims did not obtain substantial support from their employer.Conslusion
The phenomenon of stalking within therapeutic relationships needs to be incorporated into the medical and psychotherapeutic professional training, e.?g. by implementing specialized training courses and the systematic integration of this topic into clinical supervision. The institutional dealing with stalking by patients needs to optimized, e.?g. by promptly transferring treatment of patients who stalk to other professionals and, where required, providing assistance in reporting stalking incidents to the police.10.
Cheryl M. Kelly Jeffrey S. Wilson Elizabeth A. Baker Douglas K. Miller Mario Schootman 《Annals of behavioral medicine》2013,45(1):108-112
Background
Observational field audits are recommended for public health research to collect data on built environment characteristics. A reliable, standardized alternative to field audits that uses publicly available information could provide the ability to efficiently compare results across different study sites and time.Purpose
This study aimed to assess inter-rater reliability of built environment audits conducted using Google Street View imagery.Methods
In 2011, street segments from St. Louis and Indianapolis were geographically stratified to ensure representation of neighborhoods with different land use and socioeconomic characteristics in both cities. Inter-rater reliability was assessed using observed agreement and the prevalence-adjusted bias-adjusted kappa statistic (PABAK).Results
The mean PABAK for all items was 0.84. Ninety-five percent of the items had substantial (PABAK?≥?0.60) or nearly perfect (PABAK?≥?0.80) agreement.Conclusions
Using Google Street View imagery to audit the built environment is a reliable method for assessing characteristics of the built environment.11.
A.‑S. Biesalski C. Franke D. Sturm J. Behncke T. Schreckenbach S. Knauß H. Eisenberg A. Hillienhof F. Sand M. Zupanic 《Der Nervenarzt》2018,89(12):1378-1387
Background
Currently, no data are available, which reflect the situation of medical doctors specializing in neurology in German hospitals. In order to secure the high standard of neurological patient care it is essential to evaluate the working conditions and the specialty training in neurology.Objective
This nationwide survey was conducted throughout Germany with the aim to address problems and to give suggestions for improvements in neurological training curricula.Material and methods
The survey was online from February to May 2017 and 953 neurologists undergoing further training participated.Results
More than half of the young neurologists were satisfied with their medical training. One of the main problems that complicates clinical training is the workload. In addition, organizational obstacles within the clinic, such as poor structure of education or a lack of mentors, lead to dissatisfaction among participants. The size or type of the department, as well as the prevailing service system, exert only a minor influence on the quality of specialist training, although there were differences especially in the self-assessment of the participants in connection with the type of department (university hospital versus public or private hospital).Conclusion
Specialist training in neurology can be improved by simple arrangements, e.?g., the introduction of a binding rotation scheme, internal mentoring and structured feedback. In addition, it will be necessary to relieve medical staff of administrative duties in order to create time for training and the learning of competencies.12.
Background
“Bath salts” or synthetic cathinone toxicity remains a potentially deadly clinical condition. We report a delayed leukoencephalopathy with persistent minimally conscious state.Methods
Case report.Results
A 36-year-old man presents with delayed encephalopathy, dysautonomia, fulminant hepatic failure, and renal failure from severe rhabdomyolysis after consuming bath salts. MRI showed diffusion restriction in the splenium of the corpus callosum and subcortical white matter.Conclusions
The combination of acute leukoencephalopathy, rhabdomyolysis and fulminant hepatic failure may point to bath salt inhalation and should be known to neurointensivists.13.
Hua Bai Sonja A. Wilhelm Stanis Andrew T. Kaczynski Gina M. Besenyi 《Annals of behavioral medicine》2013,45(1):39-48
Background
Parks are important resources for physical activity (PA), yet few studies have examined how perceptions of park characteristics relate to PA and health.Purpose
This study investigated associations between perceptions of neighborhood park quality and overall moderate-to-vigorous PA (MVPA), park-based PA, and body mass index (BMI).Methods
Data were collected via questionnaire from 893 households in Kansas City, Missouri.Results
The newly developed neighborhood park quality scale demonstrated good test–retest and internal reliability. Residents’ perceptions of neighborhood park quality were related to PA and health outcomes. Perceiving parks as a benefit was positively related to overall MVPA and park-based PA and negatively related to BMI. Perceptions of well-used parks were positively related to BMI, while perceived cleanliness was negatively related to park-based PA.Conclusions
Better measuring and understanding how perceptions of local parks are associated with PA and health can improve appreciation of how parks facilitate active living.14.
Anouk Smeekes Maykel Verkuyten Elif Çelebi Ceren Acartürk Samed Onkun 《Social psychiatry and psychiatric epidemiology》2017,52(10):1317-1324
Purpose
Building upon social psychological work on social identity and mental health, this study among Syrian refugees in Turkey examined the importance of multiple group memberships and identity continuity for mental health and well-being.Method
A survey study was conducted among the very difficult to reach population of Syrian refugees (N = 361). With path analysis in AMOS the associations were examined between multiple group memberships, social identity continuity and mental health and psychological well-being.Results
Indicate that belonging to multiple groups before migration was related to a higher likelihood of having preserved group memberships after migration (i.e., sense of social identity continuity), which, in turn, predicted greater life satisfaction and lower levels of depression. Multiple group membership, however, was also directly related to higher depression.Conclusions
Findings are discussed in relation to the importance of multiple group membership and feelings of identity continuity for refugees.15.
