scholarly journals A-59 Psychosis and Coma in COVID-19: A Case Report

2021 ◽  
Vol 36 (6) ◽  
pp. 1101-1101
Author(s):  
Parker Kotlarz ◽  
Yasmine B Nabulsi ◽  
Joseph Cahill
Keyword(s):  
African American Male ◽  
Inflammatory Responses ◽  
White Matter Lesions ◽  
Psychiatric Disease ◽  
Future Research ◽  
High Dose ◽  
Local Hospital ◽  
Comatose State ◽  
History Of ◽  
Test Result

Abstract Objective The objective of this case is to spotlight the potential neurological andneuropsychiatric symptoms associated with COVID-19. Method A 55-year-old African American male with a history of schizophrenia, bipolar disorder, obesity, tobacco use, and hypertension voluntarily presented to the local hospital with auditoryhallucinations and delusions. During an inpatient stay, the patient developed symptomsconsistent with COVID-19 and subsequently tested positive for the virus. Thirty-nine days after the initial positive COVID-19 test result, he remained in a coma with retained brainstem responses. An EEG demonstrated encephalopathy and MRI showed multiple, well-circumscribed white matter lesions consistent with acute demyelination (Figure 1). After three days of high-dose steroids and over a month in a coma, the patient began following simple commands. Unfortunately, on hospital day 66, the patient developed sudden hypotension and worsening respiratory status. Results While psychotic episodes in relation to COVID-19 are not widely reported, psychotic episodes are shown in three COVID-19 cases. Other reports have found significant changes in consciousness in COVID-19 patients with delayed awakening from a comatose state. Pre-existing inflammatory responses in those with psychiatric disease may be accelerated by the immune response due to COVID-19. Conclusion Mental status changes in those with psychiatric illness who have COVID-19 are worth exploring. It is unclear whether a history of COVID-19 may accelerate a neuropsychiatric process or other central nervous system diseases. Future research may want to examine the possible interrelationship between pre-existing neurological vulnerabilities and COVID-19. The possibility of high-dose steroid treatment for COVID-19 neuroinflammatory complications should be considered.

Possible Hepatotoxicity Associated With Daptomycin

2016 ◽  
Vol 29 (3) ◽  
pp. 253-256 ◽  
Author(s):  
Yoonsun Mo ◽  
Fletcher Nehring ◽  
Andrew H. Jung ◽  
Seth T. Housman
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Pain Syndrome ◽  
Liver Function Tests ◽  
Future Research ◽  
High Dose ◽  
History Of ◽  
The Relationship

Purpose To report a case of isolated daptomycin-induced acute liver injury without elevations in creatine kinase (CK) levels or kidney dysfunction. Summary A 49-year-old female with a history of pancreatitis, lupus, diabetes, congestive heart failure, hypertension, and chronic pain syndrome presented to the emergency department with alteration in mental status and acute liver failure. The patient had been treated with daptomycin for methicillin-resistant Staphylococcus aureus (MRSA) endocarditis for 3 weeks. After ruling out other possible etiologies, daptomycin was suspected as a cause of acute liver failure. Her liver failure resolved gradually following withdrawal of daptomycin. Conclusion Although hepatic abnormalities caused by daptomycin are rare, a handful of cases with daptomycin-induced liver injury have been reported in the literature. Of note, in most cases, patients on daptomycin therapy developed liver damage with elevations in CK levels. Our case report suggests possible severe liver injury associated with high-dose and long-term daptomycin treatment in the absence of rhabdomyolysis. Future research is warranted to further investigate the relationship between daptomycin use and liver injury, yet it is reasonable to monitor liver function tests at baseline and weekly thereafter along with CK levels, especially in patients requiring long-term daptomycin therapy.

