Delusional of Parasitosis in Geriatric Patients

2016 ◽  
Vol 33 (S1) ◽  
pp. S470-S470
Author(s):  
M. Gutierrez Rodriguez ◽  
C. Moreno Menguiano ◽  
F. Garcia Sanchez ◽  
R. Martin Aragon
Keyword(s):  
Geriatric Patients ◽  
Current Knowledge ◽  
Case Reports ◽  
Antipsychotic Agents ◽  
The Elderly ◽  
The Body ◽  
Delusional Parasitosis ◽  
Pubmed Database ◽  
Primary Disorder ◽  
Competing Interest

IntroductionDelusional of parasitosis or Ekbom's syndrome (ES) is a psychiatric disorder in which the patient has a fixed and false belief that small organisms infest the body. The belief is often accompanied by hallucinations. It is an uncommon condition that was initially studied by dermatologists, more prevalent in the elderly and typically observed in women older than 50 years although isolated cases among men have been reported.ObjectiveTo review current knowledge about delusional of parasitosis in elderly patients through literature systematic review and the analysis of a case report.MethodologyWe performed a literature search using electronic manuscripts available in PubMed database published during the last five years, following the description and discussion of a clinical case. We report a case of an 85-year-old man who presented a delusional parasitosis as a primary disorder.ResultsThe literature on ES consists mostly of case reports and limited series. In this paper, we analyze the etiology, demographic characteristics, clinical features and treatment in geriatric patients with delusional parasitosis.ConclusionInternational classifications have included this syndrome in non-schizophrenic delusions. However, it has also been reported in schizophrenia, affective disorders, and organic or induced psychosis. Treatment is based on antipsychotic agents, psychotherapy and cooperation between dermatologists and psychiatrists.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Risperidone in the treatment of psychoses in the elderly: a case report series

2002 ◽  
Vol 17 (2) ◽  
pp. 96-103 ◽  
Author(s):  
R. Bullock ◽  
S. Libretto
Keyword(s):  
Side Effects ◽  
Elderly Patients ◽  
Negative Symptoms ◽  
Case Reports ◽  
Antipsychotic Agents ◽  
The Elderly ◽  
The Body ◽  
Continuous Treatment ◽  
Atypical Antipsychotic Agents

SummaryRisperidone is one of the newer atypical antipsychotic agents, which combines potent serotonin and dopamine receptor antagonism. It shows efficacy against the positive and negative symptoms of schizophrenic psychoses and other psychotic conditions, and has a low propensity to cause extrapyramidal side effects. The aim of these case reports in elderly patients is to provide the benefit of personal experience with risperidone to the body of published literature and to demonstrate the types of patients that may benefit from treatment. These cases were compiled retrospectively from data collected on referral and during routine hospital appointments. This series covers four main areas of concern when treating the elderly: low-maintenance dosing minimising the likelihood of adverse events; successful treatment of patients previously uncontrolled and experiencing side effects with other antipsychotics; the possibility of intermittent rather than continuous treatment; and the benefits to patients, carers and the health services. At low doses, risperidone is an effective and well-tolerated treatment for psychoses in elderly patients that improves the quality of life for both patients and their caregivers.

Proposed modified diagnostic criteria for recurrent painful ophthalmoplegic neuropathy: Five case reports and literature review

Cephalalgia ◽  
2020 ◽  
Vol 40 (14) ◽  
pp. 1657-1670
Author(s):  
Yinglu Liu ◽  
Miao Wang ◽  
Xiangbing Bian ◽  
Enchao Qiu ◽  
Xun Han ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Cranial Nerve ◽  
Current Knowledge ◽  
Case Reports ◽  
Case Series ◽  
Oculomotor Nerve ◽  
Multiplanar Reformation ◽  
Unilateral Headache ◽  
Pubmed Database ◽  
Recurrent Painful Ophthalmoplegic Neuropathy

