Langfeldt's Schizophreniform Psychoses Fifty Years Later

1990 ◽  
Vol 157 (3) ◽  
pp. 351-354 ◽  
Author(s):  
A. L. Mina Bergem ◽  
Alv A. Dahl ◽  
Cato Guldberg ◽  
Helge Hansen
Keyword(s):  
Clinical Picture ◽  
Affective Disorders ◽  
Diagnostic Systems ◽  
Good Outcome ◽  
Poor Outcome ◽  
Follow Up Studies

As a result of follow-up studies published in 1937 and 1939, Langfeldt divided schizophrenia into two groups; ‘typical schizophrenia’ which had a poor outcome, and the ‘schizophreniform psychoses' which had a less typical clinical picture of schizophrenia and a good outcome. Langfeldt's cases of schizophreniform psychoses were reclassified according to the ICD–9 and DSM–III–R diagnostic systems. Most of the schizophreniform psychoses did not appear ‘schizophrenia-like’ at all, but turned out to be mainly affective disorders. Those included in Langfeldt's diagnosis of ‘schizophreniform psychoses' were found to be too heterogenous to validate the existence of this syndrome.

Developmental and Neurologic Sequelae of Neonatal Hyperviscosity Syndrome

PEDIATRICS ◽  
1982 ◽  
Vol 69 (4) ◽  
pp. 426-431
Author(s):  
Virginia D. Black ◽  
Lula O. Lubchenco ◽  
Dennis W. Luckey ◽  
Beverly L. Koops ◽  
Gail A. McGuinness ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Apgar Scores ◽  
Hyperviscosity Syndrome ◽  
Control Subjects ◽  
Poor Outcome ◽  
Follow Up Studies ◽  
Neurologic Sequelae

One hundred eleven consecutive infants with neonatal hyperviscosity were identified by screening all newborns for polycythemia in an 18-month period. These polycythemic infants were matched with nonpolycythemic newborns for birth weight, gestational age, Apgar scores, and sex. Maternal, intrapartum, and neonatal data were analyzed for associated morbidity. Maternal preeclampsia was more common among the hyperviscous patients than among control subjects. Hypoglycemia was also significantly increased among the hyperviscous patients. Follow-up studies at 1 to 3 years of age revealed a significantly higher incidence (38% vs 11%) of motor and neurologic abnormalities in the infants with neonatal hyperviscosity. The data suggested that concurrent hypoglycemia increased the risk of a poor outcome in hyperviscous infants inasmuch as 55% of infants with both characteristics were abnormal at follow-up. This, however, was not significantly different from the outcome of infants with hyperviscosity alone (P > .05 but < .1). Further studies will be needed to confirm or deny this relationship.

Quantitative MR spectroscopic imaging in metachromatic leukodystrophy: value for prognosis and treatment

2017 ◽  
Vol 89 (1) ◽  
pp. 105-111 ◽  
Author(s):  
Diane F van Rappard ◽  
Antoine Klauser ◽  
Marjan E Steenweg ◽  
Jaap Jan Boelens ◽  
Marianna Bugiani ◽  
...  
Keyword(s):  
Logistic Regression ◽  
White Matter ◽  
Metachromatic Leukodystrophy ◽  
Spectroscopic Imaging ◽  
Complete Separation ◽  
Significant Group ◽  
Good Outcome ◽  
Poor Outcome ◽  
Metabolite Concentrations

ObjectiveTo determine whether proton magnetic resonance spectroscopic imaging is useful in predicting clinical course of patients with metachromatic leukodystrophy (MLD), an inherited white matter disorder treatable with haematopoietic cell transplantation (HCT).Methods21 patients with juvenile or adult MLD (12 HCT-treated) were compared with 16 controls in the same age range. Clinical outcome was determined as good, moderate or poor. Metabolites were quantified in white matter, and significance of metabolite concentrations at baseline for outcome prediction was assessed using logistic regression analysis. Evolution of metabolic changes was assessed for patients with follow-up examinations.ResultsIn this retrospective study, 16 patients with baseline scans were included, 5 with good, 3 with moderate and 8 with poor outcome, and 16 controls. We observed significant group differences for all metabolite concentrations in white matter (p<0.001). Compared with controls, patients had decreased N-acetylaspartate and glutamate, and increased myo-inositol and lactate, most pronounced in patients with poor outcome (post hoc, all p<0.05). Logistic regression showed complete separation of data. Creatine could distinguish poor from moderate and good outcome, the sum of glutamate and glutamine could distinguish good from moderate and poor outcome, and N-acetylaspartate could distinguish all outcome groups. For 13 patients (8 with baseline scans), one or more follow-up examinations were evaluated, revealing stabilisation or even partial normalisation of metabolites in patients with moderate and good outcome, clearly visible in the ratio of choline/N-acetylaspartate.ConclusionIn MLD, quantitative spectroscopic imaging at baseline is predictive for outcome and aids in determining eligibility for HCT.

