• 제목/요약/키워드: Clinical features

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Pharmacological Treatment of Major Depressive Episodes with Mixed Features: A Systematic Review

  • Shim, In Hee;Bahk, Won-Myong;Woo, Young Sup;Yoon, Bo-Hyun
    • Clinical Psychopharmacology and Neuroscience
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    • 제16권4호
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    • pp.376-382
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    • 2018
  • We reviewed clinical studies investigating the pharmacological treatment of major depressive episodes (MDEs) with mixed features diagnosed according to the dimensional criteria (more than two or three [hypo]manic symptoms+principle depressive symptoms). We systematically reviewed published randomized controlled trials on the pharmacological treatment of MDEs with mixed features associated with mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). We searched the PubMed, Cochrane Library, and ClinicalTrials.gov databases through December 2017 with the following key word combinations linked with the word OR: (a) mixed or mixed state, mixed features, DMX, mixed depression; (b) depressive, major depressive, MDE, MDD, bipolar, bipolar depression; and (c) antidepressant, antipsychotic, mood stabilizer, anticonvulsant, treatment, medication, algorithm, guideline, pharmacological. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We found few randomized trials on pharmacological treatments for MDEs with mixed features. Of the 36 articles assessed for eligibility, 11 investigated MDEs with mixed features in mood disorders: six assessed the efficacy of antipsychotic drugs (lurasidone and ziprasidone) in the acute phase of MDD with mixed features, although four of these were post hoc analyses based on large randomized controlled trials. Four studies compared antipsychotic drugs (olanzapine, lurasidone, and ziprasidone) with placebo, and one study assessed the efficacy of combination therapy (olanzapine+fluoxetine) in the acute phase of BD with mixed features. Pharmacological treatments for MDEs with mixed features have focused on antipsychotics, although evidence of their efficacy is lacking. Additional well-designed clinical trials are needed.

다발성 백악질공이형성증 조직병리검사시 임상, 방사선양상의 중요성 (The Diagnostic importance of clinical and radiologic features of the Multiple Cemento-osseous dysplasia)

  • 한미라;김영희;강병철
    • 치과방사선
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    • 제28권1호
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    • pp.299-309
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    • 1998
  • This case was diagnosed as multiple cementoosseous dysplasia on the basis of clinical & radiological features but was diagnosed as ossifying fibroma on the basis of histopathological feature. The histopathologic features of the multiple cementoosseous dysplasia and cementoossifying fibroma have common features of cementum, fibrous network and bone. Multiple cementoosseous dysplasia is reactive lesion and shows restricted lesion size, occurred on anterior and posterior tooth of the mandible and needs no treatement except periodic follow up. But Cementoossifying fibroma is the true neoplasm and grows continuously and needs surgical removal. The final diagnosis of the multiple cementoosseous dysplasia requires good correlation of the clinical, histopathological, and radiological features.

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Influence of Clinical and Anatomic Features on Treatment Decisions for Anterior Communicating Artery Aneurysms

  • Choi, Jae-Hyung;Kang, Myung-Jin;Huh, Jae-Taeck
    • Journal of Korean Neurosurgical Society
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    • 제50권2호
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    • pp.81-88
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    • 2011
  • Objective : The purpose of this study was to analyze the clinical and anatomic features involved in determining treatment modalities for anterior communicating artery (AcoA) aneurysms. Methods : The authors retrospectively evaluated 112 AcoA aneurysms with pretreatment clinical features including age, Hunt and Hess grade, medical or neurological comorbidity, and anatomical features including aneurysm size, neck size, dome-to-neck ratio, vessel incorporation, multiple lobulation, and morphologic scoring system. Post-treatment clinical results were classified according to the Glasgow Outcome Scale, and anatomic results in coiled patients were classified according to the modified Raymond scale. Using multivariate logistic regression, the probabilities for decision making between surgical clipping and coil embolization were calculated. Results : Sixty-seven patients (60%) were treated with surgical clipping and 45 patients (40%) with endovascular coil embolization. The clinical factor significantly associated with treatment decision was age (${\geq}$65 vs. <65 years) and anatomical factors including aneurysm size (small or large vs. medium), dome-to-neck ratio (<2 vs. ${\geq}$2), presence of vessel incorporation, multiple lobulation, and morphologic score (${\geq}$2 vs. <2). In multivariate analysis, older patients (age, 65 years) had significantly higher odds of being treated with coil embolization relative to clipping (adjusted OR=3.78; 95% CI, 1.39-10.3; p=0.0093) and higher morphological score patients (${\geq}$2) had a higher tendency toward surgical clipping than endovascular coil embolization (OR=0.23; 95% CI, 0.16-0.93; p=0.0039). Conclusion : The optimal decision for treating AcoA aneurysms cannot be determined by any single clinical or anatomic characteristics. All clinical and morphological features need to be considered, and a collaborative neurovascular team approach to AcoA aneurysms is essential.