Background Recurrent painful ophthalmoplegic neuropathy (RPON) is an uncommon disorder characterized by recurrent unilateral headache attacks associated with ipsilateral ophthalmoplegia. We intend to study the clinical picture in our case series along with the published literature to discuss the pathogenesis and propose modified diagnostic criteria for recurrent painful ophthalmoplegic neuropathy. Methods We reported five cases diagnosed as ophthalmoplegic migraine/RPON in our medical centers and reviewed the published literature related to RPON from the Pubmed database between 2000 and 2020. In one of these cases, a multiplanar reformation was performed to look at the aberrant cranial nerve. Results The mean onset age for RPON was 22.1 years, and the oculomotor nerve was the most commonly involved cranial nerve (53.9%) in 165 reviewed patients. In most patients, ophthalmoplegia started within 1 week of the headache attack (95.7%, 67/70). Additionally, 27.6% (40/145) of patients presented enhancement of the involved nerve(s) from MRI tests. Finally, 78 patients received corticosteroids, out of which 96.2% benefited from them. Conclusion This is the first time multiplanar reformation has been performed to reveal the distortion of the oculomotor nerve. Modified diagnostic criteria are proposed. We hope to expand the current knowledge and increase the detection of recurrent painful ophthalmoplegic neuropathy in the future.

Depression and mild cognitive impairment – Comorbidity and/or continuum?

2016 ◽  
Vol 33 (S1) ◽  
pp. S190-S191
Author(s):  
G. Sobreira ◽  
M.A. Aleixo ◽  
C. Moreia ◽  
J. Oliveira
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
Pubmed Database ◽  
Competing Interest ◽  
The Relationship

IntroductionDepression and mild cognitive impairment are common among the elderly. Half the patients with late-life depression also present some degree of cognitive decline, making the distinction between these conditions difficult.ObjectivesTo conduct a database review in order to understand the relationship between these entities, and treatment approaches.AimsTo create and implement clinical guidelines at our institution, to evaluate and treat elderly patients presenting with depression and mild cognitive impairment.MethodsA PubMed database search using as keywords “late life depression”, “depression”; “cognitive impairment”; “mild cognitive impairment” and “dementia” between the year 2008 and 2015.ResultsLate-life depression and cognitive impairment are frequent among the elderly (10–20%). Depression is also common in the early stages of dementia decreasing as the cognitive decline progresses. The causal relationship between these entities is not well understood and some authors advocate a multifactorial model (genetic risk factors; neuroendocrine changes; vascular risk factors) and the cognitive impairment of said changes is dependent on the individual's cognitive reserve. Regarding treatment of depression in patients with cognitive impairment, most authors advocate a stepped approach with watchful waiting and then, if symptoms persist, the introduction of pharmacotherapy and psychosocial intervention.ConclusionsThe relationship between cognitive impairment and depression is still not clear and probably multifactorial. The diagnosis of depressive symptoms in patients with severe cognitive impairment can be difficult and most forms of pharmacological treatment in this population are not beneficial, making it important to carefully evaluate the benefits of introducing new medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Vascular Effects of Pseudoxanthoma Elasticum

2021 ◽  
Vol 5 (5) ◽  
pp. 453-461
Author(s):  
Erika Hubbard ◽  
Mark Lebwohl
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Case Reports ◽  
Pseudoxanthoma Elasticum ◽  
The Body ◽  
Ectopic Calcification ◽  
Peripheral Vascular ◽  
Rete Mirabile ◽  
Pubmed Database ◽  
Carotid Rete Mirabile