P3557Heart failure patients show increase of white matter lesions in MRI-imaging: LIFE-Adult-Study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Stegmann ◽  
M L Chu ◽  
A Villringer ◽  
U Laufs ◽  
M Loeffler ◽  
...  
Keyword(s):  
Heart Failure ◽  
White Matter ◽  
Troponin T ◽  
Univariate Analysis ◽  
White Matter Lesions ◽  
Future Research ◽  
Cerebral Mri ◽  
History Of ◽  
Study Participants ◽  
Structural Brain

Abstract Background Heart Failure (HF) is a risk factor for stroke and dementia and is associated with cognitive impairment. However, whether or not HF is directly linked to structural brain changes is unknown. White matter lesions (WML) are common structural alterations in the white matter of the brain and their prevalence increases with age. They are associated with cerebral ischemia and cognitive dysfunction. However, there are only a few reports on HF and WML. Purpose We hypothesized that the presence and duration of heart failure are associated with WML. Methods LIFE Adult is a population-based study whose participants are a representative sample of the city of Leipzig, Germany (approximately 580,000 inhabitants). All study participants (18–80 years of age) underwent an extensive core assessment program (5–6 h) including structured medical interviews, medical and psychological questionnaires, physical examination and bio specimen collection. A subgroup of 2490 participants additionally underwent cerebral MRI (cMRI). The Fazekas Score was used for the classification of the WML (none or mild WML versus moderate or severe WML). Raters were blinded to other medical information of study participants. History of HF and other diseases were ascertained as part of the self-reported medical history questionnaire. Results Mean age was 64 years and 46% were female. On univariate analysis age, troponin T, NT-proBNP, body mass index, history of acute myocardial infarction, stroke, HF and diabetes were positively associated with WML. On multivariate analysis, only age, hypertension, stroke and HF were associated with WML. Interestingly, the Odd's ratio (OR) for HF was 2.5 (95% confidence interval (CI) 1.1; 5.6) and numerically higher than the OR for stroke (OR 2.0 (95% CI 1.0; 3.8)). Additionally, the OR increased with longer duration of HF (OR 1.3 for HF-duration <3 years, OR 1.7 for HF 4–6 years duration and OR 2.9 for HF-diagnosis >6 years). Conclusion HF is independently associated with structural brain damage, i. e. WML. Future research is needed to elaborate whether WML could be a therapeutic target for treatment targeting cognitive decline in HF.

A Case of Neurosarcoid Presenting as Multiple Intraparenchymal Hemorrhages

2021 ◽  
pp. 194187442110294
Author(s):  
Amit Mehta ◽  
Fahad Khan ◽  
Chris Wagner ◽  
Taymour Hashemzadeh ◽  
Andrew Stemer ◽  
...  
Keyword(s):  
African American Male ◽  
Early Recognition ◽  
Medical Center ◽  
Delayed Diagnosis ◽  
Brain Biopsy ◽  
Neurological Deficits ◽  
High Dose ◽  
Rapid Progression ◽  
History Of ◽  
Possible Cause

This report explores the case of a 49-year-old African American male with a six-month history of multifocal neurological deficits who presented to an outside hospital after a generalized seizure. Patient was transferred to our tertiary medical center after brain imaging showed multiple bilateral supratentorial intraparenchymal hemorrhages (IPH). A brain biopsy confirmed parenchymal and perivascular non-caseating granulomas with vasculitis. The patient was definitively diagnosed with neurosarcoidosis (NS) and his condition improved with high dose corticosteroids and additional immunosuppressive therapies. Intracranial hemorrhage in the setting of NS is extremely rare, with fewer than thirty documented cases; however, this is likely an underestimation of its true prevalence. This case illustrates the difficulty in diagnosis as many other etiologies of IPH must be considered. Additionally, the clinical course and manifestations of NS is often quite variable. The uniqueness of this case lies in the rapid progression from seemingly incidental microhemorrhages to multiple large IPHs over two months. While the cause of this progression is not immediately apparent, a possible cause may be inadequate initial treatment due to delayed diagnosis. Our case demonstrates the importance of early recognition and initiation of immunosuppressive therapy, potentially leading to dramatic clinical improvement, as seen in this patient.

scholarly journals Asthma death

Pneumologia ◽  
2020 ◽  
Vol 68 (4) ◽  
pp. 162-168
Author(s):  
Hana Khairina Putri Faisal ◽  
Faisal Yunus
Keyword(s):  
Mortality Rate ◽  
Inhaled Corticosteroids ◽  
Action Plan ◽  
Asthma Management ◽  
Psychosocial Problems ◽  
Poor Adherence ◽  
Psychiatric Disease ◽  
High Dose ◽  
History Of ◽  
Asthma Mortality

