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A Case of Asymmetric Seizure Termination During an Acute Course of Right Unilateral Electroconvulsive Therapy.
J ECT
January 2025
From the Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH.
Electroencephalogram (EEG) monitoring during electroconvulsive therapy (ECT) is commonly done using a 2-channel EEG in order to capture activity from both brain hemispheres, though many institutions may instead opt to utilize a 1-channel EEG, often for reasons of convenience. We present a novel case of asymmetric termination of EEG seizure activity during an acute course of right unilateral ECT, prompting a full neurological workup to investigate potential underlying structural or physiological causative factors. This case assists in informing the necessity of bilateral hemispheric EEG monitoring as well as highlights the importance of searching for undiagnosed or latent neurological dysfunction in certain clinical situations arising during ECT.
View Article and Find Full Text PDFValidating the Fluctuating Mental Status Evaluation in Neurocritically Ill Patients With Acute Stroke.
Crit Care Med
December 2024
Department of Psychiatry and Human Behavior, Brown University, Alpert Medical School, Providence, RI.
Objectives: Neurocritically ill patients are at high risk for developing delirium, which can worsen the long-term outcomes of this vulnerable population. However, existing delirium assessment tools do not account for neurologic deficits that often interfere with conventional testing and are therefore unreliable in neurocritically ill patients. We aimed to determine the accuracy and predictive validity of the Fluctuating Mental Status Evaluation (FMSE), a novel delirium screening tool developed specifically for neurocritically ill patients.
View Article and Find Full Text PDFProbing the Neurodynamic Mechanisms of Cognitive Flexibility in Depressed Individuals with Autism Spectrum Disorder.
J Child Adolesc Psychopharmacol
January 2025
Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Autism spectrum disorder (ASD) is characterized by deficits in social behavior and executive function (EF), particularly in cognitive flexibility. Whether transcranial magnetic stimulation (TMS) can improve cognitive outcomes in patients with ASD remains an open question. We examined the acute effects of prefrontal TMS on cortical excitability and fluid cognition in individuals with ASD who underwent TMS for refractory major depression.
View Article and Find Full Text PDFDisorders of Lymphatic Architecture and Flow in Critical Illness.
Crit Care Med
January 2025
Division of Trauma, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Objectives: To provide a narrative review of disordered lymphatic dynamics and its impact on critical care relevant condition management.
Data Sources: Detailed search strategy using PubMed and Ovid Medline for English language articles (2013-2023) describing congenital or acquired lymphatic abnormalities including lymphatic duct absence, injury, leak, or obstruction and their associated clinical conditions that might be managed by a critical care medicine practitioner.
Study Selection: Studies that specifically addressed abnormalities of lymphatic flow and their management were selected.
Optimizing Exclusion Criteria for Clinical Trials of Persistent Lyme Disease Using Real-World Data.
Healthcare (Basel)
December 2024
Union Square Medical Associates, 595 Buckingham Way, Suite 350, San Francisco, CA 94132, USA.
Background/objectives: Although eligibility criteria for clinical trials significantly impact study outcomes, these criteria are often established without scientific justification, leading to delayed recruitment, small sample sizes, and limited study generalizability. Persistent Lyme disease (PLD) presents unique challenges due to symptom variability, inconsistent treatment responses, and the lack of reliable biomarkers, underscoring the need for scientifically justified eligibility criteria.
Objective: This study examines the effects of commonly used enrollment criteria on sample yield in PLD clinical trials using real-world data (RWD) from the MyLymeData patient registry.
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