Case Report of Autointoxication with Nutmeg Committed By a Suicide attempter

2016 ◽  
Vol 33 (S1) ◽  
pp. S443-S444
Author(s):  
S. Petrykiv ◽  
L. de Jonge ◽  
P. Michielsen ◽  
M. arts
Keyword(s):  
Case Report ◽  
Suicide Attempts ◽  
Early Recognition ◽  
Hemodynamic Instability ◽  
Clinical State ◽  
Emergency Setting ◽  
Suicide Attempter ◽  
Sinus Arrhythmia ◽  
Competing Interest ◽  
Low Incidence

Introductionautointoxication with nutmeg in an emergency setting is a rare, but potentially a life-threatening event. Despite the low incidence of ‘tentamen suicidii’ (TS) with nutmeg, this substance is cheap and readily available. Early recognition of a suicide attempt with nutmeg poisoning can be extremely difficult, especially when nobody witnessed the nutmeg intake. Worldwide there are only a few cases reporting TS with nutmeg.ObjectivesTo present a case of TS with nutmeg committed by a suicide attempter.aimsTo review available literature on TS with nutmeg.Methodsa case report is presented and discussed, followed by a literature review.ResultsFive published cases of suicide attempts with nutmeg were found while searching through PUBMED and Embase. Our case describes a 57-year-old female, diagnosed with borderline personality disorder, who has been admitted to the emergency department in a state of agitation, diminished cognition, respiratory difficulties and hemodynamic instability. Electrocardiography showed a fast sinus arrhythmia with no uschemic or hypertropic changes. Blood sampling, serum and urine toxicology did not reveal any abnormalities. in view of the complexity of her condition, she admitted to have taken a large dose of nutmeg. The patient was kept for observation, offered reassurance, and rehydratation.ConclusionThe presentation of inexplicable clinical state accomplished by disturbances of central nervous, respiratory and hemodynamic systems in the population of patients with attempting suicide should alert the physician to the rare but probably underreported possibility of nutmeg autointoxication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychopathological approach of unsafe games among teenagers: A case report

2017 ◽  
Vol 41 (S1) ◽  
pp. S453-S453
Author(s):  
A. Ben Hamouda ◽  
S. Bourgou ◽  
S. Ben Rejeb ◽  
M. Hamza ◽  
B.N. Saguem ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Behavioral Disorders ◽  
Suicide Attempts ◽  
Early Recognition ◽  
Child And Adolescent Psychiatry ◽  
Medical Problems ◽  
History Of ◽  
Competing Interest ◽  
First Time

IntroductionVoluntary asphyxiation by practicing unsafe games such as choking, hanging, strangulation or other means of inducing hypoxia/anoxia is not uncommun among adolescents and can lead to unintended death but it stills not very well-known so underestimated by parents and underdiagnosed by health professionals.ObjectivesStudy of clinical, psychological and psychopathological features in adolescent practicing unsafe games through a case report and a literature review.MethodsWe will present the case of a 14-year-old boy followed up in the Child and Adolescent Psychiatry Department of Mongi Slim Hospital (La Marsa, Tunisia) for behavioral disorders and recurrent syncope. This case report will be supported by a literature review.Case reportS.B., 14-year-old boy, unique child of two divorced parents, with precarious family socio-economic conditions, no apparent medical problems and no known history of drug or alcohol abuse, suicidal ideation or suicide attempts, consulted first time in the department for behavioral disorders. The diagnostic of dysthymia was made. Seven months later, he was hospitalized in the medical intensive care unit for postictal coma. All medical investigations were normal. In the following, S.B. revealed that he used to practice voluntary asphyxiation by compressing the two carotids using his fingers until loss of consciousness. The diagnosis of paraphilia (DSM-5) was established.ConclusionsEarly recognition of such cases and awareness of psychological and psychopathological motivations might prevent serious complications and lethal outcome for these “unsafe-young-players”.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Antidepressant withdrawal mania: Two case reports

