Thiamine deficiency observed in a cancer patient's caregiver

2019 ◽  
Vol 17 (5) ◽  
pp. 611-613
Author(s):  
Hideki Onishi ◽  
Mayumi Ishida ◽  
Nozomu Uchida ◽  
Takao Takahashi ◽  
Daisuke Furuya ◽  
...  
Keyword(s):  
Cancer Patient ◽  
Thiamine Deficiency ◽  
Detailed Examination ◽  
Care Providers ◽  
Psychological Issues ◽  
The Family ◽  
Hospital Visits ◽  
One Year ◽  
Loss Of Appetite ◽  
Thiamine Level

AbstractObjectiveThiamine deficiency (TD) is recognized in various kinds of disease with associated loss of appetite including cancer; however, TD has not been recognized in the family caregivers of cancer patients to date.MethodFrom a series of cancer patient caregivers, we reported an aged family caregiver who developed TD while caring for the cancer patient.ResultThe caregiver was a 90-year-old male. He had been accompanying his wife, who was diagnosed with colon cancer 4 years previously, on hospital visits as the primary caregiver, but because of psychological issues, he was recommended to visit the psycho-oncology department's “caregiver's clinic” for a consultation. Detailed examination revealed that his appetite had been only about 50% of usual from about one year before, and he had lost 12 kg in weight in one year. The diagnosis of TD was supported by his abnormally low serum thiamine level.Significance of the resultsThis report demonstrates that there is a possibility that care providers could develop TD from the burdens associated with caregiving. TD should be considered whenever there is a loss of appetite lasting for more than 2 weeks, and medical staff should pay careful attention to the physical condition of care providers to prevent complications resulting from TD.

Thiamine deficiency in the bereaved after cancer-related spousal loss

2019 ◽  
Vol 17 (6) ◽  
pp. 738-740
Author(s):  
Hideki Onishi ◽  
Nozomu Uchida ◽  
Takao Takahashi ◽  
Daisuke Furuya ◽  
Yasuhiro Ebihara ◽  
...  
Keyword(s):  
Thiamine Deficiency ◽  
Detailed Examination ◽  
Hypopharyngeal Cancer ◽  
Loved One ◽  
Spousal Loss ◽  
One Year ◽  
After Cancer ◽  
Loss Of Appetite ◽  
Thiamine Level ◽  
Low Serum

AbstractObjectiveThiamine deficiency (TD) is recognized in various kinds of disease with associated loss of appetite including cancer. However, it has not been recognized to date in bereaved partners after spousal loss from cancer.MethodFrom a series of bereaved partners who lost a spouse to cancer, we report on those who developed TD after bereavement.ResultCase 1 was a 57-year-old woman who sought consultation at our “bereavement clinic.” Her husband had been diagnosed with pancreatic cancer one year earlier and had died one month previously. At the first visit, she was observed to suffer depression, anxiety, and decreased appetite. Neurological, blood, and biochemical examinations did not reveal any noteworthy findings. She was diagnosed with uncomplicated bereavement. Detailed examination revealed that her appetite had been markedly decreased for approximately five weeks. The diagnosis of TD was supported by her abnormally low serum thiamine level. Case 2 was a bereaved 73-year-old male who had lost his wife to hypopharyngeal cancer one month previously after a five-year illness. He had shown a lack of energy for the month preceding his wife's death, but because there was no improvement after her death, his family recommended he seek consultation at our “bereavement clinic.” He was suffering from major depressive disorder. Detailed examination revealed that his appetite had been decreased for more than two weeks. Again, the diagnosis of TD was supported by his abnormally low serum thiamine level.Significance of resultsThese reports demonstrate that there is a possibility that bereaved could develop TD after the loss of a loved one. TD should be considered whenever there is a loss of appetite lasting for more than 2 weeks, and medical staff should pay careful attention to the physical condition of the bereaved to prevent complications because of TD.

Early detection and successful treatment of Wernicke encephalopathy in a patient with advanced carcinoma of the external genitalia during chemotherapy

2015 ◽  
Vol 14 (3) ◽  
pp. 302-306 ◽  
Author(s):  
Hideki Onishi ◽  
Mayumi Ishida ◽  
Hiroaki Toyama ◽  
Iori Tanahashi ◽  
Kenji Ikebuchi ◽  
...  
Keyword(s):  
Early Detection ◽  
Thiamine Deficiency ◽  
External Genitalia ◽  
Clinical Findings ◽  
Wernicke Encephalopathy ◽  
Appetite Loss ◽  
Irreversible Brain Damage ◽  
Laboratory Examinations ◽  
Loss Of Appetite ◽  
Thiamine Level

