Risperidone and pulmonary embolism: a harmful association? Case series and review of the literature

2012 ◽  
Vol 24 (6) ◽  
pp. 361-368 ◽  
Author(s):  
Massimo Gallerani ◽  
Davide Imberti ◽  
Elisa Mari ◽  
Anna Marra ◽  
Roberto Manfredini
Keyword(s):  
Pulmonary Embolism ◽  
Hospital Setting ◽  
Case Series ◽  
Bipolar Disorders ◽  
Term Treatment ◽  
Review Of The Literature ◽  
Short Term Treatment ◽  
Atypical Antipsychotic Drug ◽  
Medicine Department ◽  
Increased Risk

Gallerani M, Imberti D, Mari E, Marra A, Manfredini R. Risperidone and pulmonary embolism: a harmful association? Case series and review of the literature.Objective: Risperidone is an atypical antipsychotic drug used to treat a number of psychiatric diseases, such as schizophrenia, schizoaffective and bipolar disorders and irritability in children with autism. Moreover, it is also often administered for short-term treatment of persistent aggression in people with moderate-to-severe Alzheimer's dementia. A possible association between risperidone and venous thromboembolism (VTE) has been described. We intended to verify the dimension of the problem in our hospital setting.Methods: We considered all consecutive patients hospitalised in our Internal Medicine Department from January 2004 to December 2010, who were treated with risperidone and presented pulmonary embolism (PE).Results: Four cases of patients, apparently free from the well-known major risk factors for VTE (i.e. cancer, prolonged immobilisation, acute cardiac and respiratory failure, infections), who presented PE associated with risperidone therapy, were reported in details.Conclusions: A review of the available literature, discussing the possible different pathogenic reasons for this increased risk of VTE, is provided.

Z-drugs and Falls: A Focused Review of the Literature

2020 ◽  
Vol 35 (12) ◽  
pp. 549-554
Author(s):  
Nicole Ryba ◽  
Rebecca Rainess
Keyword(s):  
Primary Outcome ◽  
Case Reports ◽  
Inappropriate Medication ◽  
Case Series ◽  
Cochrane Library ◽  
Inpatient Setting ◽  
Care Hospital ◽  
Review Of The Literature ◽  
Increased Risk ◽  
Risk Of Falls

OBJECTIVE: To provide a focused review of the literature related to the association between exposure to Z-drugs and the risk of falls, especially in the older population.<br/> DATA SOURCES: A literature search was conducted using Medline, PsychInfo, and the Cochrane Library database for all clinical trials, case series, and case reports published in English up to May 2020. The search terms used consisted of each Z-drug, including "zolpidem," "zopiclone," "eszopiclone," and "zaleplon," matched with "falls."<br/> STUDY SELECTION: The search yielded 295 studies. After review of abstracts, content and references were reviewed, and duplicates removed, a total of 9 articles met inclusion of exposure to at least 1 Z-drug and a primary outcome of falls.<br/> DATA EXTRACTION: The American Geriatrics Society 2019 Beers Criteria Update for Potentially Inappropriate Medication Use in Older Adults recommends to avoid using nonbenzodiazepine hypnotics in this patient population because of the risk of adverse events.<br/> DATA SYNTHESIS: A majority of the literature suggests an increased risk of falls with exposure to Z-drug use, especially zolpidem. Eight trials examined falls as a primary outcome in non-elderly (n=3) and elderly (n=5) patients in different settings, mostly in an inpatient setting (nursing facility or acute care hospital).<br/> CONCLUSION: Exposure to Z-drugs, especially zolpidem, should be evaluated and counseled on continuously as these medications put patients at an increased risk for falls and other complications.