2017 ◽  
Vol 41 (S1) ◽  
pp. S540-S540
Author(s):  
D. Pereira ◽  
I. Carreira Figueiredo ◽  
M. Marinho ◽  
R. Fernandes ◽  
V. Viveiros
Keyword(s):  
Case Report ◽  
Emergency Service ◽  
Case Reports ◽  
Unipolar Depression ◽  
Clinical State ◽  
Gradual Improvement ◽  
Clinical Criteria ◽  
The Past ◽  
Pubmed Search ◽  
Competing Interest

IntroductionAlthough rarely reported, antidepressant discontinuation may induce hypomania or mania even in the absence of bipolar disorder [1,2].ObjectivesWe report two cases of antidepressant withdrawal induced mania.MethodsClinical process consultation and PubMed search were performed in November 2016 using the search keywords antidepressant, mania and discontinuation.ResultsCase report 1: a dysthymic 60 years old woman with 20 years of psychiatric following had been treated with venlafaxine 150 mg/daily the past year. She abruptly stopped taking this drug, developing heightened mood, irritability and racing thoughts five days later. She was admitted at our hospital, initiating then valproate and antipsychotics. Two weeks later, the hypomania clinical state remitted completely.Case report 2: a 64 years old woman, with a 12-year-old diagnosis of unipolar depression was brought to our emergency service with complaints of disorganized behavior, paranoid delusional ideas, excessive speech, irritable mood and reduced need for sleep, 1 week after abrupt trazodone 150 mg/daily discontinuation. Valproic acid 1000 mg/daily and olanzapine 20 mg/daily were introduced, with gradual improvement of symptoms. Two weeks later she was completely asymptomatic.ConclusionPsychiatrists should be aware of the risk of antidepressant withdrawal induced mania. More studies should be conducted about this subject, aiming for the clarification of risk factors and the establishment of clinical criteria for this phenomenon.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Catatonia and Dementia

2016 ◽  
Vol 33 (S1) ◽  
pp. S467-S467
Author(s):  
M. Almeida ◽  
C. Gama Pereira
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Clinical State ◽  
Psychiatric Evaluation ◽  
Adequate Treatment ◽  
Global Rigidity ◽  
Eyes Closed ◽  
Pubmed Database ◽  
Wide Range ◽  
Competing Interest

IntroductionCatatonia, described by Kahlbaum in 1874, is usually seen as a type of schizophrenia, but it can also occur in a wide range of other psychiatric/organic disturbances. There is a documented association between dementia and catatonia, in all phases of cognitive impairment.AimsLiterature review and discussion about Catatonia, regarding a case report.MethodsClinical interviews and literature review in PUBMED database.Results (case report)Female patient, 89 years old, without psychiatric history, was diagnosed with dementia 5 months prior to episode. On admission, she presents with prostration, mutism and refusal to eat/drink. Laboratory studies were normal and TC-CE shows signs of an old stroke in left temporo-parietal region and diffuse signs of ischemic leucoencephalopathy. At psychiatric evaluation, she was stuporous, unreactive to pain, mute, not following verbal commands, keeping her eyes closed and resisting attempts to open her eyelids. She had global rigidity, axial and limbs, and maintains the postures the examiner puts her into for long periods. She was already given chlorpromazine, without improvement. Then she takes diazepam 10 mg iv, with remission of the state.ConclusionsAlthough catatonia usually presents with drama, clinicians often forget to consider it in differential diagnosis, probably because of its traditional association with schizophrenia. A promptly diagnostic is crucial to provide adequate treatment, avoiding drugs that can worsen/perpetuate the clinical state. Some authors even support the idea that motor features associated with end-line dementias may correspond to lorazepam-responsive catatonia, in which treatment may have a tremendous impact worldwide.Disclosure of interestThe authors have not supplied their declaration of competing interest.

How does someone who weighs so little feel like a burden to everyone?