Abstract 169: A Comprehensive Multicenter Evaluation of the Impact of Age on Stroke Thrombectomy Outcomes - Insights From the STAR Collaboration

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Reda M Chalhoub ◽  
Ali M Alawieh ◽  
Mohammad Anadani ◽  
Maya Eid ◽  
Adam Arthur ◽  
...  
Keyword(s):  
Age Groups ◽  
Star Collaboration ◽  
The Elderly ◽  
Complication Rates ◽  
Good Outcome ◽  
Poor Outcome ◽  
Age Dependent ◽  
Poor Outcomes ◽  
The Impact

Introduction: Elderly patients, octogenarians and nonagenarians, were excluded or under-represented in the majority of stroke endovascular thrombectomy (ET) trials. There is conflicting data on the outcomes of ET in the elderly. We evaluated age-dependent outcomes of ET for stroke in a large dataset from the Stroke Thrombectomy and Aneurysm Registry (STAR). Methods: Patients undergoing ET for acute ischemic stroke at 12 comprehensive stroke centers in the US and Europe between 01/2013 and 12/2018 were reviewed. Data was collected retrospectively from patient charts, procedure notes, and patient follow-up in neurology clinics. The primary endpoint was the modified Rankin score (mRS) at 90-days which was dichotomized into good outcome (mRS 0-2) or poor outcome (mRS 3-6). Results: Of 3,850 patients reviewed, 2,827 had 90-day follow-up (mean age 69±14), and were divided into 6 age groups: 20-49 (G1, 10%), 50-59 (G2, 10%), 60-69 (G3, 23%), 70-79 (G4, 27%), 80-89 (G5, 21%), 90 or more (G6, 4%). When adjusted for confounding variables, age was an independent predictor of poor outcome (OR=1.4, p<0.001) and mortality (OR=1.5, p<0.0001). When used as categorical variable, adjusted OR (aOR) for good outcomes were significantly lower in groups G2-G6 compared to G1 (p<0.01, figure), and OR for mortality were significantly higher in G2-G6 compared to G1 (p<0.01, figure). An age increment of 10 years was associated with 23% higher odds of symptomatic hemorrhage, and 50% higher odds of mRS 5-6. The impact of procedure time on good outcome (mRS 0-2) was also age-dependent with aOR=0.84 (p<0.05) in G1,2 compared to aOR=0.65 (p<0.05) in G5,6. Conclusions: Age is a major predictor of functional recovery after ET, and this study demonstrates a clear age-dependent increase in rate of mortality and poor outcomes after ET with exponentially worse outcomes above 80 years of age. Complication rates were not age-dependent. Further studies are required to optimize patient selection for ET in the elderly.

P117 Predictive factors of outcome in poor grade subarachnoid haemorrhage (SAH)

2019 ◽  
Vol 90 (3) ◽  
pp. e52.3-e52
Author(s):  
J Fahmy ◽  
T Boumrah ◽  
S Trippier ◽  
A Hainsworth ◽  
J Madigan ◽  
...  
Keyword(s):  
Rank Order ◽  
External Ventricular Drain ◽  
Intraventricular Haemorrhage ◽  
Endovascular Coiling ◽  
Motor Score ◽  
Poor Grade ◽  
Good Outcome ◽  
Poor Outcome ◽  
Tertiary Centre

