scholarly journals Patients with learning disability at Kneesworth House Hospital

1998 ◽  
Vol 22 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Deborah Brooke
Keyword(s):  
Learning Disability ◽  
Clinical Characteristics ◽  
Psychiatric Morbidity ◽  
Case Note ◽  
Challenging Behaviour ◽  
Retrospective Case

This paper reports a retrospective case note study of all patients with learning disability and challenging behaviour admitted to Kneesworth House Hospital between 1986 and 1991 (n=70), describing their demographic and clinical characteristics. The subjects had high levels of psychiatric morbidity, in addition to learning disability. Patients whose stay was relatively short, or who were discharged to community placements, were not able to be differentiated on clinical grounds, suggesting that the provision of local facilities determined the length of the admission. There is a need for more regional and sub-regional services for this group with multiple long-term problems.

Thyroid lymphoma: acute presentation and long-term outcome

2011 ◽  
Vol 125 (12) ◽  
pp. 1256-1262 ◽  
Author(s):  
S E Penney ◽  
J J Homer
Keyword(s):  
Case Note ◽  
Thyroid Lymphoma ◽  
Retrospective Case ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Acute Presentation ◽  
Appropriate Treatment ◽  
Diagnostic Pathways ◽  
Single Modality

AbstractBackground:Thyroid lymphomas are relatively uncommon. This study aimed to analyse our experience of thyroid lymphoma management and outcome.Materials and methods:A retrospective case note analysis of 63 patients treated in the previous 13 years was conducted.Results:The five-year survival rate was 68 per cent, with most patients dying of their lymphoma. This is at odds with the British Thyroid Association statement that the prognosis of this condition is ‘generally excellent’. The only presenting symptom found to be significantly associated with prognosis was dysphagia (p = 0.001). Dual modality treatment provided a significantly better outcome than single modality treatment (p = 0.014). Thyroid lymphoma can present to the head and neck surgeon ‘in extremis’; however, it can respond rapidly to appropriate treatment.Conclusion:The outcome of thyroid lymphoma seems unrelated to the acuteness of its presentation. Thyroid surgery has no role other than for diagnosis. However, 51 per cent of the study patients underwent some form of thyroidectomy, indicating the need to implement better diagnostic pathways.

scholarly journals Experience of thioridazine use before and after the Committee on Safety of Medicines warning

2003 ◽  
Vol 27 (03) ◽  
pp. 87-89
Author(s):  
Tim Matthews ◽  
Sian Nersy Weston
Keyword(s):  
Adverse Events ◽  
Learning Disability ◽  
Drug Withdrawal ◽  
Drug Dosage ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Before And After ◽  
Adults With Learning Disabilities ◽  
Severe Degree

Aims and Method To describe the use of thioridazine in a population of adults with learning disabilities at the time of the warning issued by the Committee on Safety of Medicines (CSM). Also, to observe the result of discontinuation of thioridazine and to examine factors that were associated with adverse events. Retrospective case note analysis was carried out for a sample of individuals with a learning disability. Results Over 50% of those on regular thioridazine experienced adverse events during or following drug withdrawal. Adverse events were significantly associated with the duration of previous thioridazine prescription. Higher drug dosage and a more severe degree of learning disability may also be factors linked to poorer outcomes. Clinical Implications More caution may be required when reducing or withdrawing antipsychotic medication in this patient group.

scholarly journals Feigned psychosis revisited –a 20 year follow up of 10 patients

1996 ◽  
Vol 20 (11) ◽  
pp. 666-669 ◽  
Author(s):  
Martin Humphreys ◽  
Alan Ogilvie
Keyword(s):  
Case Note ◽  
Psychotic Symptoms ◽  
Psychotic Illness ◽  
Retrospective Case ◽  
Long Term Follow Up ◽  
Initial Episode ◽  
Changes Over Time ◽  
Over Time

Feigned psychosis, although rare, presents considerable diagnostic problems in clinical psychiatric practice. Long-term follow up data are lacking. A retrospective case note study was undertaken of 10 patients described in a previous paper, published in 1970, on the simulation of psychosis. The computerised diagnostic instrument OPCRIT was applied to both index episode and lifetime occurrence of symptoms. All 10 patients were found to have had a major psychotic illness based on lifetime symptoms at 20 year follow-up by DSM–III–R criteria. Eight had met such criteria at the time of the initial episode. Diagnosis in patients thought to be feigning psychotic symptoms changes over time and major mental illness is likely to emerge which may be schizophrenic or affective. The term feigned psychosis should be abandoned and more attention given to why symptoms are accepted as genuine in some cases but not others.

Experience of thioridazine use before and after the Committee on Safety of Medicines warning

2003 ◽  
Vol 27 (3) ◽  
pp. 87-89 ◽  
Author(s):  
Tim Matthews ◽  
Sian Nersy Weston
Keyword(s):  
Adverse Events ◽  
Learning Disability ◽  
Drug Withdrawal ◽  
Drug Dosage ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Before And After ◽  
Adults With Learning Disabilities ◽  
Severe Degree

Aims and MethodTo describe the use of thioridazine in a population of adults with learning disabilities at the time of the warning issued by the Committee on Safety of Medicines (CSM). Also, to observe the result of discontinuation of thioridazine and to examine factors that were associated with adverse events. Retrospective case note analysis was carried out for a sample of individuals with a learning disability.ResultsOver 50% of those on regular thioridazine experienced adverse events during or following drug withdrawal. Adverse events were significantly associated with the duration of previous thioridazine prescription. Higher drug dosage and a more severe degree of learning disability may also be factors linked to poorer outcomes.Clinical ImplicationsMore caution may be required when reducing or withdrawing antipsychotic medication in this patient group.