2016 ◽  
Vol 33 (S1) ◽  
pp. S598-S598
Author(s):  
F. Coutinho ◽  
I. Brandão ◽  
E. Pereira
Keyword(s):  
Anorexia Nervosa ◽  
Case Report ◽  
Suicide Attempts ◽  
Interpersonal Theory ◽  
Thwarted Belongingness ◽  
Perceived Burdensomeness ◽  
Interpersonal Theory Of Suicide ◽  
Her Family ◽  
Completed Suicide ◽  
Competing Interest

IntroductionAnorexia nervosa (AN) is one of the most lethal psychiatric disorders, which is explained partially by starvation related health problems, but also because of high suicide rates. One of the proposed theories to explain a suicide attempt is the interpersonal theory of suicide (IPTS), with its three essential variables: feelings of thwarted belongingness, perceived burdensomeness and the acquired capacity for suicide.ObjectiveTo review the literature about suicidality in AN and to present a case report of a patient with restrictive AN who has committed suicide.MethodsTo review of the literature using the database Medline, through PubMed, with the keywords “anorexia nervosa”, “eating disorders” and “suicide”.ResultsSuicide attempts and completed suicide are highly prevalent among patients with AN, and some authors suggest that 20–40% of deaths in AN are due to suicide. Recently, the IPTS has been proposed as a mean to explain increased suicidality in AN patients.ConclusionWe present a case report about a patient with a long standing AN who has committed suicide after leaving a goodbye note describing strong feelings of perceived burdensomeness directed to her family. It is of utmost importance to continue the study about the phenomenon of suicide in AN to be able to prevent this tragic outcome.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Case Report: Hemoptysis localization – hearing with your eyes

POCUS Journal ◽  
2016 ◽  
Vol 1 (2) ◽  
pp. 7
Author(s):  
Barry Chan, MD
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Hemodynamic Instability ◽  
Clinical Vignette ◽  
Massive Hemoptysis ◽  
Airway Patency ◽  
Peripheral Site ◽  
Adventitious Sound

Clinical Vignette: 45 year old was transferred from a peripheral facility for acute massive hemoptysis though maintained sufficient airway patency with no evidence of hemodynamic instability or respiratory failure. Thoracic auscultation revealed vesicular breathing with no adventitious sound. CXR from the peripheral site was normal.

scholarly journals Retroauricular Emphysema as a Late Complication After Bonebridge Implantation: Case Report

2021 ◽  
pp. 014556132110002
Author(s):  
Soňa Šikolová ◽  
Dagmar Hošnová ◽  
Klára Perceová ◽  
Michal Bartoš ◽  
Vít Kruntorád ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Postoperative Complications ◽  
Rare Case ◽  
Late Complication ◽  
Bone Conduction ◽  
Computed Tomography Scan ◽  
Artificial Opening ◽  
Low Incidence ◽  
Tomography Scan

Bonebridge (BB) is the first active implantation system for bone conduction that is placed fully under the skin. Experience suggests that BB is characterized by low incidence of postoperative complications. This case report presents a rare case of a 16-year-old girl with incidence of emphysema occurring over the implant 1 year after operation. We performed a computed tomography scan that showed pockets of gas above the floating mass transducer so we provided the revision surgery and sealed the artificial opening with fat from the earlobe and fibrin glue. Since that time, no air has collected in the retroauricular area and the implant has been fully functional.

scholarly journals A conundrum of West syndrome, behavioural problems and parental expressed emotions: a case report

2020 ◽  
Vol 33 (5) ◽  
pp. e100111
Author(s):  
Yogender Kumar Malik ◽  
Nidhi Chauhan ◽  
Akhilesh Sharma ◽  
Susanta Padhy
Keyword(s):  
Case Report ◽  
Early Recognition ◽  
West Syndrome ◽  
Behavioural Problems ◽  
Optimal Outcome ◽  
Optimal Care ◽  
Epileptic Spasms ◽  
Expressed Emotions ◽  
Neurodevelopmental Problems ◽  
The Ideal

West syndrome (WS) is the most common epileptic syndrome in infancy characterised by epileptic spasms, hypsarrhythmia and neurodevelopmental problems. Epileptic spasms remain in many ways a conundrum, and the ideal intervention, as well as how to screen patients to provide optimal care and certainly its genetic cause, remains puzzling. It is important to screen infants for early recognition and intervention to achieve the optimal outcome. We hereby discuss the approach to management of a boy aged 4½ years old with WS and behavioural problems and of parental expressed emotions.