AbstractThe prevalence of asthma is still high in many countries. However, the asthma mortality rate has been significantly decreased after the epidemic of asthma death in the 1970s. The epidemic was occurred in New Zealand and was associated with the use of high-dose inhaled fenoterol at that time. The increased use of inhaled corticosteroids (ICS) in asthma management is proposed as the key factor in the declining trend of asthma mortality rate. The risk factors of asthma-related deaths included history of near-fatal asthma requiring intubation and mechanical ventilation, hospitalisation or emergency care visit for asthma in the past year, currently using or having recently stopped using oral corticosteroids, not currently using ICS, overuse of short-acting b2-agonists, history of psychiatric disease or psychosocial problems, poor adherence with asthma medications and/or poor adherence with (or lack of) a written asthma action plan, food allergy in a patient with asthma, and air pollution.

ITI with high-dose FIX and combined immunosuppressive therapy in a patient with severe haemophilia B and inhibitor

2009 ◽  
Vol 29 (02) ◽  
pp. 155-157 ◽  
Author(s):  
H. Hauch ◽  
J. Rischewski ◽  
U. Kordes ◽  
J. Schneppenheim ◽  
R. Schneppenheim ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Immunosuppressive Agents ◽  
Tolerance Induction ◽  
Intravenous Immunoglobulins ◽  
Factor Ix ◽  
High Dose ◽  
Allergic Reactions ◽  
Success Rates ◽  
Serious Infections ◽  
History Of

SummaryInhibitor development is a rare but serious event in hemophilia B patients. Management is hampered by the frequent occurrence of allergic reactions to factor IX, low success rates of current inhibitor elimination protocols and the risk of development of nephrotic syndrome. Single cases of immune tolerance induction (ITI) including immunosuppressive agents like mycophenolat mofetil (MMF) or rituximab have been reported. We present a case of successful inhibitor elimination with a combined immune-modulating therapy and high-dose factor IX (FIX). This boy had developed a FIX inhibitor at the age of 5 years and had a history of allergic reactions to FIX and to FEIBA→. Under on-demand treatment with recombinant activated FVII the inhibitor became undetectable but the boy suffered from multiple joint and muscle bleeds. At the age of 11.5 years ITI was attempted with a combination of rituximab, MMF, dexamethasone, intravenous immunoglobulins and high-dose FIX. The inhibitor did not reappear and FIX half-life normalized. No allergic reaction, no signs of nephrotic syndrome and no serious infections were observed.

Bayesian Inference in Human Time Perception

2017 ◽  
Author(s):  
Darren Rhodes
Keyword(s):  
Time Perception ◽  
Likelihood Function ◽  
Human Perception ◽  
Future Research ◽  
Temporal Properties ◽  
History Of Research ◽  
Psychophysical Testing ◽  
History Of ◽  
Fundamental Dimension ◽  
Perception Of Time

Time is a fundamental dimension of human perception, cognition and action, as the perception and cognition of temporal information is essential for everyday activities and survival. Innumerable studies have investigated the perception of time over the last 100 years, but the neural and computational bases for the processing of time remains unknown. First, we present a brief history of research and the methods used in time perception and then discuss the psychophysical approach to time, extant models of time perception, and advancing inconsistencies between each account that this review aims to bridge the gap between. Recent work has advocated a Bayesian approach to time perception. This framework has been applied to both duration and perceived timing, where prior expectations about when a stimulus might occur in the future (prior distribution) are combined with current sensory evidence (likelihood function) in order to generate the perception of temporal properties (posterior distribution). In general, these models predict that the brain uses temporal expectations to bias perception in a way that stimuli are ‘regularized’ i.e. stimuli look more like what has been seen before. Evidence for this framework has been found using human psychophysical testing (experimental methods to quantify behaviour in the perceptual system). Finally, an outlook for how these models can advance future research in temporal perception is discussed.