scholarly journals Ocular toxoplasmosis: phenotype differences between toxoplasma IgM positive and IgM negative patients in a large cohort

2020 ◽  
pp. bjophthalmol-2019-315522
Author(s):  
Sofia Ajamil-Rodanes ◽  
Joshua Luis ◽  
Rabia Bourkiza ◽  
Benedict Girling ◽  
Angela Rees ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Retinal Detachment ◽  
Clinical Characteristics ◽  
Rhegmatogenous Retinal Detachment ◽  
Intraocular Inflammation ◽  
Case Note ◽  
Ocular Toxoplasmosis ◽  
Retrospective Case ◽  
Patient Demographics ◽  
Comparator Group

PurposeTo investigate the differences in demographics and clinical characteristics of patients diagnosed with ocular toxoplasmosis according to their IgM status.MethodsRetrospective case note analysis was carried out on patients who tested positive for serum Toxoplasma gondii-specific IgM antibodies (IgM+) as well as a comparator group who tested negative for serum IgM (IgM-), but positive for serum IgG. Patient demographics and clinical features were compared between the two groups to evaluate for any significant differences.ResultsOne hundred and six patients were included in the study between March 2011 and June 2018, consisting of 37 in the IgM +group and 69 in the IgM- group. Patients in the IgM +group were significantly older (51.1 vs 34.1 years, p<0.0001), more likely to present with central macular lesions (32% vs 12%, p=0.012), and more likely to develop rhegmatogenous retinal detachment (11% vs 1%, p=0.049). In contrast, patients in the IgM- group were more likely present with pain (20% vs 3%, 0.017) and exhibit more severe inflammation of the anterior chamber and vitreous (p<0.05). Overall, retinal lesions were more likely to be superotemporal (55%) and superonasal (31%). Furthermore, age was associated with larger (p=0.003) and more peripheral lesions (p=0.007).ConclusionsThis study demonstrated significant differences in clinical characteristics of ocular toxoplasmosis according to serum IgM status. IgM+ patients were older, less likely to report pain, had lower levels of intraocular inflammation, but were more likely to have macular involvement. We also found age to be correlated with larger and more peripheral lesions.

The prevalence of neuroleptic malignant syndrome in learning disability

2003 ◽  
Vol 20 (3) ◽  
pp. 102-104 ◽  
Author(s):  
Caryl N Morgan ◽  
Renarta Rowe
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Neuroleptic Malignant Syndrome ◽  
Prevalence Rate ◽  
Case Note ◽  
Neurological Symptoms ◽  
Lifetime Prevalence ◽  
Retrospective Case ◽  
Catchment Areas ◽  
Lifetime Prevalence Rate

AbstractObjectives: No information has been published on the incidence of neuroleptic malignant syndrome in learning disability. However, some studies of individuals who have developed neuroleptic malignant syndrome have suggested that individuals with learning disabilities may be over represented. This study aims to identify the association between learning disability and neuroleptic malignant syndrome.Method: A retrospective case-note analysis was performed with psychiatric case notes for clients with learning disability, in two geographical catchment areas. It was recorded whether clients had been exposed to neuroleptics, and whether any neurological symptoms had subsequently developed which could have been suggestive of neuroleptic malignant syndrome.Results: It was found that 301 individuals had been exposed to neuroleptics, out of 570 case notes examined. Only one case of neuroleptic malignant syndrome was identified, giving a lifetime prevalence rate of 0.3%.Conclusion: This study failed to demonstrate a higher than expected prevalence of neuroleptic malignant syndrome in clients with learning disability exposed to neuroleptics.

Psychopathology 8½ Years Post Parasuicide

Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Stephen Curran ◽  
Michael Fitzgerald ◽  
Vincent T Greene
Keyword(s):  
Rating Scales ◽  
Psychiatric Morbidity ◽  
Parental Bonding ◽  
Social Maladjustment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Face To Face ◽  
Long Term Follow Up

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8½ years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five had died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

Ketamine Treatment in Depression: A Systematic Review of Clinical Characteristics Predicting Symptom Improvement

2020 ◽  
Vol 20 (15) ◽  
pp. 1398-1414 ◽  
Author(s):  
Darby J.E. Lowe ◽  
Daniel J. Müller ◽  
Tony P. George
Keyword(s):  
Clinical Features ◽  
Clinical Characteristics ◽  
Bipolar Depression ◽  
Antidepressant Effect ◽  
Future Research ◽  
Symptom Improvement ◽  
Randomized Controlled ◽  
Treatment Of Depression ◽  
Future Direction

Ketamine has been shown to be efficacious for the treatment of depression, specifically among individuals who do not respond to first-line treatments. There is still, however, a lack of clarity surrounding the clinical features and response periods across samples that respond to ketamine. This paper systematically reviews published randomized controlled trials that investigate ketamine as an antidepressant intervention in both unipolar and bipolar depression to determine the specific clinical features of the samples across different efficacy periods. Moreover, similarities and differences in clinical characteristics associated with acute versus longer-term drug response are discussed. Similarities across all samples suggest that the population that responds to ketamine’s antidepressant effect has experienced chronic, long-term depression, approaching ketamine treatment as a “last resort”. Moreover, differences between these groups suggest future research to investigate the potential of stronger efficacy towards depression in the context of bipolar disorder compared to major depression, and in participants who undergo antidepressant washout before ketamine administration. From these findings, suggestions for the future direction of ketamine research for depression are formed.

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