Berker Duman Vesile Senturk Cankorur Clare Taylor Robert Stewart 《Social psychiatry and psychiatric epidemiology》2018,53(4):385-392
Purpose
Recalled experiences of parental bonding may be important in the aetiology of perinatal depression. We hypothesized that lower recalled parental bonding would be associated with perinatal depression.Method
In a cohort study of perinatal depression in Turkey, 677 women were recruited in their third trimester. Parental Bonding Inventory (PBI) scores at baseline were investigated as predictors of depression on the Edinburgh Postnatal Depression Scale (EPDS) at 4, 14 and 21 months after childbirth in mothers without depression at baseline.Results
Poor parental bonding scores, apart from paternal control and overprotection, were independently associated with antenatal depression. Incident postnatal depression at 4 months was predicted by parental overprotection, at 14 months by parental care and overprotection, and at 21 months by paternal control and overprotection.Conclusions
Less satisfactory parenting recalled in the antenatal period was an independent predictor of postnatal depression; however, the different bonding subscales varied as predictors according to the timing of the depression assessment after childbirth.16.
Background
Recidivism rates in substance-addicted patients placed in institutions according to §64 of the German legal code are approximately 50%, 3 years after discharge from inpatient treatment. The recidivism rates of patients with premature termination of inpatient treatment who had then been referred back to prison and were finally discharged into the community are unknown.Research question
Is premature termination of treatment a risk factor for recidivism?Methods
Patients released from forensic treatment according to § 64 of the German legal code were followed up for violent and non-violent recidivism. Full data were acquired for Baden-Württemberg patients released in 2010 and 2011 with regular vs. premature termination of treatment.Results
All measures revealed highly significant group differences: 48% of the patients discharged after subsequent prison sentences recidivated within the first year and 73% within 3 years after discharge. Among recidivists, the severity of offences was much higher (odds ratio > 3.8 each). Regularly discharged patients also re-offended to a remarkable extent (50%).Discussion
Patients serving prison sentences after unsuccessful forensic treatment are a high-risk group for recidivism. Alternative concepts of clinical and legal treatment of this group should be developed.17.
Laurent M. Willems Lara Kay Felix Rosenow Adam Strzelczyk 《Zeitschrift für Epileptologie》2018,31(4):267-271
Background
In times of an increasing economic impact on healthcare systems the collection, processing and analysis of disease-specific costs becomes more and more relevant. This is particularly true for chronic diseases, such as epilepsy where the focus of interest is due to the high direct and indirect costs of the disease. The additional economic impact of status epilepticus (SE) is under-represented in the few available cost of illness studies (COI).Objective
The systematic analysis and comparison of disease-specific costs and mortality of SE in Germany and other countries.Methods
A systematic combined literature search was performed via the PubMed gateway in June 2018.Results
A total number of three COI studies was available on SE in Germany. The median direct costs amounted to ca. 4000–15,000?€ per stay with a mean length of stay (LOS) of 1–2 weeks. The inhospital mortality was 10–15%. For patients with non-refractory SE (NSE) average costs were calculated as 4500–5500?€ (mortality 10%, LOS 8 days), whereas refractory SE (RSE) accounted for 4500–13,500?€ (mortality 15%, LOS 14 days) and super-RSE (SRSE) 33,000–50,500?€ (mortality 40%, LOS 37 days). These results are comparable to other COI studies on SE from Australia, India and the USA.Conclusion
From both health-economic and healthcare perspectives SE represents a relevant disease manifestation. Further studies to collate the incidence, mortality and costs are urgently needed in view of the increasing number of treatment options.18.
Background
Most work testing links between emotional competencies and health has focused on self-reported and/or trait assessments. However, more objective assessments of skills and knowledge may also predict health relevant outcomes.Purpose
The current study investigated whether performance-based tests of emotional knowledge and expressive skill predicted symptoms of depression and anxiety, self-reported physical symptoms, perceived health, and a range of immunoregulatory molecules.Methods
Eighty females aged 18–35 completed self-report assessments before attending a testing session in which they provided blood samples and completed performance-based assessments of expressive skill and emotional knowledge.Results
Greater expressive skill predicted better self-reported outcomes, but links to immunoregulatory molecules were mixed. Expressive skill for contempt and anger predicted higher, whereas skill for happiness predicted lower, concentrations of immunoregulatory molecules.Conclusions
These data highlight the need to extend research beyond self-reported emotional competencies and suggest that performance-based skill and knowledge metrics may be associated with health relevant outcomes.19.
Background
We examined gender difference in QTc interval distribution and its related factors in people with mental disorders.Methods
We retrospectively reviewed medical charts of patients discharged from a university psychiatric unit between November 1997 and December 2000. Subjects were 328 patients (145 males and 183 females) taking psychotropics at their admission. We examined patient characteristics, medical history, diagnosis, and medication before admission.Results
Mean QTc interval was 0.408 (SD = 0.036). QTc intervals in females were significantly longer than those in males. QTc of females without comorbidity was significantly longer than that of males.Conclusion
The influence of gender difference on QTc prolongation in people with mental disorders merits further research.20.