Acute confusion and visual disturbance in a chronic alcoholic

2020 ◽  
Vol 21 ◽  
pp. 100878
Author(s):  
Vadivalagianambi Sivakumar ◽  
Venkatraman Indiran
Keyword(s):  
Visual Disturbance ◽  
Chronic Alcoholic ◽  
Acute Confusion

Alterations in Ultrastructure of Skeletal Muscle From Newborn Guinea Pigs Following in Utero Exposure to Ethanol

1985 ◽  
Vol 43 ◽  
pp. 686-687
Author(s):  
C. Uphoff ◽  
C. Nyquist-Battie ◽  
T.B. Cole
Keyword(s):  
Skeletal Muscle ◽  
Guinea Pigs ◽  
Muscle Development ◽  
In Utero ◽  
Ethanol Exposure ◽  
Prenatally Exposed ◽  
Chronic Alcoholic ◽  
Test Kit ◽  
Food And Water Intake ◽  
Post Intubation

Ultrastructural alterations of skeletal muscle have been observed in adult chronic alcoholic patients. However, no such study has been performed on individuals prenatally exposed to ethanol. In order to determine if ethanol exposure in utero in the latter stages of muscle development was deleterious, skeletal muscle was obtained from newborn guinea pigs treated in the following manner. Six Hartly strain pregnant guinea pigs were randomly assigned to either the ethanol or the pair-intubated groups. Twice daily the 3 ethanol-treated animals were intubated with Ensure (Ross Laboratories) liquid diet containing 30% ethanol (6g/Kg pre-pregnant body weight per day) from day 35 of gestation until parturition at day 70±1 day. Serum ethanol levels were determined at 1 hour post-intubation by the Sigma alcohol test kit. For pair-intubation the Ensure diet contained sucrose substituted isocalorically for ethanol. Both food and water intake were monitored.

Prolactinoma causing visual disturbance in pregnancy - a multidisciplinary management conundrum

2019 ◽  
Author(s):  
Sultana Azam ◽  
Rebecca Scott ◽  
Chioma Izzi-Engbeaya ◽  
Sheba Jarvis ◽  
Suhaniya Samarasinghe ◽  
...  
Keyword(s):  
Visual Disturbance ◽  
Multidisciplinary Management ◽  
In Pregnancy

scholarly journals A case of splenic artery pseudoaneurysm rupture presenting as rectal bleeding in a regional hospital

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Jonathon N Holt ◽  
Heinrich E Schwalb
Keyword(s):  
Rectal Bleeding ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Regional Hospital ◽  
Alcoholic Pancreatitis ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Artery Pseudoaneurysm ◽  
Previous Trauma ◽  
Splenic Artery Pseudoaneurysm

Abstract Splenic artery pseudoaneurysm is a rare phenomenon most associated with chronic pancreatitis or previous trauma. Complications can include erosion and rupture into local structures, a situation that carries a reported mortality of 10–40%. A 58-year-old male with chronic alcoholic pancreatitis and a known splenic artery pseudoaneurysm presented to the emergency department of a regional hospital with rectal bleeding and sepsis. Computed tomography revealed a peri-splenic mass communicating with the splenic flexure. The patient was taken for an emergency splenectomy and left hemicolectomy and was confirmed to have rupture of the splenic artery aneurysm into the large bowel. This case presented with comparable features reported in the literature and demonstrates that access to emergency specialist surgical services in a regional setting offers the capability to manage rare, life threatening surgical emergencies.

scholarly journals Reconstruction of a Combined Frontal Bone and Orbital Roof Defect With Associated Meningoencephalocele Using 3D Modeling and 3D Navigation

2021 ◽  
Vol 6 ◽  
pp. 247275122110233
Author(s):  
Rory C. O’Connor ◽  
Sead Abazi ◽  
Jehuda Soleman ◽  
Florian M. Thieringer
Keyword(s):  
3D Modeling ◽  
Road Traffic ◽  
Treatment Algorithm ◽  
Visual Disturbance ◽  
High Energy ◽  
Frontal Bone ◽  
3D Navigation ◽  
Orbital Roof ◽  
Close Observation ◽  
Orbital Roof Fractures