AbstractObjective:Few reports of Wernicke encephalopathy in oncological settings have been published. Some cases of Wernicke encephalopathy are related to appetite loss; however, the degree to which loss of appetite leads to thiamine deficiency is not known.Method:A 63-year-old female with advanced cancer of the external genitalia was referred for psychiatric consultation because of disorientation, insomnia, and bizarre behaviors. Her symptoms fulfilled the diagnostic criteria for delirium. Routine laboratory examinations did not reveal the cause of the delirium. Thiamine deficiency was suspected because appetite loss had continued for 19 days since she had been admitted to hospital.Results:Intravenous administration of thiamine resulted in recovery from the delirium within three days. Serum thiamine level was found to be 16 ng/ml (normal range: 24–66 ng/ml). The clinical findings, the low level of thiamine in the serum, and the effective alleviation of delirious symptoms after thiamine administration fulfilled Francis's criteria for delirium induced by thiamine deficiency.Significance of results:Clinicians must be aware of the possibility of Wernicke encephalopathy in cancer patients, especially in those with loss of appetite for longer than 18 days. The degree of appetite loss in such patients might serve as a reference. Early detection and intervention may alleviate the symptoms of delirium and prevent irreversible brain damage.

Wernicke encephalopathy in a lung cancer patient during treatment with nivolumab

2018 ◽  
Vol 17 (2) ◽  
pp. 245-247 ◽  
Author(s):  
Hideki Onishi ◽  
Mayumi Ishida ◽  
Hiroshi Kagamu ◽  
Yoshitake Murayama ◽  
Kunihiko Kobayashi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patient ◽  
Thiamine Deficiency ◽  
Lung Cancer Patient ◽  
Advanced Lung Cancer ◽  
Wernicke Encephalopathy ◽  
Laboratory Findings ◽  
Patients With Cancer ◽  
Cancer Trajectory ◽  
Loss Of Appetite

AbstractObjectiveWernicke encephalopathy (WE) is a neuropsychiatric disorder caused by thiamine deficiency. It is recognized in various stages of the cancer trajectory but has not previously been recognized during nivolumab treatment.MethodFrom a series of WE patients with cancer, we report a lung cancer patient who developed WE during treatment with nivolumab.ResultA 78-year-old woman with lung cancer was referred to our psycho-oncology clinic because of depressed mood. Psychiatric examination revealed disorientation to time, date, and place, which had not been recognized 1 month previously. Her symptoms fulfilled the diagnostic criteria for delirium. No laboratory findings or drugs explaining her delirium were identified. WE was suspected as she experienced a loss of appetite lasting 4 weeks. This diagnosis was supported by abnormal serum thiamine and the disappearance of delirium after intravenous thiamine administration.Significance of resultsWe found WE in an advanced lung cancer patient receiving treatment with nivolumab. Further study revealed the association between nivolumab and thiamine deficiency. Oncologists should consider thiamine deficiency when a patient experiences a loss of appetite of more than 2 weeks regardless of the presence or absence of delirium.

scholarly journals Subclinical thiamine deficiency identified by pretreatment evaluation in an esophageal cancer patient

2020 ◽  
Author(s):  
Akira Yoshioka ◽  
Izumi Sato ◽  
Hideki Onishi ◽  
Mayumi Ishida
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patient ◽  
Cancer Patients ◽  
Thiamine Deficiency ◽  
Treatment Plan ◽  
The Body ◽  
Nutritional Evaluation ◽  
Ocular Symptoms ◽  
Marked Decline ◽  
Thiamine Level

Abstract Despite the fact that both thiamine deficiency (TD) and Wernicke encephalopathy (WE) have been observed to some degree in cancer patients, such cases of TD and/or WE reported to date have all been diagnosed after the initiation of treatment. We here report a case of TD that presented without the commonly accepted triad of WE symptoms based on a total nutritional evaluation prior to the onset of treatment for cancer. The patient was a 71-year-old man with esophageal cancer who was referred to the oncology outpatient clinic for evaluation to determine the treatment plan. Although he did not present with delirium, cerebellar signs, or ocular symptoms, TD was suspected based on a reduction in appetite lasting 2 months as thiamine stores in the body are depleted in as few as 18 days. Blood findings showed a marked decline in serum thiamine level supported, which the diagnosis of TD. This case revealed the existence of a cancer patient with subclinical TD prior to the onset of treatment for cancer. Due to the fact that TD can occur without the characteristic symptoms as in this case, we believe it is important that total nutritional evaluation of cancer patients always be considered.

