scholarly journals A within-subject comparison of seizure duration with etomidate and methohexital in electroconvulsive therapy

2013 ◽  
Author(s):  
Kevin J Black
Keyword(s):  
Clinical Significance ◽  
Electroconvulsive Therapy ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
The Other ◽  
Seizure Duration ◽  
Subject Comparison ◽  
First Session

Objective: To determine whether etomidate is associated with longer seizures than methohexital in ECT anesthesia. Methods: Retrospective chart review in 39 patients who were switched from one anesthetic to the other. We compared motor and EEG seizure duration in the last ECT session on one anesthetic and the first session on the other anesthetic. Results: Motor seizures were about 10 seconds longer with etomidate (p < 0.05). However, few of the increases in seizure duration had obvious clinical import. Conclusions: Etomidate can lengthen ECT seizure time compared with methohexital, but the clinical significance of this observation requires further study.

scholarly journals A within-subject comparison of seizure duration with etomidate and methohexital in electroconvulsive therapy

2013 ◽  
Author(s):  
Kevin J Black
Keyword(s):  
Clinical Significance ◽  
Electroconvulsive Therapy ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
The Other ◽  
Seizure Duration ◽  
Subject Comparison ◽  
First Session

Objective: To determine whether etomidate is associated with longer seizures than methohexital in ECT anesthesia. Methods: Retrospective chart review in 39 patients who were switched from one anesthetic to the other. We compared motor and EEG seizure duration in the last ECT session on one anesthetic and the first session on the other anesthetic. Results: Motor seizures were about 10 seconds longer with etomidate (p < 0.05). However, few of the increases in seizure duration had obvious clinical import. Conclusions: Etomidate can lengthen ECT seizure time compared with methohexital, but the clinical significance of this observation requires further study.

scholarly journals Induction agents in electroconvulsive therapy: a comparison of methohexitone and propofol

2002 ◽  
Vol 26 (12) ◽  
pp. 455-457 ◽  
Author(s):  
Allan Scott ◽  
Harold Boddy
Keyword(s):  
Electroconvulsive Therapy ◽  
Therapeutic Efficacy ◽  
Seizure Threshold ◽  
Clinical Implications ◽  
Seizure Duration ◽  
Efficacy Of Treatment ◽  
Induction Agents ◽  
Subject Comparison

Aims and MethodTo compare methohexitone and propofol in electroconvulsive therapy (ECT). A retrospective within-subject comparison was made of the use of these drugs in separate courses of bilateral ECT in one clinic over 10 years. Patients taking mood stabilising or anti-epileptic drugs were excluded. The initial seizure threshold and seizure duration were of particular interest.ResultsThe median initial seizure thresholds were identical (75 mC). The median initial seizure duration with threshold stimulation was 25% shorter with propofol (21v.28 s). The median total numbers of treatments in the courses were identical (eight treatments).Clinical ImplicationsThe shorter seizure duration observed with propofol was not associated with a commensurate rise in the initial seizure threshold. The shorter seizure duration may therefore have no effect on the therapeutic efficacy of treatment.

Safety and efficacy of electroconvulsive therapy for depression following cerebrovascular accident

2012 ◽  
Vol 24 (4) ◽  
pp. 226-229 ◽  
Author(s):  
Magdalena Romanowicz ◽  
Bruce Sutor ◽  
Christopher Sola
Keyword(s):  
Electroconvulsive Therapy ◽  
Cerebrovascular Accident ◽  
Chart Review ◽  
Short Term Memory ◽  
Retrospective Chart Review ◽  
Neurological Deficits ◽  
Response To Treatment ◽  
Short Term ◽  
Memory Problems ◽  
Depressive Syndromes

Introduction: Depressive syndromes are common following cerebrovascular accident (CVA) and many patients do not respond to pharmacotherapy. Electroconvulsive therapy (ECT) is a safe and effective treatment for mood disorders arising with many comorbid medical conditions. In this paper, we describe the successful treatment of post-CVA depression with ECT.Methods: Retrospective chart review of 24 patients hospitalised for depression on an in-patient Medical Psychiatry unit between 2000 and 2010. Medical, neurologic and psychiatric histories, physical examination findings, results of laboratory, imaging and neurophysiologic investigations and treatment response with medications and ECT were recorded.Results: Twenty patients (83%) showed a positive response to treatment with ECT. None had worsening of depression after the ECT or experienced exacerbation of post-stroke neurological deficits. Three patients suffered from minor complications of ECT (prolonged confusion or short-term memory problems).Conclusions: This review supports the use of ECT after a stroke with appropriate clinical observation. The treatment was well tolerated and the majority obtained clinical benefit.

