Delirium in Parkinson's disease patients. a five-year follow-up study

OBJECTIVE: To assess the significance of delirium in parkinsonian patients in a 5-year follow-up case-control study with three groups of patients: Parkinsonian and Delirium (PDG), Parkinsonian (PG) and Control (CG). METHODS: Comparisons of Short Test of Mental Status (STMS) and Unified Parkinson's Disease Rating Scale-motor section (UPDRS(m)) between groups were performed using analysis of variance with repeated measurements. Comparisons of survival functions and Cox regression models were used to analyse the time until death. RESULTS: STMS and UPDRS(m) mean scores were statistically different between PDG group and the other two groups (p < 0.001) and between PDG and PG groups (p < 0.001), respectively. Including all groups, PG's patients (HR = 0.29; 95% C.I. = 0.09-0.93) and CG's patients (HR = 0.13; 95% C.I. = 0.03-0.60) had less hazard to die than PDG's patients; patients with a STMS basal score >33 (HR = 0.37; 95% C.I. = 0.13-0.99) had less hazard to die than patients with a score < or =33. Finally, including PDG and PG groups, patients with basal UPDRS(m) score >17 (HR = 4.88; 95% C.I. = 1.11-21.48) had higher hazard to die than patients with a score < or =17. CONCLUSION: For patients with Parkinson's, delirium is an increased risk factor for developing dementia, to have a more severe motor impairment and to death.     

Electroencephalographic abnormalities in clozapine-treated patients: a cross-sectional study

The objective of our study was to examine the electroencephalogram (EEG) abnormalities associated with clozapine treatment. It was a cross-sectional study on 87 psychiatric patients on clozapine treatment. 32 channel digital EEG was recorded and analysed visually for abnormalities. EEG abnormalities were observed in 63.2% of patients. Both slowing and epileptiform activities were noted in 41.4% of patients. The EEG abnormalities were not associated with dose or duration of clozapine exposure.     

Quantitative evaluation of WEB shape modification: A five-year follow-up study

Background and purposeWeb shape modification (WSM) has previously been associated with aneurysm recurrence. We report here our five-year experience of WEB device use with a quantitative approach of the WSM phenomenon.MethodsFrom July 2012 to July 2017, 50 patients with 51 unruptured aneurysms treated with the WEB device have been prospectively enrolled in our data base and retrospectively analyzed. An independent “core lab” evaluated anatomical results and potential WSM in DSA follow-up. We defined the WSM ratio (WSMr) as a relative index between the height and the width of the device in working projections which gave an evaluation of the device deformation over the time.ResultsDuring the total follow-up period, WSM was observed in 35/48 aneurysms (72.9%). Adequate occlusion rates were 87.0% and 92.6% with and without WSM respectively (P = 0.65). 30 out the 35 (85.7%) shape modifications were already noticed at short-term follow-up (6-month DSA). 33 patients had 2 DSA controls and WSMr measurements were available in 24 patients: 18 (75%) with WSM and 6 (25%) without WSM. In the group with WSM, WSMr values were 0.80 in post-embolization, 0.52 at the first DSA angiogram and 0.42 at the second DSA angiogram.ConclusionWEB shape modification was observed in more than half of cases but with no influence regarding adequate occlusion rate. This quantitative approach of WSM highlights that this phenomenon appears to be early and progressive over time. This supports the hypothesis that WSM could be more probably related to aneurysm healing rather than external compression.     

Outcome of patients with chronic affective disorder: a five-year follow-up

Patients with major depression, mania, or schizo-affective disorder that had been present without remission for 2 years or more at intake (N = 129) were followed prospectively for 5 years, as were 580 patients who had been ill for shorter periods at intake. Despite very substantial durations of episode, three-quarters of the chronic patients recovered, although recovery occurred much later in the follow-up period than it did among the nonchronic patients. Factors associated with recovery were less severe illness at intake, lack of psychotic features, good friendship patterns in adolescence, and, most important, a relatively high maximum level of functioning in the 5 years preceding intake.     

Stroke Mimics: A five-year follow-up study from the Qatar Stroke Database

Background and purposeMimics comprise a third of patients presenting with an acute stroke. There is limited information on their natural history.MethodsWe evaluate long term major cardiovascular events (MACE) in stroke mimics in a prospective database from Qatar.ResultsBetween Feb 2014 and Jan 2019, 481 patients (male: 238; female: 243) mean age 57.5 years (±18.0), with 399 (83%) medical mimics and 82 (17%) functional mimics were evaluated. Imaging revealed previous old stroke in 26.6% and small vessel disease in 5%. MACE occurred in 57 (11.9%) and there were 31 deaths (6.4%) with majority of deaths (5.6%) from cardiovascular causes. MACE was significantly higher in patients with previous stroke, p < 0.0001), coronary artery disease, p = 0.002), diabetic, p = 0.01), and hypertensive on admission, p < 0.0001. MACE were also significantly higher in patients where imaging showed a previous stroke, p = 0.006).ConclusionThe occurrence of MACE during follow-up suggests that patients with existing vascular disease require aggressive management of vascular risk factors.     