scholarly journals A Case of Wernicke Encephalopathy in a Dementia Caregiver: the Need for Nutritional Evaluation in Family Caregivers

2020 ◽  
Author(s):  
Mayumi Ishida ◽  
Nozomu Uchida ◽  
Kumi Itami ◽  
Izumi Sato ◽  
Akira Yoshioka ◽  
...  
Keyword(s):  
Thiamine Deficiency ◽  
The Body ◽  
Dementia Patient ◽  
Wernicke Encephalopathy ◽  
Case Presentation ◽  
Dementia Caregiver ◽  
Ocular Symptoms ◽  
Psychiatric Outpatient Clinic ◽  
The Family ◽  
Loss Of Appetite

Abstract Background: We report a case in which a family member caring for her mother with dementia developed Wernicke encephalopathy, which is a neuropsychiatric disorder caused by acute/subacute thiamine deficiency, during the course of care. Case presentation: A 63-year-old woman consulted our psychiatric outpatient clinic complaining of difficulty in providing care. She had started caring for her mother with dementia 6 months previously, during which time she began to feel tired. In addition, a loss of appetite had appeared 2 months prior to her visit, and this had decreased to about 30% of normal from 10 days previously. Neurologically, she experienced mild unsteadiness, but she was fully conscious and had no ocular symptoms. Based on the fact that the store of thiamine in the body is exhausted in about 18 days, the possibility of thiamine deficiency was considered, and her unsteadiness disappeared after an intravenous injection of thiamine. Test results showed her serum thiamine level to be abnormally low, and the patient was diagnosed with Wernicke encephalopathy. Conclusions: The burden of caring for a dementia patient may affect the nutritional status of the family caregiver. Thiamine deficiency should be one of the items considered as a nutritional issue in such caregivers.

Working with Sexual-Minority Individuals

2010 ◽  
pp. 837-868 ◽  
Author(s):  
Lisa M. Diamond ◽  
Molly R. Butterworth ◽  
Ritch C. Savin-Williams
Keyword(s):  
Identity Development ◽  
Sexual Minority ◽  
Minority Stress ◽  
Sexual Minorities ◽  
Minority Population ◽  
Same Sex ◽  
Psychological Issues ◽  
The Family ◽  
And Behavior ◽  
Oriented Research

The present chapter provides a review of some of the primary psychological issues confronting sexual minorities (i.e., individuals with same-sex attractions and relationships). Our goal is to provide a flexible set of preliminary questions that can be used to help sexual-minority clients to articulate their own idiosyncratic experiences and give voice to their own unique needs. We begin by addressing two of the most common and important clinical issues faced by sexual minorities: generalized “minority stress” and acceptance and validation from the family of origin. We then turn attention to the vast—and vastly underinvestigated—population of individuals with bisexual attractions and behavior, who actually constitute the majority of the sexual-minority population, despite having been systematically excluded from most prior research. We review the increasing body of research suggesting that individuals with bisexual patterns of attraction and behavior actually face greater mental health risks than those with exclusive same-sex attractions and behavior, and we explore potential processes and mechanisms underlying this phenomenon, focusing particular attention on issues of identity development and transition over the life span. We conclude by outlining a number of areas for future clinically oriented research.

scholarly journals Men’s perceptions of sexual and reproductive health education within the context of pregnancy and HIV in Zambia: a descriptive qualitative analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tulani Francis L. Matenga ◽  
Joseph Mumba Zulu ◽  
Sharon Nkwemu ◽  
Perfect Shankalala ◽  
Karen Hampanda
Keyword(s):  
Reproductive Health ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Decision Makers ◽  
Care Providers ◽  
Convenience Sample ◽  
Essential Information ◽  
Women Living With Hiv ◽  
The Family

Abstract Background Although health care providers are beginning to focus on men’s roles as fathers and husbands, there is limited understanding of how men view their ability to promote sexual and reproductive health in families affected by HIV and their experiences with receiving education through antenatal care. This paper aims to explore men’s perceptions of the education they need regarding sexual and reproductive health within the family in the context of HIV. Methods We interviewed a convenience sample of 18 male partners of pregnant women living with HIV in Lusaka, Zambia. Atlas.ti was used to facilitate data management and content analysis. Results Men reported being the primary decision-makers regarding sexual and reproductive issues in the family; however, they admitted far-reaching unmet needs in terms of information on sexual and reproductive health in the context of HIV. Most men felt that antenatal care was not a conducive setting to fully educate men on sexual and reproductive health because it is a woman’s space where their health concerns were generally neglected. There was a strong desire for more education that was specific to men’s sexual and reproductive health, especially because all the couples were affected by HIV. Men especially requested education on sexual preparedness, safe sex, the use of condoms in sero-concordant and sero-discordant relationships and general health information. Although men stated they were the main decision-makers regarding sexual and reproductive issues such as pregnancy, most men were not confident in their ability to promote sexual and reproductive health in the family because of limited knowledge in this area. Conclusion There is need to change the environment and messaging of antenatal care, as well as offer relevant education opportunities outside health facility settings to empower men with essential information for meaningful involvement in sexual and reproductive health in the context of HIV.

