ECT in major recurrent depressive syndrome with Parkinsonism syndrome

2017 ◽  
Vol 41 (S1) ◽  
pp. S769-S769
Author(s):  
T. Gómez Alemany ◽  
J. Soler Vidal ◽  
I. Targa ◽  
B. Garcia Alarcon ◽  
A. Santoro ◽  
...  
Keyword(s):  
Medical Records ◽  
Depressive Syndrome ◽  
Recurrent Depression ◽  
Pharmacological Management ◽  
History Of ◽  
Competing Interest ◽  
One Year ◽  
Different Levels ◽  
Progressive Cognitive Impairment

A 71-year-old woman with history of major recurrent depressive syndrome responsive to clomipramine (last episode at 50-year-old) with the following medical records: ischaemic stroke with progressive cognitive impairment to the extent of requiring wheelchair.Current episodeDepressive symptoms, with suicidal thoughts, anxiety, tremor and low food intake in the last month (due to choke phobia) with up to 10 kg of weight loss.DiagnosisMajor recurrent depressive syndrome resistant to treatment with Parkinson syndrome.TreatmentLorazepam 10 mg/day levodopa 150/carbidopa 37.5 mg/day, LART Electroconvulsive therapy (Thymatron SYSTEM IV) was also carried out 3 times a week until 15 sessions were reached.DiscussionThis case illustrates the successful response with LART ECT towards major recurrent depression syndrome associated with a pharmacological parkinsonism maintained over the long-term (one year with ECT). There are sufficient evidences showing that the ECT has an effect in the dopaminergic system at different levels: dopamine release, dopamine neurotransmission and linkage with its receptor, and these effects differ between an acute stimulation and when repeated stimulation is carried out. It must be taken into consideration the fact that concomitant existence of depression and parkinsonism could represent another indication for ECT, since the pharmacological management of these patients is highly complex and could even more if we bear in mind that one of the therapeutical options towards the antidepressant potentiation (atypical anti-psychotics) can worsen the symptomatology.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Impact of atrial fibrillation pattern on outcomes after left atrial appendage closure: lessons from the prospective LAARGE registry

2021 ◽  
Author(s):  
Shinwan Kany ◽  
Johannes Brachmann ◽  
Thorsten Lewalter ◽  
Ibrahim Akin ◽  
Horst Sievert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial Appendage ◽  
Systemic Embolism ◽  
Long Term Outcomes ◽  
Increased Risk ◽  
History Of ◽  
One Year ◽  
The One

Abstract Background Non-paroxysmal (NPAF) forms of atrial fibrillation (AF) have been reported to be associated with an increased risk for systemic embolism or death. Methods Comparison of procedural details and long-term outcomes in patients (pts) with paroxysmal AF (PAF) against controls with NPAF in the prospective, multicentre observational registry of patients undergoing LAAC (LAARGE). Results A total of 638 pts (PAF 274 pts, NPAF 364 pts) were enrolled. In both groups, a history of PVI was rare (4.0% vs 1.6%, p = 0.066). The total CHA2DS2-VASc score was lower in the PAF group (4.4 ± 1.5 vs 4.6 ± 1.5, p = 0.033), while HAS-BLED score (3.8 ± 1.1 vs 3.9 ± 1.1, p = 0.40) was comparable. The rate of successful implantation was equally high (97.4% vs 97.8%, p = 0.77). In the three-month echo follow-up, LA thrombi (2.1% vs 7.3%, p = 0.12) and peridevice leak > 5 mm (0.0% vs 7.1%, p = 0.53) were numerically higher in the NPAF group. Overall, in-hospital complications occurred in 15.0% of the PAF cohort and 10.7% of the NPAF cohort (p = 0.12). In the one-year follow-up, unadjusted mortality (8.4% vs 14.0%, p = 0.039) and combined outcome of death, stroke and systemic embolism (8.8% vs 15.1%, p = 0.022) were significantly higher in the NPAF cohort. After adjusting for CHA2DS2-VASc and previous bleeding, NPAF was associated with increased death/stroke/systemic embolism (HR 1.67, 95% CI 1.02–2.72, p = 0.041). Conclusion Atrial fibrillation type did not impair periprocedural safety or in-hospital MACE patients undergoing LAAC. However, after one year, NPAF was associated with higher mortality. Graphic abstract