Insight into the prognostic factors of chronic inflammatory demyelinating polyneuropathy

  • Baek, Seol-Hee
    • Annals of Clinical Neurophysiology
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    • 제22권1호
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    • pp.8-12
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    • 2020
  • Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy with heterogeneous features. Appropriate treatment will produce a favorable outcome, but a poor treatment response and severe disability have also been reported. The roles of the clinical phenotypes and electrophysiological features of CIDP as well as of autoantibodies against nodal and paranodal proteins have been highlighted previously due to their association with the treatment response and long-term prognosis. This review addresses the diverse factors associated with the prognosis of CIDP.

소뇌기능이상의 임상양상을 특징으로 보인 뇌교부출혈 환자 1례 (A Case of a Patient of Pontine Hemorrhage with Clinical Features of Cerebellar Dysfunction)

  • 이유경;공경환;용형순;고성규;부송아
    • 대한한방내과학회지
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    • 제21권5호
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    • pp.889-895
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    • 2000
  • I experienced a case of a patient with clinical features of cerebellar dysfunction in the intracranial hemorrhage which encroached the basis of lower pontine and all parts of pontine tegmentum. So I report this case with bibliographical inquiry. In addition, I applied the treatment of Oriental medicine to sequelae of intracranial hemorrhage like disorders of eye movement, central dizziness, cerebellar tremor and ataxias but the effect did not meet my expectation. I anticipate more clinical studies and reports on this hereafter.

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Clinical, radiologic, and genetic features of Korean patients with Mucopolysaccharidosis IVA

  • Lee, Na Hee;Cho, Sung Yoon;Maeng, Se Hyun;Jeon, Tae Yeon;Sohn, Young Bae;Kim, Su Jin;Park, Hyung-Doo;Jin, Dong Kyu
    • Clinical and Experimental Pediatrics
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    • 제55권11호
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    • pp.430-437
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    • 2012
  • Purpose: Mucopolysaccharidosis IVA (MPS IVA; Morquio A syndrome) is rare lysosomal storage disorder caused by N-acetylgalactosamine-6-sulfatase (GALNS) deficiency. Only a few MPS IVA cases have been reported in the Korean literature; there is a paucity of research about clinical or radiologic findings for this disorder. Therefore, we studied clinical findings, radiological features, and genetic data of Korean MPS IVA patients for determining factors that may allow early diagnosis and that may thus improve the patients' quality of life. Method: MPS IVA was confirmed via assay for enzymatic activity of leukocytes in 10 patients. The GALNS gene was analyzed. Patients' charts were retrospectively reviewed for obtaining clinical features and evaluated for radiological skeletal surveys, echocardiography, pulmonary function test, and ophthalmologic test results. Result: Nine patients had severe clinical phenotype, and 1 had an intermediate phenotype, on the basis of clinical phenotype criteria. Radiologic findings indicated skeletal abnormalities in all patients, especially in the hips and extremities. Eight patients had an odontoid hypoplasia, and 1 showed mild atlantoaxial subluxation and cord myelopathy. Genetic analysis indicated 10 different GALNS mutations. Two mutations, c.451C>A and c.1000C>T, account for 37.5% (6/16) and 25% (4/16) of all mutations in this samples, respectively. Conclusion: An understanding of the clinical and radiological features involved in MPS IVA may allow early diagnosis of MPS IVA. Adequate evaluations and therapy in the early stages may improve the quality of life of patients suffering from skeletal abnormalities and may reduce life-threatening effects of atlantoaxial subluxation.

Clinical assessment and grading of back pain in horses

  • Mayaki, Abubakar Musa;Razak, Intan Shameha Abdul;Adzahan, Noraniza Mohd;Mazlan, Mazlina;Rasedee, Abdullah
    • Journal of Veterinary Science
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    • 제21권6호
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    • pp.82.1-82.10
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    • 2020
  • Background: The clinical presentation of horses with back pain (BP) vary considerably with most horse's willingness to take part in athletic or riding purpose becoming impossible. However, there are some clinical features that are directly responsible for the loss or failure of performance. Objectives: To investigate the clinical features of the thoracolumbar region associated with BP in horses and to use some of the clinical features to classify equine BP. Methods: Twenty-four horses comprised of 14 with BP and 10 apparently healthy horses were assessed for clinical abnormality that best differentiate BP from normal horses. The horses were then graded (0-5) using the degree of pain response, muscular hypertonicity, thoracolumbar joint stiffness and overall physical dysfunction of the horse. Results: The common clinical features that significantly differentiate horses with BP from non-BP were longissimus dorsi spasm at palpation (78.6%), paravertebral muscle stiffness (64.3%), resist lateral bending (64.3%), and poor hindlimb impulsion (85.7%). There were significantly (p < 0.05) higher scores for pain response to palpation, muscular hypertonicity, thoracolumbar joint stiffness and physical dysfunction among horses with BP in relation to non-BP. A significant relationship exists between all the graded abnormalities. Based on the cumulative score, horses with BP were categorized into mild, mild-moderate, moderate and severe cases. Conclusions: BP in horse can be differentiated by severity of pain response to back palpation, back muscle hypertonicity, thoracolumbar joint stiffness, physical dysfunctions and their cumulative grading score is useful in the assessment and categorization of BP in horses.