ObjectivesTo study the factors associated with outcome in poor grade SAH in a busy tertiary centre.DesignRetrospective records review.SubjectsAll Patients with SAH WFNS grades IV and V admitted Jan 2016-Dec 2017.MethodsWe admitted 379 SAH patients, 84 (22%) were poor grade (n=84, 33M/51F mean age 60.7±1.4 y). Outcome was assessed by Modified Rankin Scale (mRS) scores before surgery and at latest follow up (3–6 months). mRS was dichotomised as good (0–3) and poor (4–6).Spearman’s rank-order test evaluated correlation between latest mRS and all other variables (WFNS grade, GCS, Motor score of GCS, age, sex, smoking, hypertension, intraventricular haemorrhage (IVH) and intracerebral haemorrhages (ICH)).Results63 patients (75%) had poor outcome, of which 46 (55%) died (44 with 30 days), versus 21 (25%) had good outcome. Spearman’s correlation analysis revealed that patients with smaller aneurysms (3.3±0.4 mm in good outcome patients vs 11.3±1.2 mm in poor outcome) (rs=0.37, p=0.009), who are younger (rs=0.24, p=0.03), have higher GCS (rs=−0.24, p=0.03), higher motor score (rs=0.25, p=0.02), lower WFNS grade (rs=0.3, p=0.007) and received coiling of aneurysms vs no treatment (rs=−0.39, p<0.0001) had better outcome. There was no significant correlation in outcome with ICH, IVH, external ventricular drain insertion, location of aneurysms, smoking, hypertension, other co-morbidities or sex.ConclusionsIn poor grade SAH, younger patients with smaller aneurysms, higher GCS and higher motor score who received endovascular coiling had better outcome.

Vein of Galen aneurysmal malformation—clinical and angiographic spectrum with management perspective: an institutional experience

2016 ◽  
Vol 9 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Himanshu Agarwal ◽  
Leve Joseph Devarajan Sebastian ◽  
Shailesh B Gaikwad ◽  
Ajay Garg ◽  
Nalini K Mishra
Keyword(s):  
Vein Of Galen ◽  
Management Options ◽  
Good Outcome ◽  
Poor Outcome ◽  
Clinical Presentations ◽  
Wide Range ◽  
Management Perspective ◽  
Institutional Experience ◽  
Intracranial Vascular Malformation

Background and purposeVein of Galen aneurysmal malformation (VGAM) is a rare developmental intracranial vascular malformation. We analyzed the clinical presentations, imaging findings, angioarchitecture, management options, and outcome in a demographically heterogeneous set of VGAM patients.MethodsWe retrospectively analyzed cases of VGAM from our departmental archive collected between 1988 and January 2015. Demographic, clinical, therapeutic, and follow-up details were obtained for each patient from the available records.ResultsWe identified 36 patients with VGAM including 6 neonates, 18 infants, 7 children aged 2–10 years, and 5 adults. Macrocrania was the commonest presenting feature. Type of fistulae was mural in 14 and choroidal in 18 patients while 4 had a thrombosed sac at presentation. In 3 cases the dilated venous sac had connection with the deep venous system. Bilateral jugular atresia and stenosis were seen in 9 and 6 patients, respectively. Giant venous sac (>4 cm) was significantly correlated with mural type (p=0.0001). Dural arterial recruitment was seen in 4 patients including 3 adults. Among the 23 patients treated by endovascular means, 14 had a good outcome, 5 had a poor outcome, and 4 died. A significant correlation was noted between jugular atresia and poor outcome (p=0.003).ConclusionsWe encountered a wide range of demographic, clinical, and angiographic features in VGAM. Mural type malformations were associated with giant venous sacs. Good outcome after embolization was seen in selected neonates and in most of the infants, children, and adults. Jugular atresia was significantly associated with poor outcome.

Aminotransferase as a prognostic index in infants with liver disease

1990 ◽  
Vol 36 (2) ◽  
pp. 346-348 ◽  
Author(s):  
P Rosenthal ◽  
M Haight
Keyword(s):  
Liver Disease ◽  
Prognostic Index ◽  
Prognostic Indicator ◽  
Liver Disorders ◽  
Good Outcome ◽  
Poor Outcome ◽  
Poor Outcome Group ◽  
Outcome Group ◽  
Serum Aspartate Aminotransferase

Abstract To assess the utility of the serum aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio in a group of infants with liver disorders, we retrospectively analyzed the charts of 73 infants with chronic liver disorders. Patients were considered as having either a good outcome (n = 40) or a poor outcome (n = 33), based upon the clinical course. AST and ALT in serum were measured simultaneously at the time of initial presentation and at various follow-up visits during the first 13 months after birth. At presentation (mean age 1.65 months), there was no difference in the AST/ALT ratios between the good (1.61 +/- 0.62; mean +/- SD) and poor (1.65 +/- 0.78) outcome groups (P = 0.81). However, over time, the AST/ALT ratio increased in patients in the poor-outcome group and decreased in patients in the good-outcome group. Calculating the AST/ALT ratio appears to be an easy, early, and reliable prognostic indicator for infants with hepatic disease, and may be a useful measure for evaluating liver-disease patients.