scholarly journals Clinical Characteristics of Non-Suicidal Self-Injury and Suicide Attempts among Psychiatric Patients in Korea: A Retrospective Chart Review

2020 ◽  
Vol 17 (4) ◽  
pp. 320-330
Author(s):  
Yubeen Bae ◽  
Yoanna Seong ◽  
Seok Hyeon Kim ◽  
Sojung Kim
Keyword(s):  
Clinical Characteristics ◽  
Chart Review ◽  
Suicide Attempts ◽  
Medical Center ◽  
Psychiatric Patients ◽  
Retrospective Chart Review ◽  
The Other ◽  
Novelty Seeking ◽  
Medical Chart Review ◽  
Self Injury

Objective Limited data exist on non-suicidal self-injury (NSSI) and suicide attempts among psychiatric patients in Korea. In this study, we investigated the clinical characteristics of patients who engaged in NSSI and/or suicide attempts.Methods We performed a retrospective medical chart review of patients with NSSI and/or suicide attempts at the psychiatric department of a university medical center in Seoul between 2017 and 2019. According to their history, patients were allocated to one of three groups: NSSI only, suicide attempts only and NSSI and suicide attempts group. Groups were compared based on sociodemographic characteristics and psychological assessments.Results Overall, 80 patients with NSSI and/or suicide attempts were evaluated. Patients with NSSI and suicide attempts were more likely to be female than the other two groups. Patients with NSSI and suicide attempts were more likely to suffer from Cluster B personality disorder than the other groups. And patients with NSSI and suicide attempts scored significantly higher on novelty-seeking in TCI and RC8, RC9 in MMPI-2.Conclusion Patients with NSSI and/or suicide attempts were more likely to be female, younger, and showed higher levels of psychological disturbances. These findings highlight the importance of early detection and intervention for patients with NSSI.

scholarly journals P.123 Normal pressure hydrocephalus with associated tremor

2019 ◽  
Vol 46 (s1) ◽  
pp. S45-S46
Author(s):  
A Persad ◽  
K Meguro
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Normal Pressure Hydrocephalus ◽  
Chart Review ◽  
Functional Decline ◽  
Retrospective Chart Review ◽  
Normal Pressure ◽  
Careful Consideration ◽  
The Other ◽  
Extrapyramidal Signs

Background: Normal pressure hydrocephalus is a frequent cause of cognitive and functional impairment. Many symptoms are shared between Parkinson’s disease and normal pressure hydrocephalus. Only few studies examine extrapyramidal signs in NPH, and only one case report exists describing tremor improvement with shunting. Methods: We performed a retrospective chart review of our NPH database. We selected patients who had both NPH and question of Parkinsonism due to tremor. Results: Six patients with both NPH diagnosis and tremor were identified. Three patients were treated for Parkinson’s disease and followed by neurology. After shunting, all three improved and attempt was made to wean medications, which led to functional decline. The other three patients improved with shunting and after titration of the shunt had resolution of tremor. Conclusions: We provide evidence that NPH can result in tremor, treatable by shunting. We also emphasize that those patients do exist who have both diseases. This likely exists along a continuum. Careful consideration of NPH should be undertaken in those patients with suspected Parkinson’s disease and imaging findings reminiscent of NPH.

Early Detection of Renal Dysfunction in Pediatric Sickle Cell Patients

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1017-1017
Author(s):  
Marwah W. Farooqui ◽  
Santosh Saraf ◽  
Victor R. Gordeuk ◽  
Kimberly Czech ◽  
Eunice John ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Renal Dysfunction ◽  
Sickle Cell ◽  
Chart Review ◽  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
The Other ◽  
Cell Disease ◽  
Urine Protein ◽  
Sickle Cell Nephropathy