Background: Pseudoxanthoma elasticum (PXE) is a rare hereditary disease caused by mutations in the ABCC6 gene, characterized by ectopic calcification of connective tissue throughout the body. Vascular conditions associated with PXE have been well-documented in the literature, but to our knowledge, analysis of the myriad of PXE case reports with associated vascular diseases in addition to larger cohort studies, has not been undertaken. Objective: To review existing literature reporting peripheral vascular disease (PVD), cardiovascular disease (CVD), cerebrovascular disease (CeVD), hypertension, and carotid rete mirabile (CRM) in PXE patients as of June 2021. Methods: A search of the PubMed database using the key words “pseudoxanthoma elasticum” and “vascular” was performed. Results: A total of 345 cases of PVD, 97 cases of CVD, and 123 case of CeVD were reported.  Additionally, 88 cases of hypertension and 5 cases of CRM were reported. Conclusions: PXE patients are at risk of developing serious vascular conditions, particularly peripheral vascular disease.  This condition also appears to have some connection to carotid rete mirabile, which is extremely rare in humans.  Further research should be conducted to analyze the connection between PXE and CRM in order to better understand and treat both conditions.

scholarly journals Sarcopenia and Frailty in Liver Cirrhosis

Life ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 399
Author(s):  
Hiroki Nishikawa ◽  
Shinya Fukunishi ◽  
Akira Asai ◽  
Shuhei Nishiguchi ◽  
Kazuhide Higuchi
Keyword(s):  
Skeletal Muscle ◽  
Liver Cirrhosis ◽  
Physical Function ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Current Knowledge ◽  
The Elderly ◽  
The Body ◽  
Assessment Criteria ◽  
Skeletal Muscle Atrophy

Skeletal muscle is the largest organ in the body, and skeletal muscle atrophy results from a shift in the balance of protein synthesis and degradation toward protein breakdown. Primary sarcopenia is defined as a loss of skeletal muscle mass and strength or physical function due to aging, and secondary sarcopenia is defined as a loss of skeletal muscle mass and strength or physical function due to underlying diseases. Liver cirrhosis (LC) is one of the representative diseases which can be complicated with secondary sarcopenia. Muscle mass loss becomes more pronounced with worsening liver reserve in LC patients. While frailty encompasses a state of increased vulnerability to environmental factors, there is also the reversibility of returning to a healthy state with appropriate intervention. Several assessment criteria for sarcopenia and frailty were proposed in recent years. In 2016, the Japan Society of Hepatology created assessment criteria for sarcopenia in liver disease. In Japan, health checkups for frailty in the elderly aged 75 years or more started in April 2020. Both sarcopenia and frailty can be adverse predictors for cirrhotic patients. In this review article, we will summarize the current knowledge of sarcopenia and frailty in LC patients.

scholarly journals Overview of SARS-CoV-2 Infection and Its Potential Reactions

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Esmaeil Mortaz ◽  
Neda K. Dezfuli
Keyword(s):  
Immune System ◽  
Current Knowledge ◽  
Serum Levels ◽  
The Body ◽  
Immune System Dysfunction ◽  
Pubmed Database ◽  
Tnf Α ◽  
Key Points ◽  
Severity Of The Disease ◽  
Review Current

Context: The immunopathology of SARS-CoV-2 infection in COVID-19 is not well described yet, especially regarding dysregulation of the immune system. In this mini-review, current knowledge about the SARS-CoV-2 infection and immunopathogenesis of COVID-19 disease is described. We also discuss possible induced reactions against SARS-COV-2. Evidence Acquisition: Based on the authors' experience and knowledge, the current review aimed to, firstly, discuss and overview SRAS-CoV-2 infection and reactions in the body, and, secondly, to obtain related subjects from the PubMed database. Results and Conclusion: In most COVID-19 patients, uncontrollable cytokines secretion and mediators are major key points in the pathogenesis of the disease. Of all cytokines and mediators, serum levels of IL-6, IL-1β, TNF-α, IL-8, and soluble TNF-α receptor (sTNFR) have been reported. Lymphopenia and hypoxia, as well as the severity of the disease, can be considered as COVID-19 manifestations. High levels of intracellular NO inside of the red blood cells (RBCs) of patients drive the unexpected silent hypoxia phenotype induced ARDS importantly related to the patient's immune system dysfunction.