Going Forward

2018 ◽  
pp. 189-192
Author(s):  
Mary C. Zanarini
Keyword(s):  
Suicide Rate ◽  
Experiential Avoidance ◽  
Good Outcome ◽  
Poor Outcome ◽  
Analytical Results ◽  
Borderline Patients ◽  
Symptomatic Remission ◽  
Almost All

Two waves of additional follow-up have recently been completed: 18-year follow-up and20-year follow-up. Two other waves will be completed in the next year or so: 22-year follow-up and 24-year follow-up. We have found that almost all borderline patients achieve at least a two-year symptomatic remission, and that symptomatic recurrences are relatively rare. We have also found that 60% of borderline patients eventually recover. In addition, we have found that the suicide rate in this sample is about half that found in older follow-back studies. We have also found areas with more guarded outcomes, particularly for those with BPD who have not recovered. We suggest that resilience is a factor that may be strongly related to a good outcome. In contrast, experiential avoidance may be a factor strongly related to a poor outcome. These additional waves of data will allow us to address these hypotheses with actual analytical results.

scholarly journals The Problems of Tracing

1986 ◽  
Vol 10 (3) ◽  
pp. 51-52
Author(s):  
Art O'Connor ◽  
Joan Daly
Keyword(s):  
Clinical Picture ◽  
Treatment Methods ◽  
Follow Up Study ◽  
Follow Up Studies ◽  
Long Term Follow Up

The importance of tracing technique and persistence was stressed by Sims. Long-term follow-up studies help to complete the clinical picture, a phrase used by Morris. They also help to clarify such issues as the effectiveness of treatment methods and changes in the socio-demographic status of patients. Unless a high percentage of the follow-up group is effectively traced, then the results of a long-term follow-up study must be suspect.

The Munich 15-year follow-up study (MUFUSSAD) on first-hospitalized patients with schizophrenic or affective disorders: Assessing courses, types and time stability of diagnostic classification

2011 ◽  
Vol 26 (4) ◽  
pp. 231-243 ◽  
Author(s):  
H.J. Möller ◽  
M. Jäger ◽  
M. Riedel ◽  
M. Obermeier ◽  
A. Strauss ◽  
...  
Keyword(s):  
Affective Disorders ◽  
Time Stability ◽  
Diagnostic Systems ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Icd 10 ◽  
Dsm Iv ◽  
Chronic Course

AbstractObjectiveIn the context of the development of DSM-V and ICD-11 it appears to be useful to get further data on the validity of the diagnostic differentiation between schizophrenic and affective disorders. This study investigated the relevance of the main diagnostic groups schizophrenia, schizoaffective psychosis and affective disorder in the context of different diagnostic systems (ICD-9, ICD-10, DSM –IV), assessing their time stability, long-term courses, types and functional outcome.MethodsA total of 323 first hospitalized inpatients of the Psychiatric Department of the University Munich were recruited at index time. The full follow-up evaluation including standardized assessment procedures could be performed in 197 patients.ResultsThe re-diagnosis of the patients’ disorders shows that with the transition from ICD-9 to ICD-10 or DSM-IV, the group of affective disorders increased numerically while the diagnostic groups of schizophrenia and schizoaffective disorders decreased in size. The structured clinical interview for DSM-IV (SCID) analysis showed that altogether ICD-10 and DSM-IV had a relatively high diagnostic stability. Of the patients with an ICD-10 diagnosis of schizophrenia, 57% had a chronic course; 61% of the patients with a DSM-IV diagnosis of schizophrenia. Patients with affective disorders, according either to ICD-10 or DSM-IV, had in more than 90% of the cases an episodic-remitting course. In terms of prediction of long-term outcome regarding the differentiation between chronic and non-chronic course, the ICD-10 diagnoses did give a slightly better predictive result than a dimensional approach based on the key psychopathological syndrome scores.ConclusionsThe differentiation between schizophrenic and affective disorders seems meaningful especially under predictive aspects. A dimensional syndromatological description does not exceed the predictive power of the investigated main diagnostic categories, but might increase the clinically relevant information.

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