Abstract Abstract 1017 In sickle cell disease, patients are predisposed to renal dysfunction and eventual renal failure as they reach adulthood. Many advances have been made within the field of sickle cell anemia, yet to this day sickle cell nephropathy remains an important cause of mortality in adult patients. Previous studies have determined that proteinuria and hematuria are two useful markers of sickle cell nephropathy. Currently, the best marker for detecting early renal dysfunction is proteinuria on urine dipstick due to its ease of use and efficiency. Our goal in this study is to determine the age at which the first signs of renal dysfunction appear. Pediatric patients with sickle cell disease were selected for a retrospective chart review to determine age of onset for renal abnormalities. The sickle cell pediatric roster was used from the Children's Hospital University of Illinois to study a total of 175 patients within the age range of 0–31 years. Urinalysis was captured at patient's baseline when available and possible risk factors for glomerular dysfunction were studied. Factors such as urine protein and blood on dipstick were recorded and proteinuria was further quantified by using the urine protein to creatinine ratio. Blood on dipstick was further analyzed by red blood cells on microscopic urinalysis. Patients with positive urine for blood on dipstick with <5 RBCs on microscopic UA were marked as patients with hemoglobinuria. Other factors such as sickle cell hemoglobin type, LDH, reticulocyte count, HbF, and hydroxyurea treatment were also recorded to look for correlation with predictors of early renal dysfunction. The Fisher's exact test was used to compute the (two-tailed) probability. Urinalysis results were available for 141 of the 175 pediatric patients from the sickle cell roster. From the 141 patients that were studied 65% of the patients had urinalysis done at baseline, the other 35% had UA when acutely ill. The mean overall age was 9.9 years and a total of 25 of the 141 (17.7%) patients were observed to have proteinuria on dipstick. In the proteinuria group, 64% of the UA were obtained at baseline and the other 36% were during a sick visit. The majority (66%) of these ‘sick’ patients were febrile under the age of 7. Obtaining a UA during an acute illness could skew our results since pediatric patients who are acutely ill may have transient proteinuria but none at baseline. In our pediatric sickle cell population, about 14% had hemoglobinuria. Analysis of only baseline UA showed that no patients under the age of 5 at baseline had proteinuria and there is a strong correlation between age and proteinuria (R2 = 0.81, p<0.02). Similarly there is a correlation between age and hemoglobinuria (R2 = 0.57). Hemoglobinuria is occasionally observed in 11.4% of children <5 years of age, and at 12.9% in the teenage group. A significant increase in incidence of hemoglobinuria is noted in the young adults (40%). Of the 16 patients with hemoglobinuria only 8 had concurrent proteinuria. A larger sample size is needed to determine whether proteinuria and hemoglobinuria are independent versus correlated markers of early renal dysfunction. Preliminary analyses of baseline UA found no correlations between proteinuria and Hb level, LDH, reticulocytes, serum creatinine, or creatinine clearance. From this retrospective chart review in this pediatric sickle cell disease population, it can be deduced that proteinuria becomes a concern in sickle patients in the adolescent years while hemoglobinuria appears in late teen to young adult years. It can be concluded that the first clinical signs of renal dysfunction which lead to nephropathy in sickle patients are more frequently seen in adolescent to late teen years and this is likely the marks the beginning of the deterioration of kidney function. Further studies are needed for multivariate analysis of other markers (GFR, Cr, Cr Clearance) of nephropathy and to improve early detection of renal dysfunction by conducting longitudinal studies. Our goal is to improve our current practice by routine screening in sickle patients to preserve renal function and improve the morbidity and mortality related to sickle cell nephropathy in the aging patient. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Maintenance Electroconvulsive Therapy and hospital re-admission days among patients with mental illness in Malaysia

2020 ◽  
Author(s):  
Benedict Francis ◽  
Yit Han Ng ◽  
Julian Joon Ip Wong ◽  
Shiau Thin Ling ◽  
Jesjeet Singh Gill ◽  
...  
Keyword(s):  
Mental Illness ◽  
Electroconvulsive Therapy ◽  
Treatment Modality ◽  
Affective Disorders ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
National Data ◽  
Schizophrenia Spectrum ◽  
Maintenance Ect ◽  
Review Study

Abstract Background : Relapse prevention strategies are important as part of optimal patient care. As such, maintenance electroconvulsive therapy (mECT) is an important treatment modality to keep patients in remission longer. Aims : Our study aimed to explore the characteristics of patients receiving maintenance ECT (mECT) and further investigate whether this treatment modality reduces re-admission days in patients with severe mental illness. Methods : A retrospective chart review study design was employed. The medical records of 22 patients followed up at University Malaya Medical centre, were analysed with regards to the outcome measures, which was days of re-admission post mECT, Potential confounders were controlled for via stratification analysis. Results : There was a significant reduction in re-admission days post mECT (p<0.001, r:0.85 ) across all the variables analysed. The variable with the biggest effect size were patients younger than 60 years old (p:0.01, r:0.70), followed by medication with polypharmacy (p:0.002, r: 0.65). The magnitude of reduction in re-admissions was greater in the schizophrenia spectrum group compared to the affective disorders group (r: 0.64 vs. 0.57). Conclusion : Our study provides national data regarding the efficacy of mECT in significantly reducing days of re-admission in patients with treatment resistant schizophrenia spectrum illness and affective disorders. As widespread usage of mECT is still lacking in Asia, our results is encouraging for more practitioners to prescribe mECT for their patients.