Clinical features, treatment, and outcome of dogs with Coccidioides osteomyelitis

2022 ◽  
pp. 1-8
Author(s):  
Stephanie L. Shaver ◽  
Daniel S. Foy ◽  
Todd D. Carter
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Signs ◽  
Test Results ◽  
Serologic Test ◽  
Rapid Improvement ◽  
Radiographic Appearance ◽  
One Year ◽  
Positive Results

Abstract OBJECTIVE To describe signalment, clinical signs, serologic test results, treatment, and outcome of dogs with Coccidioides osteomyelitis (COM) and to compare those findings with findings for dogs with osteosarcoma (OSA). ANIMALS 14 dogs with COM and 16 dogs with OSA. PROCEDURES Data were retrospectively gathered from electronic medical records. RESULTS Dogs with COM were younger and weighed less than dogs with OSA. Six dogs with COM had appendicular lesions, 5 had axial lesions, and 3 had both appendicular and axial lesions; 9 had monostotic disease, and 5 had polyostotic disease. Axial lesions and nonadjacent polyostotic disease were more common in dogs with COM than in dogs with OSA, but radiographic appearance was not different between the 2 groups. Median IgG titer at diagnosis of COM was 1:48 and was significantly decreased after 6 and 12 months of treatment. Percentage of dogs with COM that had clinical signs was significantly decreased after 1, 3, 6, and 12 months of treatment. One year after initiation of treatment, 9 of 9 dogs were still receiving fluconazole and 8 of 9 dogs had positive results for serum IgG titer testing. CLINICAL RELEVANCE Dogs with COM typically had a rapid improvement in clinical signs after initiating treatment with fluconazole but required long-term antifungal treatment. Dogs with COM differed from dogs with OSA, but radiographic features had a great degree of overlap between groups, confounding the ability to make a diagnosis on the basis of diagnostic imaging alone.

scholarly journals Impact of atrial fibrillation pattern on left atrial appendage closure: insights from the prospective LAARGE registry

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
S Kany ◽  
J Brachmann ◽  
T Lewalter ◽  
I Akin ◽  
H Sievert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Systemic Embolism ◽  
Long Term Outcomes ◽  
Left Atrial Appendage Closure ◽  
History Of ◽  
One Year

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Stiftung für Herzinfarkforschung Background  Non-paroxysmal (NPAF) forms of atrial fibrillation (AF) have been reported to be associated with an increased risk for systemic embolism or death compared with paroxysmal AF (PAF). This study investigates the procedural safety and long-term outcomes of left atrial appendage closure (LAAC) in patients with different forms of AF. Methods  Comparison of procedural details and long-term outcomes in patients (pts) with PAF against controls with NPAF in the prospective, multicentre observational registry of patients undergoing LAAC in Germany (LAARGE).  Results  A total of 638 pts (PAF 274 pts, NPAF 364 pts) were enrolled. NPAF consisted of 31.6% patients with persistent AF and 68.4% with longstanding persistent AF or permanent AF. In both groups, a history of PVI was rare (4.0% vs 1.6%, p = 0.066). The PAF group had significantly less history of heart failure (19.0% vs 33.0%, p < 0.001) while the current median LVEF was similar (60% vs 60%, p = 0.26). The total CHA2DS2-VASc score was lower in the PAF group (4.4 ± 1.5 vs 4.6 ± 1.5, p = 0.033), but no difference in the HAS-BLED score (3.8 ± 1.1 vs 3.9 ± 1.1, p = 0.40) was observed. The rate of successful implantation was equally high (97.4% vs 97.8%, p = 0.77) in both groups. In the three-month echo follow-up, device-related thrombi (2.1% vs 7.3%, p = 0.12) and peridevice leak >5 mm (0.0% vs 7.1%, p= 0.53) were numerically higher in the NPAF group. Overall, in-hospital complications occurred in 15.0% of the PAF cohort and 10.7% of the NPAF cohort (p = 0.12). In the one-year follow-up, unadjusted mortality (8.4% vs 14.0%, p = 0.039) and combined outcome of death, stroke and systemic embolism (8.8% vs 15.1%, p = 0.022) were significantly higher in the NPAF cohort. After adjusting for CHA2DS2-VASc and previous bleeding, NPAF was associated with increased death/stroke/systemic embolism (HR 1.67, 95%-CI: 1.02-2.72). Conclusion  Atrial fibrillation type did not impair periprocedural safety or in-hospital MACE of patients undergoing LAAC. However, after one year, NPAF was associated with higher mortality and combined outcome of death, stroke and systemic embolism.