在校青少年心理行为问题的五年后随访研究

目的:纵向研究在校学生心理行为问题的变化,方法:采用中文版Conners教师用儿童行为量表,对同一群体的儿童分别于1992年及1997年进行随访调查分析;1997年同时进行Piers-Harris儿童自我意识量表测主,结果:男生的行为,情绪问题检出率高于女生;Conners量表五年前后资料配对t检验表明因子分值均无显著性差异,儿童自我意识量表测评结果表明,在行为,合群,智力与学校情况三个方面有性别差异,即男生自我意识评价低于女生.结论:提示儿童早期的情绪,行为总是可延续到少年前期,儿童自我意识评价,男生低于女生.     

Electroencephalographic features in a series of patients with neuronal ceroid lipofuscinoses

We report the electroencephalographic (EEG) features of 22 patients with neuronal ceroid lipofuscinoses (NCL) who were referred to the Neurological Institute of Milan between 1984 and 1998. The EEG data were reviewed, taking into account the different forms of NCL on the basis of age at onset, clinical features and morphological appearance. The study group included patients with infantile NCL (one case), late-infantile NCL (ten cases), juvenile NCL (seven cases) and adult NCL (four cases). We looked for the presence of homogeneous EEG features associated with these different forms, particularly in the early phases of the disease. Our data indicate that the EEG characteristics of late-infantile NCL and of the myoclonic form of adult NCL are quite distincitve, and that their particular spontaneous epileptiform anomalies and response to intermittent light stimulation can be considered relevant diagnostic clues at an early disease stage.     

Need-adapted treatment of schizophrenia: a five-year follow-up study from the Turku project

The five-year follow-up results of 28 first-contact schizophrenic patients are compared with an older patient series of 53 patients from the same district. The treatment of the new series followed the principles of the need-adapted model. The emphasis was on immediate initial crisis-oriented family interventions. The treatment of the old series followed psychodynamic principles with an emphasis on individual and milieu therapy. The patients in the new group manage better with half the number of hospital days and less outpatient treatment. The differences are most clear in men. The crisis orientation caused failure in sustaining longer treatment relationships. This was harmful for patients and families with a more chronic development. In future, better continuity of treatment must be emphasized.     

Skull fracture during infancy: a five-year follow-up

A group of 19 children, who had received a skull fracture during infancy, were assessed at least 5 years following injury. The majority of the group (89%) had received a mild traumatic brain injury (TBI), with the remaining two (11%) having a moderate injury. The neuropsychological, academic, and psychosocial functioning of the TBI group was compared to that of 20 orthopedic subjects. The two groups were matched on the variables of gender, age, and socio-economic status. The TBI group was impaired on tests of visual attention and memory for faces. The two groups did not differ significantly on measures of language, sensorimotor functions, or visuospatial functioning. There were no statistically significant differences between the two groups on academic performance, or parent and teacher reports of psychosocial functioning. It is concluded that while there is an absence of deficits in the vast majority of functions, skull fracture in infancy can result in enduring impairment in specific cognitive skills related to the processing of complex nonverbal stimuli.     

Psychogeriatric day care outcome: A five-year follow-up

All 224 consecutive new patients who were admitted in 1982 through 1985 to the day care department of a skilled-care psychogeriatric nursing home were followed longitudinally until death. Dementia was diagnosed in 95.1% of the 133 women and 91 men. Their mean age at admission was 78.7 years (SD = 7.4). Every 12 months after their initial attendance the patients' status was recorded and coded as living in the community, institutionalized or dead. At one year after initial attendance 99 (44.2%) patients still resided in the community, 94 (42.0%) were admitted to a nursing home or (psychiatric) hospital and 31 (13.8%) had died. At five years only nine (4.0%) patients resided in the community, 65 (29.0%) were in long-term institutional care and 150 (67.0%) had died. Age, gender, socioeconomic status or living alone did not contribute to first-year outcome, but severity of cognitive impairment was associated with an increased risk of becoming institutionalized. Using logistic regression analysis, a model of three variables, living at home, needing help from caregiving children, and high ratings of dependency, assigned 61.4% of 176 subjects correctly as institutionalized versus residing in the community.     

Depression in narcotic addicts—A prospective study with a five-year follow-up

A number of recent studies have reported on the presence and significance of clinical depression in narcotic addicts.^1–7 The majority of these prior reports have been conducted with male addicts at one point in time only. To our knowledge there have been no long-term follow-up studies of narcotic addicts which have looked at the recurrence of depression.The purpose of this article is to describe the recurrence of depression during a 5-year period of follow-up of male and female narcotic addicts. It has been observed that addiction, especially chronic, and withdrawal can cause or are associated with many of the somatic and psychological symptoms of depression. To investigate this effect, episodes of depression in the present study were categorized by subjects' reports into drug-related and nondrug-related episodes, and the usefulness of this categorization in predicting future episodes of depression during the follow-up period was investigated. Incidence rates of depression in subjects without a prior history of depression are also reported.