A retrospective study was designed to determine whether socio-demographic and clinical factors at onset, previously shown to relate to outcome, differentiated those with a single episode with no persistent symptoms of schizophrenia from other outcome groups. In a geographically determined sample of 436 people with schizophrenia spectrum disorder and a minimum followup period of at least 6 years, 68 people (15.6%) had a single episode with complete remission. The single episode group differed significantly from the rest of the sample at onset on nine variables. On a logistic regression, employment status independently predicted single episodes. Although those with single episodes differed from the rest of the sample on a number of variables, they did not differ significantly at onset from the other better outcome group (repeated episodes without persistent symptoms) on any variables with the exception of insight. Two possibilities are considered: (1) the two better outcome groups differed very little at onset but subsequent treatment or experiences accounted for the differences in outcome; or (2) important differences, not routinely assessed at onset, influenced outcome. The implications of these findings for research into the prevention of relapse in psychosis are considered.
This retrospective study examines data from 55 patients sedated in a paediatric intensive care unit (PICU) with midazolam. Midazolam sedation was initiated with a bolus of 0.25 mg.kg-1 followed by a continuous infusion of 0.4-4 micrograms.kg-1.min-1. Physiological and metabolic parameters, infusion rates, duration, and sedation scores were monitored. Midazolam infusions were effective in sedating all the children studied during all or part of their PICU admission. The median duration of sedation was 74 h with a range of 4 to 1272 h. Haemodynamics were unchanged. Of the patients 46% were effectively alimented by the enteral route, and enteral alimentation was successful in all patients in whom it was attempted. Unassisted ventilation occurred in 44% of the patients during infusion. Oxygen consumption was 28% lower than in the control. Disadvantages of midazolam infusion have included inability to sedate during extracorporeal membrane oxygenation and development of acute tolerance.
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