Subclinical thiamine deficiency: What is the most appropriate method of diagnosis and treatment?

2020 ◽  
Vol 18 (5) ◽  
pp. 614-616
Author(s):  
Hideki Onishi ◽  
Nozomu Uchida ◽  
Kumi Itami ◽  
Masakazu Sato ◽  
Saki Tamura ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Weight Loss ◽  
Thiamine Deficiency ◽  
Neuropsychiatric Symptoms ◽  
Adjustment Disorder ◽  
Diagnosis And Treatment ◽  
Normal Range ◽  
Psychiatric Examination ◽  
End Of Treatment

AbstractObjectivesThe symptoms of thiamine deficiency vary considerably and asymptomatic cases; i.e., subclinical thiamine deficiency (SCTD), are known to exist. However, there is no information available on the treatment of SCTD.MethodsWe report a patient who underwent intravenous thiamine replacement therapy for about a month after being diagnosed with SCTD, but who developed SCTD again about three weeks after finishing the treatment.ResultsThe patient was a 64-year-old woman who, after starting treatment for cervical cancer, complained of anxiety and underwent an initial psychiatric examination. The psychiatric diagnosis was an adjustment disorder. Based on the possibility of SCTD complications due to her decreased appetite and weight loss, her serum thiamine concentration was measured and found to be low. Therefore, thiamine was administered intravenously for 29 days. At the end of treatment, thiamine administration was discontinued as there were no apparent neuropsychiatric symptoms or problems with appetite. Twenty-three days later, there were still no problems with appetite or neuropsychiatric symptoms, but a follow-up blood sample revealed that her serum thiamine was again below the normal range.Significance of resultsCurrently, there is no information available regarding the diagnosis and treatment of SCTD in cancer patients. In some cases, such as this case, the deficiency recurs without any symptoms indicative of SCTD; therefore, further examination for diagnosis and treatment is necessary.

scholarly journals AB0887 PATIENTS DEMOGRAPHIC CHARACTERISTICS WITH ESTABLISHED OSTEOPOROSIS TREATED WITH DENOSUMAB IN A THIRD LEVEL HOSPITAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1748.3-1748
Author(s):  
E. Andrés Trashaedo ◽  
D. Fernandez ◽  
R. Dos Santos Sobrín ◽  
I. González Fernández ◽  
A. Souto Vilas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Fragility Fracture ◽  
Vertebral Fractures ◽  
University Hospital ◽  
Diagnosis And Treatment ◽  
Adherence To Treatment ◽  
End Of Treatment

Background:Osteoporosis (OP) is the most common cause of fragility fractures. It is characterized by a loss of bone mass that modifies the bone microstructure, increases fragility and predisposes to fractures. There are numerous risk factors for fragility fracture that must be evaluated for diagnosis and treatment. The treatment consists of non-pharmacological measures (balanced diet and exercise), adequate intake of calcium and vitamin D and specific pharmacological treatment (bisphosphonates, teriparatide, denosumab or selective estrogen receptor modulator) 1-3.Objectives:To perform a descriptive evaluation of the demographic and clinical characteristics of patients with osteoporosis treated with Denosumab, their degree of compliance with the therapy as well as the evaluation of the possible causes of treatment cessation.Methods:All patients diagnosed with OP from January 2015 to January 2020 have been reviewed in the Rheumatology Service of the University Hospital of Santiago de Compostela and patients treated with denosumab have been selected. Demographic, clinical and treatment data have been collected from data collected in their electronic medical recordResults:Of the 507 patients diagnosed with Osteoporosis from January 2015 to January 2020, a total of 133 patients (26.2%) have received treatment with Denosumab. The majority are women (92.5% n = 122) with a mean age of 76 years (age range: 49-105 years). Previously, 38% (n = 51) had vertebral fractures, with 8% (n = 11) standing out who had presented 3 or more vertebral fractures prior to Denosumab treatment.The mean time to start Denosumab therapy since the diagnosis of Osteoporosis (by Densitometry or established by fractures) has been 35 months (0 to 84 months from diagnosis)Through the electronic Medical Record the dispensations were accessed in the Denosumab pharmacy office and its administration in Primary Care was verified. Complete adherence to treatment (without skipping any dose) was observed in 73% of patients (n = 97). In 5.2% (n = 7) an omission was avoided. In 21.8% (n = 29) 2 or more dose omissions were corroborated 9 patients (6.8%) completed treatment with Denosumab in the follow-up period (55% due to the need for dental interventions, 33% for loss of follow-up and 12% for fear of secondary effects).In 66 patients (49.6%) risk factors were identified to present Osteoporosis; being corticosteroid therapy at doses greater than 5 mg / day of Prednisone or equivalent (26% n = 33) the most frequently identified risk factor.No vertebral fractures were registered at the end of treatment with Denosumab, with an average time since the end of treatment of 2.77 years (6 months - 8 years).Conclusion:The rate of patients diagnosed with Osteoporosis who receive Denosumab therapy at some time reaches 26%, being the most frequent drug used after bisphosphonates.Complete adherence to treatment has been observed in 73% of patients.We have not observed vertebral fractures after suspension of Denosumab in our series of patients, although the total exposure time (from the end of treatment to the end of follow-up) is short: 2.77 yearsReferences:[1]Passini M. Osteoporosis diagnosis and treatment. Rev Bras Ortop. 2010;45(3):220-229.[2]Lems WF, et al. EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures. Ann Rheum Dis. 2017;76:802-810.[3]Naranjo A, et al. Recomendaciones de la Sociedad Española de Reumatología sobre osteoporosis. Reumatol Clin. 2019;15(4):188-210.Disclosure of Interests:None declared