Fragments of the American Dream: Immigration, Race, and Medical Care in the Segregated South, 1929

Public Voices ◽  
2016 ◽  
Vol 13 (2) ◽  
pp. 1
Author(s):  
John R Phillips
Keyword(s):  
United States ◽  
American Dream ◽  
Black Population ◽  
The United States ◽  
Single Woman ◽  
Future Research ◽  
Legal Doctrine ◽  
Quarter Century ◽  
History Of ◽  
Sunflower County

The cover photograph for this issue of Public Voices was taken sometime in the summer of 1929 (probably June) somewhere in Sunflower County, Mississippi. Very probably the photo was taken in Indianola but, perhaps, it was Ruleville. It is one of three such photos, one of which does have the annotation on the reverse “Ruleville Midwives Club 1929.” The young woman wearing a tie in this and in one of the other photos was Ann Reid Brown, R.N., then a single woman having only arrived in the United States from Scotland a few years before, in 1923. Full disclosure: This commentary on the photo combines professional research interests in public administration and public policy with personal interests—family interests—for that young nurse later married and became the author’s mother. From the scholarly perspective, such photographs have been seen as “instrumental in establishing midwives’ credentials and cultural identity at a key transitional moment in the history of the midwife and of public health” (Keith, Brennan, & Reynolds 2012). There is also deep irony if we see these photographs as being a fragment of the American dream, of a recent immigrant’s hope for and success at achieving that dream; but that fragment of the vision is understood quite differently when we see that she began a hopeful career working with a Black population forcibly segregated by law under the incongruously named “separate but equal” legal doctrine. That doctrine, derived from the United States Supreme Court’s 1896 decision, Plessy v. Ferguson, would remain the foundation for legally enforced segregation throughout the South for another quarter century. The options open to the young, white, immigrant nurse were almost entirely closed off for the population with which she then worked. The remaining parts of this overview are meant to provide the following: (1) some biographical information on the nurse; (2) a description, in so far as we know it, of why she was in Mississippi; and (3) some indication of areas for future research on this and related topics.

Powerful Inscriptions: On the Semiotic Phenomenology of BDSM

2020 ◽  
Author(s):  
Richard Joseph Martin
Keyword(s):  
Future Research ◽  
Ethnographic Research ◽  
Linguistic Turn ◽  
Making Sense ◽  
Sociology Of Deviance ◽  
History Of ◽  
Semiotic Phenomenology ◽  
Sex Wars

BDSM encompasses a range of practices—bondage and discipline (BD), dominance and submission (DS), sadism and masochism (SM)—involving the consensual exchange of power in erotic contexts. This chapter provides an overview of scholarship on BDSM, drawing on the history of academic studies of the phenomenon, ranging from the psychology of perversion, the sociology of deviance, and the feminist “sex wars” to more recent ethnographic and phenomenological turns. The chapter focuses on the importance of discourse and affect for making sense of BDSM, both for those who seek to analyze the phenomenon and for practitioners themselves. Drawing on ethnographic research and other data, the chapter shows how language and discourse are key to answering interconnected questions about the semiotics and phenomenology of BDSM (what these practices mean and how practitioners experience these practices affectively). Thus, a potential “linguistic turn” in BDSM studies is essential for future research on this erotic minority.

Introduction

2017 ◽  
Author(s):  
Travis D. Stimeling
Keyword(s):  
United States ◽  
The United States ◽  
Country Music ◽  
Future Research ◽  
Music Culture ◽  
Rich Variety ◽  
Ethnographic Studies ◽  
Folklore Studies ◽  
History Of ◽  
The Rich

This chapter offers a historiographic survey of country music scholarship from the publication of Bill C. Malone’s “A History of Commercial Country Music in the United States, 1920–1964” (1965) to the leading publications of the today. Very little of substance has been written on country music recorded since the 1970s, especially when compared to the wealth of available literature on early country recording artists. Ethnographic studies of country music and country music culture are rare, and including ethnographic methods in country music studies offers new insights into the rich variety of ways in which people make, consume, and engage with country music as a genre. The chapter traces the influence of folklore studies, sociology, cultural studies, and musicology on the development of country music studies and proposes some directions for future research in the field.

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