Vitamin B12 deficiency induced psychosis – a case report

2017 ◽  
Vol 41 (S1) ◽  
pp. s805-s805 ◽  
Author(s):  
A.R. Carvalho ◽  
S. Vacas ◽  
C. Klut
Keyword(s):  
Vitamin B12 ◽  
Case Reports ◽  
Vitamin B12 Deficiency ◽  
The Body ◽  
Psychotic Symptoms ◽  
Concurrent Administration ◽  
Persecutory Delusions ◽  
B12 Deficiency ◽  
Competing Interest ◽  
Psychotic Features

Vitamin B12 is one of the most essential vitamins affecting various systems of the body. Cases of neuropsychiatry disorders due to its deficiency are more common in elderly patients with prevalence of 10–20%. The most common psychiatry symptoms reported in the literature associated with vitamin B12 deficiency was depression, mania, psychotic symptoms, cognitive impairment and delirium. Here, we report a case of vitamin B12 deficiency in a 52-year-old male who presented with psychotic features: persecutory delusions, tactile and auditory hallucinations. Patient had neither recorded psychiatry history nor any drug abuse. Medical history includes hypertension, diabetes mellitus and glaucoma. The patient was not a vegetarian. All relevant laboratory evaluations and head CT were normal except vitamin B12. The patient was treated with antipsychotics (risperidone 3 mg/day) and intramuscular vitamin B12. One week after, there was total remission of psychotic symptoms. In the follow-up during the next four months, psychiatry symptoms did not recur at any time. This case reports a rare case of vitamin B12 deficiency induced psychosis. Although there was concurrent administration of an antipsychotic along with vitamin B12, it underlines the importation of evaluation of vitamin B12 and other potential reversible causes of psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Sleep related painful erection: an algorithm for evaluation and management

2019 ◽  
Vol 29 (1) ◽  
Author(s):  
Maher Abdessater ◽  
Anthony Kanbar ◽  
Ahmed S. Zugail ◽  
Abdalla Al hammadi ◽  
Bertrand Guillonneau ◽  
...  
Keyword(s):  
Side Effects ◽  
Randomized Clinical Trials ◽  
Current Knowledge ◽  
Case Reports ◽  
Treatment Success ◽  
Treatment Decision ◽  
Rare Condition ◽  
Level Of Evidence ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Pubmed Database

Abstract Background Sleep related painful erection (SRPE) is a rare parasomnia consisting of nocturnal penile tumescence accompanied by pain that awakens the individual. Normal non-painful erections are experienced when awake. No penile anatomic abnormalities are present. No conclusive randomized clinical trial is present in the literature about the management of this rare condition. The aim of this article is to review the current knowledge about the management of SRPE and to suggest an algorithm to help physicians evaluate and manage SRPE. Material and methods A literature review was conducted through PubMed database using the terms: sleep, pain, painful, penile, and erection. The reference lists of the articles were also reviewed. The search returned 23 references that were published between 1987 and 2019. Results were presented in a descriptive manner. Results Treatment decision for now is based on reports of the treatment success, the sustainability of remission, the tolerability by the patients and the potential side effects of each medication. From data available in literature, Baclofen is the mostly used medication with a tolerable profile of adverse effects. Phosphodiesterase type 5 inhibitors are considered potential treatments and are already widely used and tolerated for other indications, but so far only 2 successful trials have been reported for SRPE. Cinitapride is very promising, but only one case was studied and no side effects were reported. Clozapine can be very dangerous although highly effective. Conclusion Based on the limited number of treatment trials and reported cases, the low level of evidence and the lack of randomized clinical trials, no treatment consensus for SRPE can be reached. We suggested a useful tool for clinicians: an algorithm for the management of SRPE to facilitate their access to the literature without exhaustive return to case reports and series upon each case faced.