Hypnotherapy for Weight Control

1980 ◽  
Vol 46 (1) ◽  
pp. 311-314 ◽  
Author(s):  
Sally Davis ◽  
Joseph G. Dawson
Keyword(s):  
Weight Loss ◽  
Weight Control ◽  
Case Histories ◽  
Control Techniques ◽  
Length Of Treatment ◽  
End Of Treatment ◽  
Behavioral Techniques ◽  
Desire To Eat ◽  
Booster Effect

A survey of weight control techniques indicates need for a weight-loss program which integrates appropriate eating behavior into everyday life and research that follows up patients to see if weight loss is maintained. A successful hypnotherapeutic program is described and illustrated through six case histories. Beginning, end-of-treatment, and follow-up data are presented and compared to summarized results of behavioral techniques; hypnotherapy showed shorter length of treatment and greater loss at follow-up. Patients' success with the adjunct of a taped induction was interpreted as failure to internalize suggestions, increased relaxation with resultant reduction in desire to eat, or a booster effect, similar to but not as powerful as, a return session.

Low-income minority women at risk for cervical cancer: a process to improve adherence to follow-up recommendations

2001 ◽  
Vol 116 (6) ◽  
pp. 608-616 ◽  
Author(s):  
Virginia A Cardin ◽  
Richard M Grimes ◽  
Zhi Dong Jiang ◽  
Nancy Pomeroy ◽  
Luther Harrell ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
At Risk ◽  
Low Income ◽  
Minority Women

Three-year follow-up of women who participated in a prison cervical cancer screening intervention

2005 ◽  
Author(s):  
Ruth Elwood Martin ◽  
Greg Hislop ◽  
Veronika Moravan ◽  
Garry Grams ◽  
Betty Calam
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening

Predicting the risk of becoming lost to follow-up in a lifestyle weight-loss intervention

2013 ◽  
Author(s):  
Danielle M. Lespinasse ◽  
Kristen E. Medina ◽  
Stacey N. Maurer ◽  
Samantha A. Minski ◽  
Renee T. Degener ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Loss Intervention ◽  
Lost To Follow Up

Efficiency of diagnosis and treatment non-invasive and microinvasive sgamous cell cervical cancer

2020 ◽  
pp. 71-74
Author(s):  
M.M. Melnyk ◽  
◽  
S.V. Nespradko ◽  
I.V. Goncharuk ◽  
M.V. Marchenko ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Key Words ◽  
National Cancer Institute ◽  
Reproductive Function ◽  
Diagnosis And Treatment ◽  
Non Invasive ◽  
Corpus Uteri ◽  
Complex Program ◽  
Early Cervical Cancer

The objective: analyse the effectiveness of diagnosis and treatment for early cervical cancer. Materials and methods. Analysed 107 cases of women’s disease on CIN ІІІ, cancer in situ, they were on treatment in National cancer institute and Kyiv dictrict cancer dispensary from 2010 till 2015 years. Results. Diagnosed percent relapse CIN ІІІ, cancer in situ contain 4.57% uninvasive and invasive form – 0.94%. Conclusion. According diagnostic CIN ІІ and CIN ІІІ is recommended to do treatment conization and dynamic dispensary observation. Are making complex program of infection HPV16, 18. In appering of margins resection some elements of tumor after wider conization by forms of cancer in situ. Many of expansive burns in cervical glands, in making of reproductive function, going disease (nodel leiomyoma of corpus uteri etc). In perspective is accept the notion of looking after and screening research of considering infection HPV16, 18 on CIN І, CIN ІІ. Key words: cervical cancer, сancer in situ, CIN І–ІІІ, diagnostic, treatment, conization.

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