Cerebellar atrophy supporting diagnosis of alcohol dependence: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S311-S311
Author(s):  
F. Pavez Reyes ◽  
M. Sánchez ◽  
E. Moral ◽  
M. Terradillos ◽  
N. López ◽  
...  
Keyword(s):  
Case Report ◽  
Alcohol Dependence ◽  
Cerebellar Atrophy ◽  
Clinical Suspicion ◽  
Gamma Glutamyl Transferase ◽  
The Family ◽  
Other Information ◽  
Diagnostic Hypothesis ◽  
Competing Interest ◽  
Glutamyl Transferase

Chronic use of alcohol is a known cause of cerebellar atrophy. This finding could be a valuable diagnosis support when there are not other information sources. In this case report, we describe a 65-year-old male patient who was referred from primary care to specialized consultation because a depressive syndrome it was unresponsive to treatment with desvenlafaxine and lorazepam. In psychopathological exploration we found overvalued ideas of suffering some kind of injury and damage by the family, which oriented the diagnostic hypothesis of delusional disorder with secondary mood symptoms, although the clinical suspicion of abuse of alcohol was proposed as a differential diagnosis. The continuing minimization and denial of consumption by the patient as well as their reluctance to incorporate an external informant made that the workup was a key element to elucidate the diagnosis. We found a discrete increase in transaminases, gamma glutamyl transferase and alkaline phosphatase. Magnetic resonance imaging showed cerebellar atrophy (vermian and, in a lesser extent, in both hemispheres). Once the patient was confronted with these results, he agreed to disclose his problem, which fulfilled alcohol dependence criteria. After that, he accepted to initiate treatment and detoxification in a specialized unity.ConclusionsAlthough psychiatric diagnosis is based on the clinical features and the exclusion of associated medical conditions, in this case the workup provided support to our clinical suspicion, favouring recognition of the problem and willingness to treatment by the patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Attempted suicide attention at an emergency room: A hospital-based descriptive approach

2016 ◽  
Vol 33 (S1) ◽  
pp. S603-S603
Author(s):  
D. Torres ◽  
G. Martinez-Ales ◽  
M. Quintana ◽  
V. Pastor ◽  
M.F. Bravo
Keyword(s):  
Emergency Room ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Study Results ◽  
History Of ◽  
Competing Interest ◽  
Reported Data ◽  
Medium Cost ◽  
Rule Out

IntroductionSuicide causes 1.4% of deaths worldwide. Twenty times more frequent, suicide attempts entail an important source of disability and of psychosocial and medical resources use.ObjectiveTo describe main socio-demographical and psychiatric risk factors of suicide attempters treated in a general hospital's emergency room basis.AimsTo identify individual features potentially useful to improve both emergency treatments and resource investment.MethodsA descriptive study including data from 2894 patients treated in a general hospital's emergency room after a suicidal attempt between years 2006 and 2014.ResultsSixty-nine percent of the population treated after an attempted suicide were women. Mean age was 38 years old. Sixty-six percent had familiar support; 48.5% had previously attempted a suicide (13% did not answer this point); 72.6% showed a personal history of psychiatric illness. Drug use was present in 38.3% of the patients (20.3% did not answer this question); 23.5% were admitted to an inpatient psychiatric unit. Medium cost of a psychiatric hospitalization was found to be 4900 euros.ConclusionThis study results agree with previously reported data. Further observational studies are needed in order to bear out these findings, rule out potential confounders and thus infer and quantify causality related to each risk factor.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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