Introduction: Orbital roof fractures are uncommon and normally associated with high energy trauma in which multiple other injuries are present. Most can be managed non-operatively with close observation. However, in a small proportion the defect is such that it permits the development of a meningoencephalocele, which can cause exophthalmos, a reduction in visual acuity and pain, all of which are unlikely to improve without surgical treatment. In light of their scarcity and the potential of serious risks with surgery that includes meningitis and visual disturbance (or even loss), thorough planning is required so that the meningoencephalocele can be reduced safely and the orbital roof adequately reconstructed. Methods: We report a case of a patient with a frontal bone defect, orbital roof fracture and associated meningoencephalocele that presented years after being involved in a road traffic accident in another country, who complained of a significant headache and orbital pain. The use of 3D modeling to help plan the surgery, and intraoperative 3D navigation to help negotiate the anterior skull base are described along with the reconstruction of the frontal bone and orbital roof using titanium mesh contoured on the 3D model. Conclusions: Although conservative management of orbital roof fractures predominates; those that are symptomatic, have associated neurologic symptoms or pose a risk to the eyesight warrant a surgical approach. The methods of repair, which center around separating the intracranial and intraorbital contents, are described in the context of this patient and previous cases, and a treatment algorithm is proposed.

scholarly journals Characteristics of patients who had a stroke not initially identified during emergency prehospital assessment: a systematic review

2021 ◽  
pp. emermed-2020-209607
Author(s):  
Stephanie P Jones ◽  
Janet E Bray ◽  
Josephine ME Gibson ◽  
Graham McClelland ◽  
Colette Miller ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
False Negative ◽  
Visual Disturbance ◽  
Screening Tools ◽  
False Negatives ◽  
Presenting Symptoms ◽  
Ischaemic Attack ◽  
Stroke Type ◽  
Key Terms

BackgroundAround 25% of patients who had a stroke do not present with typical ‘face, arm, speech’ symptoms at onset, and are challenging for emergency medical services (EMS) to identify. The aim of this systematic review was to identify the characteristics of acute stroke presentations associated with inaccurate EMS identification (false negatives).MethodWe performed a systematic search of MEDLINE, EMBASE, CINAHL and PubMed from 1995 to August 2020 using key terms: stroke, EMS, paramedics, identification and assessment. Studies included: patients who had a stroke or patient records; ≥18 years; any stroke type; prehospital assessment undertaken by health professionals including paramedics or technicians; data reported on prehospital diagnostic accuracy and/or presenting symptoms. Data were extracted and study quality assessed by two researchers using the Quality Assessment of Diagnostic Accuracy Studies V.2 tool.ResultsOf 845 studies initially identified, 21 observational studies met the inclusion criteria. Of the 6934 stroke and Transient Ischaemic Attack patients included, there were 1774 (26%) false negative patients (range from 4 (2%) to 247 (52%)). Commonly documented symptoms in false negative cases were speech problems (n=107; 13%–28%), nausea/vomiting (n=94; 8%–38%), dizziness (n=86; 23%–27%), changes in mental status (n=51; 8%–25%) and visual disturbance/impairment (n=43; 13%–28%).ConclusionSpeech problems and posterior circulation symptoms were the most commonly documented symptoms among stroke presentations that were not correctly identified by EMS (false negatives). However, the addition of further symptoms to stroke screening tools requires valuation of subsequent sensitivity and specificity, training needs and possible overuse of high priority resources.

Chronic alcoholism in relation to attempted or effected suicide. A long-term study

1988 ◽  
Vol 3 (3) ◽  
pp. 181-188 ◽  
Author(s):  
O.M. Lesch ◽  
H. Walter ◽  
R. Mader ◽  
M. Musalek ◽  
K. Zeiler
Keyword(s):  
Suicide Attempts ◽  
Depressive Symptomatology ◽  
Chronic Alcoholism ◽  
Chronic Alcoholic ◽  
Chronic Alcohol Abuse ◽  
Drinking Habits ◽  
Psychiatric Illnesses ◽  
Long Term Study ◽  
Structural Connection

SummaryRushing (1968) offers two hypotheses for the possible structural connection between suicidal and chronic alcoholic case groups : the “processual cause theory” is based on the idea that alcoholism leads through its problematic nature to suicide attempts. In the “common cause theory” alcoholism and suicidai acts are due to mutually shared factors, e.g., social isolation and enforced social integration.Data on suicide and suicide attempts were obtained as a separate aspect of a comprehensive follow-up investigation. All patients from one particular region in Austria, who had been admitted to hospital between 1976 and 1978 for treatment of chronic alcoholism took part in this study. Follow-up time was 4 to 7 years. 101 patients died during this period. 356 patients remained under close follow-up investigation. In addition to information about basic drinking habits, we attempted to identify predictive factors regarding the course of alcoholism and investigated familial circumstances, development and interactions.In contradiction with both theories forwarded by Rushing, we were able to isolate a special subgroup of chronic alcoholics attempting or committing suicide. This group is characterized by a depressive symptomatology (endogeneous-depressive syndrome, according to the Viennese Diagnostic Criteria), as well as by the presence of other psychiatrie disturbances underlying chronic alcohol abuse. Family histories also uncovered evidence of psychiatric illnesses. Cases of negative alteration in social status and problematical partnerships could be found in this subgroup. Drinking habits themselves did not differ from non suicide-prone alcoholics.

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