침도 침술 후 나타나는 두통에 대한 임상적 고찰 (The Study on Post Acupotomy Headache)

  • 고민경;김정호;홍권의
    • Journal of Acupuncture Research
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    • 제27권2호
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    • pp.89-95
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    • 2010
  • Objectives : This study was designed to investigate incidence rate, clinical features and treatment of headache followed after acupotomy. And based on that, we study correlating between post acupotomy headache and post-lumbar puncture headache(PLPH). Methods : From September 1st, 2007 to December 31st, 2007, the 73 inpatients who admitted to Daejeon Oriental hospital and underwent acupotomy on lumbar spine and cervical spine etc. more than once were observed. Then 9 inpatients who occurred headache after acupotomy was analyzed according to incidence rate, gender, age, clinical features. Results : We investigated clinical features of post acupotomy headache and made comparative study of post acupotomy headache and PLPH. The average frequency of post acupotomy headache was about 12.3%. The risk factors are undergoing acupotomy on lumbar spine, young age. Gender does not affect the incidence of post acupotomy headache. Patients complain of headache which worsen when the patients is upright and improve after the patients lie back down in a few minutes. Those clinical features are similar to PLPH. Conclusions : Although two type of headache have significant similarities, there is no enough evidence to support this study. In addition, the cause and treatment of post acupotomy headache are still unclear. Thus, based on the above study, more studies have to be investigated.

Clinical Features of the Persistent Idiopathic Dentoalveolar Pain Compared with Inflammatory Dental Pain

  • Jang, Ji Hee;Chung, Jin Woo
    • Journal of Oral Medicine and Pain
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    • 제47권2호
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    • pp.87-94
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    • 2022
  • Purpose: This study aimed to evaluate the differences between clinical and quantitative sensory testing (QST) results among persistent idiopathic dentoalveolar pain (PIDP), inflammatory dental pain, and control group subjects to identify discriminative clinical features for differential diagnosis. Methods: Thirty-three patients (5 PIDP-a without surgical procedures 10 PIDP-b with surgical procedures, 8 dental pain patients, and 10 controls) were evaluated for clinical features and QST results. Cold pain threshold, heat pain threshold, mechanical pain threshold (MPT), mechanical pain sensitivity, and pressure pain threshold (PPT) were performed. Psychological factors were assessed using Symptom Checklist-90-Revision (SCL-90-R) and a chart review was conducted to evaluate additional discriminative clinical features such as pain quality and treatment prognosis. Results: The dental pain group had lower PPT than the PIDP-b and the control group. The PIDP-a group showed higher MPT and PPT than the PIDP-b and dental pain group but the difference was not statistically significant. Differences in SCL-90-R SOM (Somatization), O-C (obsessive-compulsive), ANX (anxiety), and PSY (Psychoticism) values were statistically significant among groups. PIDP-a and PIDP-b groups showed remaining symptoms after treatment and the pain tended to spread widely, whereas, in toothache patients, symptoms disappeared after treatment. However, factors that confound the diagnosis, such as an increase in pain during chewing and a decrease in the pain threshold at the affected site, could also be identified. Conclusions: PIDP and dental pain groups have distinct clinical symptoms, but there are also factors that cause confusing in diagnosis. Therefore, various clinical examination results should be carefully reviewed and comprehensively evaluated in the differential diagnosis process.

Correlation Between Mammograghic Findings and Clinical/Pathologic Features in Women with Small Invasive Breast Carcinomas

  • Li, Jun-Nan;Xu, Jing;Wang, Ju;Qing, Chun;Zhao, Yu-Mei;Liu, Pei-Fang
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10643-10646
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    • 2015
  • Background: To study the relationship between mammographic findings and clinical/pathologic features in women with 1-15mm sized invasive breast cancer. Materials and Methods: We investigated a consecutive series of 134 cases diagnosed in Tianjin Medical University Cancer Institute and Hospital in 2007. Mammographic findings were classified into five groups as follows :1) stellate mass without calcification; 2) non-stellate mass without calcification; 3) intermediate suspicious calcification with or without associated mass; 4) higher probability malignant calcification with or without associated mass; 5) focal asymmetry/distortion without associated calcification. Associations between mammographic and clinical/pathological features (menopause status/family history/histologic grade/lymph node status and ER/PR/HER2 status) was analyzed through logistic regression and chi square tests. Results: Compared to the stellate mass without calcification group, higher probability malignant calcification patients were associated significantly with a positive lymph node status, always presenting in patients who were non-menopausal and with a family history of carcinoma. Conclusions: Higher probability malignant calcifications with or without associated tumor masses are associated with clinical/pathologic features of poor prognosis.