Trichotillomania in delusional infestation

2016 ◽  
Vol 33 (S1) ◽  
pp. S639-S640
Author(s):  
P. Sales ◽  
A. Lopes ◽  
S. Hanemann
Keyword(s):  
Case Reports ◽  
Hair Follicles ◽  
The Body ◽  
Obsessive Compulsive ◽  
Current Case ◽  
Compulsive Disorder ◽  
Pull Out ◽  
Online Databases ◽  
Ekbom Syndrome ◽  
Competing Interest

IntroductionTrichotillomania is described as a recurrent failure to resist impulses to pull out hairs. It is usually associated with obsessive-compulsive disorder and body dismorphic disorder. It is usually confined to one or two sites in the body.ObjectiveThe aim of our work is to describe a case of delusional infestation with secondary trichotillomania and briefly review the theoretical aspects of this clinical presentation.MethodsWe searched online databases and reviewed current case reports published, using the keywords “delusional infestation”, “Ekbom syndrome” and “trichotillomania” and compared similarities in the presentation, development and outcome. We present a clinical vignette of a 38-year-old female, with no relevant psychiatric history. The patient developed severe itching that she believed was caused by bugs that lived inside her hair follicles, so she pulled out completely all of her eyebrows, eyelashes, pubic and underarms hairs. She maintained some hair on her head, that she repeatedly pulled out and proceeded to break in order to kill the bugs. She claimed to have absolutely no itchiness in the hairless areas of her body.ResultsThe patient was referred to psychiatric consultation and was started on oral antipsychotics but, as the review from literature suggested, the clinical evolution only became satisfactory when an antidepressant (SSRI) was added.ConclusionAlthough, trichotillomania is more commonly seen in clinical practice in association with other psychiatric disorders, it may also present itself as a symptom of delusional activity.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Impact of level of vitamin D in the body on the severity of COVID-19 – review of the literature

2020 ◽  
pp. 583-595
Keyword(s):  
Vitamin D ◽  
Immune System ◽  
Metabolic Diseases ◽  
Serum Levels ◽  
The Elderly ◽  
Vitamin D Supplementation ◽  
The Body ◽  
Current Time ◽  
Pubmed Database ◽  
Vitamin D Levels

INTRODUCTION. The aim of the study is to present the current state of knowledge on the influence of vitamin D levels on the severity of the course of COVID-19. MATERIAL AND METHODS. The latest available literature was reviewed until October 30, 2020 from the PubMed database. RESULTS. The literature reports that vitamin D has immunomodulatory and anti-inflammatory effects. It reduces the expression of cytokines such as IL-6, TNF-α and INF-γ, regulates the activity of T helper lymphocytes, and other elements of the immune system at the molecular level. The deficiency of this vitamin promotes the activation of the renin-angiotensin-aldosterone system, contributing to the development of acute respiratory distress syndrome. The severity of the course of SARS-CoV-2 infection depends on comorbidities, the development and course of which may also be affected by vitamin D levels (coagulopathies, pulmonary, cardiological, metabolic diseases). Most of the analyzed research studies from different countries indicated a relationship between insufficient vitamin D levels and a more severe course of COVID-19 and an increase in mortality due to it, especially among the elderly. Researchers agree that further analyzes are necessary concerning both the influence of the vitamin D blood serum levels on the morbidity and mortality due to COVID-19 as well as the use of its supplementation in the struggle against SARS-CoV-2 virus. There are reports of possible beneficial interactions of vitamin D with other substances, such as quercetin, estradiol, some microelements, and other vitamins. CONCLUSIONS. Maintaining an adequate level of vitamin D has a positive effect on the functioning of the immune system. At the moment, there is insufficient evidence to establish a clear relationship between vitamin D levels and the severity of COVID-19. It is necessary to conduct further research on a larger study group. The literature does not mention the use of vitamin D as a medication for COVID-19. People at risk of vitamin D deficiency should consider vitamin D supplementation at the current time of the pandemic.

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