Z-drugs and Falls: A Focused Review of the Literature

2020 ◽  
Vol 35 (12) ◽  
pp. 549-554
Author(s):  
Nicole Ryba ◽  
Rebecca Rainess
Keyword(s):  
Primary Outcome ◽  
Case Reports ◽  
Inappropriate Medication ◽  
Case Series ◽  
Cochrane Library ◽  
Inpatient Setting ◽  
Care Hospital ◽  
Review Of The Literature ◽  
Increased Risk ◽  
Risk Of Falls

OBJECTIVE: To provide a focused review of the literature related to the association between exposure to Z-drugs and the risk of falls, especially in the older population.<br/> DATA SOURCES: A literature search was conducted using Medline, PsychInfo, and the Cochrane Library database for all clinical trials, case series, and case reports published in English up to May 2020. The search terms used consisted of each Z-drug, including "zolpidem," "zopiclone," "eszopiclone," and "zaleplon," matched with "falls."<br/> STUDY SELECTION: The search yielded 295 studies. After review of abstracts, content and references were reviewed, and duplicates removed, a total of 9 articles met inclusion of exposure to at least 1 Z-drug and a primary outcome of falls.<br/> DATA EXTRACTION: The American Geriatrics Society 2019 Beers Criteria Update for Potentially Inappropriate Medication Use in Older Adults recommends to avoid using nonbenzodiazepine hypnotics in this patient population because of the risk of adverse events.<br/> DATA SYNTHESIS: A majority of the literature suggests an increased risk of falls with exposure to Z-drug use, especially zolpidem. Eight trials examined falls as a primary outcome in non-elderly (n=3) and elderly (n=5) patients in different settings, mostly in an inpatient setting (nursing facility or acute care hospital).<br/> CONCLUSION: Exposure to Z-drugs, especially zolpidem, should be evaluated and counseled on continuously as these medications put patients at an increased risk for falls and other complications.

RISPERIDONE AND PULMONARY EMBOLISM: A HARMFUL ASSOCIATION? CASE SERIES AND REVIEW OF THE LITERATURE

2011 ◽  
pp. no-no
Author(s):  
Massimo Gallerani ◽  
Davide Imberti ◽  
Elisa Mari ◽  
Anna Marra ◽  
Roberto Manfredini
Keyword(s):  
Pulmonary Embolism ◽  
Case Series ◽  
Review Of The Literature

Pulmonary embolism after short‐term treatment of acne vulgaris with ovulation suppressor agents

1986 ◽  
Vol 145 (7) ◽  
pp. 345-345 ◽  
Author(s):  
Josef Poran ◽  
Alexander Guber ◽  
Dan Schindler ◽  
Yoshua Shachor
Keyword(s):  
Pulmonary Embolism ◽  
Acne Vulgaris ◽  
Term Treatment ◽  
Short Term ◽  
Short Term Treatment

Long-Term Management of Generalized Pustular Psoriasis with Infliximab: Case Series

2008 ◽  
Vol 12 (4) ◽  
pp. 184-188 ◽  
Author(s):  
Shannon B. Routhouska ◽  
Pranav B. Sheth ◽  
Neil J. Korman
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Term Treatment ◽  
Pustular Psoriasis ◽  
Short Term Treatment ◽  
Long Term Treatment ◽  
Generalized Pustular Psoriasis ◽  
Factor Α ◽  
Term Management

Background: Infliximab, a tumor necrosis factor α antagonist, has recently been shown to be successful for the short-term treatment of generalized pustular psoriasis (GPP) in multiple case reports. Objective: The goal of this case series was to assess the efficacy of the longer-term management of GPP with infliximab. Methods: Three patients with severe GPP were followed to assess the efficacy of long-term treatment with infliximab. Results: Infliximab therapy was more efficacious with infusion every 6 to 8 weeks in combination with methotrexate. Conclusion: Infliximab may be efficacious for some patients for the long-term management of GPP. Maintaining a strict infliximab infusion schedule and concomitant methotrexate therapy may decrease infusion reactions and increase efficacy.

scholarly journals Parosmia due to COVID-19 Disease: A 268 Case Series

2021 ◽  
Author(s):  
Rasheed Ali Rashid ◽  
Ameer A. Alaqeedy ◽  
Raid M. Al-Ani
Keyword(s):  
Recovery Rate ◽  
Clinical Characteristics ◽  
Treatment Options ◽  
Smoking Habit ◽  
Case Series ◽  
Term Treatment ◽  
Clinical Aspects ◽  
Short Term Treatment ◽  
Odor Group