Multiple Spinal Perimedullary Arteriovenous Fistulae Associated with the Parkes-Weber Syndrome

1998 ◽  
Vol 4 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Y. Niimi ◽  
U. Ito ◽  
O. Tone ◽  
K. Yoshida ◽  
S. Sato ◽  
...  
Keyword(s):  
Lower Extremities ◽  
Arteriovenous Fistulae ◽  
Left Posterior ◽  
Weber Syndrome ◽  
Long Term Follow Up ◽  
History Of ◽  
One Year ◽  
Polyvinyl Alcohol Particles

We present a rare case of multiple spinal perimedullary arteriovenous fistulae associated with the Parkes-Weber (PW) syndrome. A 31-year-old male known to have the PW syndrome involving the left leg since birth, presented with a 7-month-history of progressive myelopathy of the lower extremities and dysfunction of the bladder and bowel. Myelography demonstrated dilated intradural vessels. Angiography demonstrated two distinct single hole perimedullary arteriovenous fistulae near the conus at two different metameres. They were supplied by the left posterior spinal artery. The patient was treated by transarterial embolisation using polyvinyl alcohol particles, which resulted in venous side occlusion of the fistulae. After the treatment, the patient developed transient worsening of the spasticity of the lower extremities, and was treated by heparinization. After heparinization, the patient partially recovered from the pre-embolisation status of his myelopathy. The follow-up angiogram one year after the embolisation demonstrated persistent obliteration of both fistulae. At long-term follow-up, the patient can ambulate without assistance and work as a farmer.

Old and New Rights

2009 ◽  
pp. 20-39 ◽  
Author(s):  
Mauro Di Meglio ◽  
Enrico Gargiulo
Keyword(s):  
16Th Century ◽  
Modern World ◽  
Nation State ◽  
Social Imagination ◽  
Unit Of Analysis ◽  
History Of ◽  
Recent Phase ◽  
Effective Instrument ◽  
Different Levels

This chapter offers a long-term perspective on citizenship, questioning one of the basic assumptions of most of the literature on this topic, that is, the nation-state as unit of analysis. Through the adoption of a world-systemic perspective, two basic aspects of the history of citizenship stand out. Firstly, the fundamentally exclusive nature of this category, as it emerged and developed over the history of the modern world-system, since at least the “long 16th Century”. And, secondly, that well before the so-called “information revolution” of the last decades, “technology” has shaped the Western social imagination, acting, in various and changing historical forms, as an effective instrument of control and supremacy, producing asymmetric and inegalitarian effects, and providing a yardstick of the different “levels of development” of Western and non-Western peoples. In this view, the most recent phase of the history of citizenship, his e-form, seems to replicate, in new ways, the explanations of the gap existing both between and within countrie—now conceptualized as “digital divide”—and, at the same time, the illusory universalistic promise of an expansion of the citizenship and the rights associated to it.

scholarly journals Mycobacteriosis treatment challenges in patients with HIV-infection