Attitudes of Psychiatric Ex-Patients toward a Study of Community Adjustment

1968 ◽  
Vol 23 (2) ◽  
pp. 567-572 ◽  
Author(s):  
Mary Helen Michaux ◽  
William W. Michaux ◽  
Eugenie K. Esser ◽  
Barbara A. Oliver
Keyword(s):  
Mental Illness ◽  
Study Participation ◽  
Community Adjustment ◽  
The Family ◽  
One Year ◽  
Research Demands

Questionnaires were presented to 73 psychiatric ex-patients to determine their retrospective attitudes toward participation in a one-year study of post-hospital adjustment. More than 50% of Ss reported that research contacts had been helpful in one or more specific respects. Attitudes toward research demands were predominantly neutral. Patients who completed 6 or more monthly interview-test sessions ( N = 53) differed from those who completed 5 or less ( N = 20) in finding research contacts more helpful, questions easier to answer and enlightening vs confusing, and study participation conducive to cohesion vs disruption in the family. Dropouts appeared to have in common wishes to deny mental illness and to forget hospitalization.

Physical activity in a German breast cancer patient cohort: One-year trends and characteristics associated with change in activity level

2012 ◽  
Vol 48 (3) ◽  
pp. 297-304 ◽  
Author(s):  
Christina Huy ◽  
Martina E. Schmidt ◽  
Alina Vrieling ◽  
Jenny Chang-Claude ◽  
Karen Steindorf
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Patient ◽  
Breast Cancer Patient ◽  
Activity Level ◽  
Patient Cohort ◽  
One Year

Resolving the Lourinia armata (Claus, 1866) complex with remarks on the monophyletic status of Louriniidae, Monard 1927 (Copepoda: Harpacticoida)

Zootaxa ◽  
2021 ◽  
Vol 5051 (1) ◽  
pp. 346-386
Author(s):  
SÜPHAN KARAYTUĞ ◽  
SERDAR SAK ◽  
ALP ALPER ◽  
SERDAR SÖNMEZ
Keyword(s):  
Comparative Evaluation ◽  
Species Complex ◽  
Detailed Examination ◽  
The Other ◽  
Phylogenetic Position ◽  
Nicobar Island ◽  
Other Hand ◽  
The Family ◽  
Close Relationship ◽  
Almost All

An attempt was made to test if Lourinia armata (Claus, 1866)—as it is currently diagnosed—represents a species complex. Detailed examination and comparisons of several specimens collected from different localities suggest that L. armata indeed represents a complex of four closely related morphospecies that can be differentiated from one another by only detailed observations. One of the four species is identified as Lourinia aff. armata and the other three species are described as new to science and named as Lourinia wellsi sp. nov., L. gocmeni sp. nov., and L. aldabraensis sp. nov. Detailed review of previous species records indicates that the genus Lourinia Wilson, 1924 is distributed worldwide. Ceyloniella nicobarica Sewell, 1940, originally described from Nicobar Island and previously considered a junior subjective synonym of L. armata is reinstated as Lourinia nicobarica (Sewell, 1940) comb. nov. on the basis of the unique paddle-shaped caudal ramus seta V. It is postulated that almost all of these records are unreliable in terms of representing true Lourinia aff. armata described herein. On the other hand, the comparative evaluation of the illustrations and descriptions in the published literature indicates the presence of several new species waiting to be discovered in the genus Lourinia.                 It has been determined that, according to updated modern keys, the recent inclusion of the monotypic genus Archeolourinia Corgosinho & Schizas, 2013 in the Louriniidae is not justified since Archeolourinia shermani Corgosinho & Schizas, 2013 does not belong to this family but should be assigned to the Canthocamptidae. On the other hand, it has been argued that the exact phylogenetic position of the Louriniidae still remains problematic since none of the diagnostic characters supports the monophyly of the family within the Oligoarthra. It has also been argued that the close relationship between Louriniidae and Canthocamptidae is supported since both families share the homologous sexual dimorphism (apophysis) on P3 endopod. The most important characteristic that can possibly be used to define Louriniidae is the reduction of maxilliped.  

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