Abstract Although parosmia is a common problem in the era of the COVID-19 pandemic, few studies assessed the demographic and clinical aspects of this debilitating symptom. We aimed to evaluate the socio-clinical characteristics and outcome of various options of treatment of individuals with parosmia due to COVID-19 infection. The study was conducted at two main Hospitals in the Ramadi and Tikrit cities, Iraq, on patients with a chief complaint of parosmia due to COVID-19 disease. The study involved 7 months (August 2020-February 2021). Detailed demographic and clinical characteristics and treatment options with their outcome were recorded and analyzed. Out of 268 patients with parosmia, there were 197 (73.5%) females. The majority were from age group ≤ 30 years (n = 188, 70.1%), housewives (n = 150, 56%), non-smokers (n = 222, 82.8%), and associated with dysgeusia (n = 207, 77.2%) but not associated with nasal symptoms (n = 266, 99.3%). All patients have complained of anosmia (89.9%) or hyposmia (10.1%). Troposmia was reported in the majority of participants. The majority of the patients were suffering from severe parosmia (65.7%). Around 3 quarters of the cases were presented in ≤ 4 months. Altered quality of life (AQL) was presented in 91.8% of subjects, and there was a significant association with the presence of dysgeusia and type and severity of parosmia. The smoking habit didn't show a significant association with AQL, the severity of parosmia, and the recovery rate. Most of the odor group was the most triggering stimuli eliciting parosmia, while, the sewage was the response odor in above 50% of the cases. The recovery rate was poor with olfactory training plus either tonics or local and systemic steroids. Parosmia due to COVID-19 infection is a common problem with poor results in the short-term treatment and follow-up. The AQL was seen in a greater proportion of patients and strongly associated with the presence of dysgeusia, type, and severity of parosmia.

scholarly journals Pharmacological Approaches to Controlling Cardiometabolic Risk in Women with PCOS

2020 ◽  
Vol 21 (24) ◽  
pp. 9554
Author(s):  
Andrea Cignarella ◽  
Roberto Mioni ◽  
Chiara Sabbadin ◽  
Francesca Dassie ◽  
Matteo Parolin ◽  
...  
Keyword(s):  
Cardiometabolic Risk ◽  
Polycystic Ovary ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Later Life ◽  
Term Treatment ◽  
Hypoglycemic Agents ◽  
Short Term Treatment ◽  
Aldosterone Antagonists ◽  
Increased Risk

Polycystic ovary syndrome (PCOS) is characterized by elevated androgen production and subclinical changes in cardiovascular and metabolic risk markers. Total cholesterol, high-density lipoprotein (HDL) cholesterol, fasting glucose, and fasting insulin appear to increase specifically in PCOS compared with fertile women. PCOS also confers an increased risk of cardiometabolic disease in later life. Novel biomarkers such as serum’s cholesterol efflux capacity and blood-derived macrophage activation profile may assist in more accurately defining the cardiometabolic risk profile in these women. Aldosterone antagonists, androgen receptor antagonists, 5α-reductase inhibitors, and synthetic progestogens are used to reduce hyperandrogenism. Because increased insulin secretion enhances ovarian androgen production, short-term treatment with metformin and other hypoglycemic agents results in significant weight loss, favorable metabolic changes, and testosterone reduction. The naturally occurring inositols display insulin-sensitizing effects and may be also used in this context because of their safety profile. Combined oral contraceptives represent the drug of choice for correction of androgen-related symptoms. Overall, PCOS management remains focused on specific targets including assessment and treatment of cardiometabolic risk, according to disease phenotypes. While new options are adding to established therapeutic approaches, a sometimes difficult balance between efficacy and safety of available medications has to be found in individual women.

Intracerebral pneumocephalus and hemiparesis as a complication of a halo vest in a patient with multiple myeloma

2004 ◽  
Vol 100 (4) ◽  
pp. 367-371 ◽  
Author(s):  
Yasushi Hashimoto ◽  
Minoru Doita ◽  
Keiichiro Hasuda ◽  
Kazuyoshi Korosue
Keyword(s):  
Multiple Myeloma ◽  
Parietal Lobe ◽  
Late Onset ◽  
Term Treatment ◽  
Short Term Treatment ◽  
Halo Vest ◽  
Content Type ◽  
Increased Risk ◽  
Pin Site ◽  
The Right