2020 ◽  
Vol 12 (3) ◽  
pp. 35-45
Author(s):  
M. A. Savchenko ◽  
A. M. Panteleev
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
The United States ◽  
Steady Increase ◽  
The Past ◽  
Highly Active ◽  
History Of ◽  
One Year

Over the past decade, in Russian Federation there has been a steady increase in the incidence of MAC-infection in patients with HIV (the growth of nosology over the past five years, on average, was 57% per year). This determines the interest in this problem, especially in terms of the high inefficiency of treatment for the disease, the long term and cost of treatment. The history of the study of Mycobacterium Avium Complex-infection (MAC) originates in the early eighties in the United States, when the prognosis for a patient with AIDS and mycobacteriosis was extremely poor: mortality within one year after the detection of pathogen reached 71%. The role of infection in the thanatogenesis of patients was, however, established only by the beginning of the nineties. The detection of macrolide activity against the pathogen significantly improved the prognosis for patients, especially in combination with highly active antiretroviral therapy. The widespread introduction of antiviral drugs into practice and the ability to achieve immune reconstitution prevented the development of opportunistic infections, but did not solve the remaining issues of the treatment of the MAC-infection. The main one is the treatment of patients with a clarithromycin-resistant pathogen. There is no consensus on the sensitivity of non-tuberculous mycobacteria to antibacterials.

Long-term cimetidine for duodenal ulceration?

1982 ◽  
Vol 20 (8) ◽  
pp. 31-32
Keyword(s):  
Standard Dose ◽  
Term Treatment ◽  
Duodenal Ulceration ◽  
Intermittent Therapy ◽  
Short Term Treatment ◽  
History Of ◽  
Symptomatic Remission ◽  
One Year ◽  
Do So

Duodenal ulceration is a chronic disease in which patients relapse with varying frequency over perhaps 10 years or so.1 Although about 70% of ulcers heal on cimetidine 1 g/day given for four to six weeks, such short-term treatment does not alter the subsequent natural history of the illness.2–4 About 65% of patients relapse within one year of stopping cimetidine as judged on symptoms alone,2 and about 80% do so if the assessment includes regular endoscopy.5 It is not yet known whether the maintenance of endoscopic, as opposed to symptomatic, remission is important, nor whether it is practicable, but it might prevent complications in patients who have already suffered a perforation or haemorrhage. The frequency of relapses cannot however be predicted. If cimetidine is to be used in the long term what regimen should be recommended? Two have been tried: (1) to give it continuously in a smaller dose to try to prevent relapse (maintenance therapy); (2) to give the standard dose for four to six weeks for each relapse and then stop (intermittent therapy).

Treatment with intramuscular paliperidone palmitate in schizoaffective disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S581-S581
Author(s):  
L. Maroto Martin ◽  
P. Hervías Higueras
Keyword(s):  
Schizoaffective Disorder ◽  
Complex Disease ◽  
Psychotic Disorders ◽  
Paliperidone Palmitate ◽  
Valuable Treatment ◽  
History Of ◽  
Competing Interest ◽  
One Year ◽  
Long Acting ◽  
Monthly Dose

IntroductionInjectable formulations of long acting antipsychotic are a valuable treatment option for patients with psychotic disorders. Schizoaffective Disorder (SAD) is a complex disease; the optimal treatment is not well established yet.ObjectiveAnswer the question about the effectiveness offered by intramuscular Paliperidone Palmitate in SAD versus other injectable antipsychotics. Keywords: schizoaffective disorder; paliperidone palmitate injection.MethodsA case report of a 35-year-old male diagnosed with Schizoaffective Disorder six years ago and with personal history of multiple manic decompensation after treatment discontinuation. Throughout his life he has been treated with intramuscular Risperidone 87.5 mg (50 + 37.5) every 14 days, Olanzapine flas 20 mg/day, Risperidone flas 3 mg, Amisulpride 600 mg/day, Valproic acid 1500 mg/day Clonazepam 2 mg/day and Lormetazepam 1 mg. In the last admission one year ago, he started treatment with intramuscular paliperidone palmitate up to 200 mg a month. Currently he receives a monthly dose of 100 mg and concomitant lithium 800 mg/day.DiscussionThe use of intramuscular paliperidone palmitate in SAD and its effectiveness against other injectable antipsychotic is discussed.ConclusionsThe use of intramuscular paliperidone palmitate appears to constitute an employment opportunity in the treatment of intramuscular maintenance in SAD. It could be effective in stabilizing episodes of acute exacerbation and remissions of psychotic, manic and depressive symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Vortioxetine Efficiency in Controlling Obsessive Symptoms in Patients with Depression. A Case Report