scholarly journals Psychosocial Outcomes following Electroconvulsive Therapy in a Community Setting: Retrospective Chart Review with 2-Year Follow-up

2007 ◽  
Vol 52 (9) ◽  
pp. 598-604 ◽  
Author(s):  
Biju Mathew ◽  
Marliese Y Dawson ◽  
Chris Kozanitis ◽  
Britt Bright ◽  
HV Gopinath ◽  
...  
Keyword(s):  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Psychosocial Functioning ◽  
Chart Review ◽  
Community Hospital ◽  
Retrospective Chart Review ◽  
Psychosocial Outcomes ◽  
Open Label ◽  
Meaningful Improvement

Objective: Electroconvulsive therapy (ECT) continues to be one of the most effective biological therapies for patients with mood disorders. Numerous studies address clinical response; however, few have examined psychosocial or occupational outcomes following ECT, especially in community settings. This study aimed to examine these outcomes in short- and long-term naturalistic follow-up of ECT conducted in a community hospital. Methods: A retrospective chart review was conducted of all patients who received ECT at Ridge Meadows Hospital in Maple Ridge, British Columbia, between January 1997 and December 2003. Charts were evaluated with the Clinical Global Impression (CGI), Global Assessment of Functioning, and Social and Occupational Functioning Assessment Scales prior to ECT and at 6 months, 1 year, and 2 years post-ECT. Results: A total of 90 patients with mood disorders underwent ECT; 86.5% were rated on the CGI as “markedly ill” to “among the most extremely ill” at baseline. All clinical ratings improved at every follow-up point, and by the end of 24 months, 56.6% of patients were rated as “much improved” or “very much improved” on the CGI. Similarly, the measures of psychosocial functioning also showed significant improvement throughout the follow-up period. Conclusions: These findings show that substantial and meaningful improvement occurred in clinical and psychosocial outcomes after ECT conducted in a community hospital. These changes were robust and stable over the 2-year follow-up period. Limitations of the study include the retrospective ratings, the open-label use of ECT, and the naturalistic treatment in follow-up.

Endoscopic temporal ventriculocisternostomy: an option for the treatment of trapped temporal horns

2013 ◽  
Vol 11 (5) ◽  
pp. 568-574 ◽  
Author(s):  
Anna K. Krähenbühl ◽  
Jörg Baldauf ◽  
Michael R. Gaab ◽  
Henry W. S. Schroeder
Keyword(s):  
Chart Review ◽  
Standard Treatment ◽  
Tumor Resection ◽  
Retrospective Chart Review ◽  
Septum Pellucidum ◽  
The Other ◽  
Rare Form ◽  
Temporal Horn ◽  
Multiloculated Hydrocephalus ◽  
Postoperative Meningitis

Entrapment of the temporal horn is a rare form of isolated hydrocephalus. Standard treatment has not yet been established for this condition, and only a few cases have been reported in the literature. The authors reviewed their prospectively maintained database to report their experience with endoscopic temporal ventriculocisternostomy. All endoscopic operations performed in the Department of Neurosurgery at Ernst Moritz Arndt University between March 1993 and August 2012 were reviewed, and a retrospective chart review of all patients with temporal ventriculocisternostomy was performed. Four patients were identified (3 children and 1 adult). In 3 patients, the condition developed after tumor resection, and in 1 patient it developed due to postmeningitic multiloculated hydrocephalus. In 2 patients, a recurrent trapped temporal horn developed. Refenestration was successful in one of these patients, and dilation in the trigone area with a subsequent stomy of the septum pellucidum was successful in the other. In 1 patient, postoperative meningitis developed, which was treated with antibiotics. Endoscopic temporal ventriculocisternostomy is an option in the treatment of trapped temporal horns. However, more experience is required to recommend it as the treatment of choice.

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