✓ A halo orthosis is often used to immobilize the cervical spine after severe injury in patients who cannot tolerate surgery. Although complications such as pin loosening or brain abscess have been reported, there are no reported cases of hemiparesis following pneumocephalus associated with halo use. The authors report the case of a 77-year-old man with multiple myeloma who, after undergoing halo vest therapy and chemotherapy, suddenly developed hemiparesis and speech disturbance. Diagnostic neuroimaging demonstrated penetration of the inner table at the right posterior pin site and intracerebral pneumocephalus at the parietal lobe. Intraoperative inspection revealed only air and no purulent materials or cerebrospinal fluid in the cystic lesion. When a halo device is used, attention to detail in pin application, maintenance, and proper pin-site care must be undertaken to minimize complications. The tightening of the pin in cases in which late-onset loosening has occurred should not be performed. Additionally, because late loosening of the pin and pin-site infection increase the risks of complications, a halo vest should be used only as a short-term treatment, and the clinician should be aware of the possible increased risk of serious complications such as pneumocephalus or subdural abscess formation.

Psoriasis and Multiple Sclerosis: Is There a Link?

2010 ◽  
Vol 14 (4) ◽  
pp. 151-155 ◽  
Author(s):  
Tiffany Kwok ◽  
Wei Jing Loo ◽  
Lyn Guenther
Keyword(s):  
Multiple Sclerosis ◽  
Case Series ◽  
Cochrane Library ◽  
Review Of The Literature ◽  
T Helper ◽  
Canadian Study ◽  
T Helper 17 ◽  
Increased Risk ◽  
Genetic Linkages ◽  
Interleukin 23

Background: Psoriasis and multiple sclerosis (MS) are both autoimmune T cell-mediated diseases. Some case series have suggested an association. Objective: To investigate the potential relationship between psoriasis and MS based on a systematic review of the literature. Methods: Medline, Cochrane Library, and EMBASE searches were performed. Results: T-helper 17 cells are involved in the pathogenesis of both psoriasis and MS. Both conditions have been associated with interleukin-23 receptor (IL23R) polymorphisms. Studies have reported psoriasis in 0.41 to 7.7% of individuals with MS. A higher rate of psoriasis compared to controls was noted in a few small MS cohorts, but the number of cases was too small to draw any firm conclusions. In two studies, including a large Canadian study of 5,031 patients with MS, there was no increased prevalence of psoriasis in patients over the control population. Family members of individuals with MS do not appear to be at increased risk for psoriasis in these studies. Psoriasis has developed during treatment for MS, and MS has developed during treatment for psoriasis. Conclusion: Although there are some common genetic linkages in psoriasis and MS, psoriasis does not appear to be more common in patients with MS or their relatives.

scholarly journals Catheter-Related Right Atrial Thrombus and Pulmonary Embolism: A Case Report and Systematic Review of the Literature

2009 ◽  
Vol 16 (5) ◽  
pp. 163-165 ◽  
Author(s):  
Karen EA Burns ◽  
Andrew McLaren
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
Right Atrial ◽  
Pulmonary Vasculature ◽  
Review Of The Literature ◽  
Atrial Thrombus ◽  
Right Heart ◽  
True Incidence ◽  
Increased Risk ◽  
Right Atrial Thrombus

Central venous catheters (CVCs) are commonly used in clinical practice. One of the foremost complications associated with their use is the potential for symptomatic or asymptomatic thrombosis. CVC thrombosis, in turn, may not only result in vascular and catheter occlusion but also infection, pulmonary embolism, and formation of right heart thromboemboli. Thrombi within cardiac chambers are associated with an increased risk of mortality due to their potential for embolization to the pulmonary vasculature. We describe the case of a 77-year-old man, who was successfully thrombolyzed following detection of a right atrial thrombus and hemodynamically significant pulmonary embolism resulting from thrombus formation on the tip of a peripherally inserted central catheter (PICC). The present article is the first report of a PICC-related right atrial thrombus in an adult treated with thrombolysis. A systematic review of the literature suggests that the true incidence of this complication may be underestimated because the diagnosis may not be considered in asymptomatic and symptomatic patients, or may be missed by transthoracic echocardiography. The present case highlights the importance of maintaining a high index of suspicion for thromboembolic complications and heparin-induced thrombocytopenia in patients with CVCs or a PICC. It also underscores the important role of transesophageal echocardiography and thrombolysis in the diagnosis and management, respectively, of right heart thromboemboli with associated pulmonary embolism.

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