2017 ◽  
Vol 41 (S1) ◽  
pp. S715-S715
Author(s):  
G. Pardo de Santayana ◽  
R. Landera ◽  
M. Juncal ◽  
O. Porta ◽  
L. Sánchez ◽  
...  
Keyword(s):  
Case Report ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Depressive Episode ◽  
Therapeutic Option ◽  
Recurrent Depression ◽  
Patient Reported ◽  
History Of ◽  
Competing Interest ◽  
Stress At Work

IntroductionObsessive symptomatology can sometimes be worsened when a patient with this personality trait suffers through a period of increased stress.AimTo review articles in PubMed related to how vorticoxetine affects obsessive symptoms in patients with depression.MethodsWe review the case of a 45-year-old male with obsessive personality traits diagnosed of recurrent depression. He was going through a period of stress at work that had worsened his obsessive symptoms (primarily obsessive thoughts). In a previous depressive episode, he was treated with an antidepressant that triggered sexual dysfunction as a side effect. Trying to prevent another antidepressant-induce sexual dysfunction, we decided to use voricoxetine because of its low tendency to interact with the sexual function.ResultsWe started treatment with vorticoxetine reaching a dose of 10 mg/day. Three weeks later the patient reported a decrease in his levels of anxiety, a slight upturn of his mood and a relieve of his obsessive symptoms.ConclusionsVorticoxetine can be considered a good therapeutic option in the treatment of obsessive symptoms in a depressive episode with patients with a history of antidepressant-induce sexual dysfunction.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Post-traumatic Mania Symptoms: About One Case

2017 ◽  
Vol 41 (S1) ◽  
pp. S724-S725
Author(s):  
H. El Kefi ◽  
I. Beldi ◽  
W. Krir ◽  
C. Benchikh Brahim ◽  
S. Eddif ◽  
...  
Keyword(s):  
Terrorist Attack ◽  
Post Traumatic Stress ◽  
Psychological Reactions ◽  
Manic Symptoms ◽  
Induced Mood ◽  
History Of ◽  
Post Traumatic ◽  
Competing Interest ◽  
Significant Regression

IntroductionPsychotraumatism can constitute for some people a real existential fracture, a real upheaval of the psychic organization.Immediate psychological reactions can vary from one-off and temporary reactions to far more severe and sometimes enduring reactions.Material and methodsWe collected the case of a patient who was hospitalised in April 2015 for manic symptoms in the immediate aftermath of a terrorist attack, with a review of the literature.Clinical caseThis is Mr. A. F., aged 38, with a personal history of AVP and a shooting wound following a terrorist attack. He had presented a psychomotor instability and an exaltation of the mood in the immediate aftermath of an ambush.Behavioural problems were identified by the psychiatric team during the group debriefing conducted at the HMPIT emergency room. During his hospitalisation, a chemotherapy based on thymoregulators, neuroleptics and anxiolytics was introduced.The evolution was marked by a significant regression of the manic syndrome after ten days, and the installation of a post-traumatic stress condition (PTSD). At the end of eight months, the patient was able to resume his work with long-term thymoregulatory treatment, a ban on weapons and safety posts.ConclusionManic episodes are rarely observed as an immediate post-traumatic reaction. Their occurrence does not prevent the subsequent installation of PTSD. Has psychic trauma revealed a latent psychosis? Is it a trauma-induced mood disorder?Disclosure of interestThe authors have not supplied their declaration of competing interest.

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