scholarly journals Moyamoya vasculopathy in a young Caucasian woman with significant methamphetamine use

2020 ◽  
Vol 2 (1) ◽  
pp. e000066
Author(s):  
Tiffany Lin ◽  
Charmaine Yam ◽  
Su-Ling Lai ◽  
Geoffrey Cloud

BackgroundMoyamoya is a rare cerebrovascular disorder seen predominantly in Asian populations. Methamphetamine use is a recognised cause of stroke in young people, but its pathophysiology is not fully understood. The incidence of moyamoya vasculopathy in methamphetamine-associated stroke is unknown due to a lack of sufficient data. We present a rare case of moyamoya syndrome in a young Caucasian woman with methamphetamine-associated stroke.CaseA 31-year-old Caucasian woman presented with progressive right arm weakness, speech disturbance and seizures on a background of escalating methamphetamine use in the 9 months prior to admission. She did not have a personal or family history of stroke. MRI revealed both embolic and watershed infarcts in bilateral frontal regions and CT angiography showed development of new lenticulostriate collateral vessels. Digital subtraction angiography confirmed steno-occlusive disease of the bilateral anterior circulations and a ‘puff of smoke’ appearance.ConclusionIn young patients who present with stroke with unclear aetiology, it is important to obtain a thorough substance use history. Moyamoya vasculopathy should be considered when evaluating the pathophysiology of stroke in young people.

2013 ◽  
Vol 2 (2) ◽  
pp. 78-80
Author(s):  
MS Showkat ◽  
S Nuruzzaman ◽  
A Datta

Moya moya disease is a chronic cerebral vasculopathy characterized by progressive occlusion of circle of Willis arteries that leads to development of collateral vessel which has a characteristic puff of smoke appearance on imaging. Here we described 2 cases, both were young and presented with history of stroke and repeated headache. In Magnetic Resonance Angiogram (MRA), we found marked narrowing in internal carotid, anterior, middle and posterior cerebral artery with multiple collaterals producing puff of smoke appearence which is the diagnostic imaging feature of Moya Moya disease. This is an important cause of repeated stroke in young patients. So physicians should be aware of this clinical entity. DOI: http://dx.doi.org/10.3329/cbmj.v2i2.16705 Community Based Medical Journal 2013 July: Vol.02 No 02: 77-80


2021 ◽  
Vol 2 (1) ◽  
pp. 18-21
Author(s):  
Galina A. Batrak ◽  
◽  
Maria V. Zhaburina ◽  

In recent decades, type 2 diabetes is increasingly recorded in young people, adolescents and children. The most significant risk factors for type 2 diabetes in young patients are family history of the disease, overweight and obesity, and the presence of insulin resistance. The main diagnostic criteria for type 2 diabetes mellitus in young patients, in addition to the traditional ones (hyperglycemia and glycosylated hemoglobin), are a high level of C-peptide and insulin resistance in the absence of antibodies to ICA, insulin, GAD. In connection with the projected increase in the incidence of type 2 diabetes at a young age, it is necessary to pay attention to the implementation of preventive measures and timely clinical examination among groups of children and adolescents with the presence of abdominal obesity, burdened with a family history of obesity and type 2 diabetes, in order to prevent or delay the early development of disorders carbohydrate metabolism among this group at an earlier age. Given the predominance of insulin resistance in the pathogenesis of type 2 diabetes in young people, it is necessary to give priority to drugs from the metformin group when prescribing treatment. Thus, the global growth of type 2 diabetes, the tendency to "rejuvenate" diabetes, insufficient information on the prevalence, risk factors and clinical manifestations of the disease at a young age emphasize the urgency of studying this problem.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
James Fowler ◽  
Brian Fiani ◽  
Syed A. Quadri ◽  
Vladimir Cortez ◽  
Mudassir Frooqui ◽  
...  

Methamphetamine or “meth” is a sympathomimetic amine of the amphetamine-type substances (ATS) class with an extremely high potential for abuse. Illicitly abused neurostimulants like cocaine and meth predispose patients to the aneurysmal formation with reported rupture at a younger age and in much smaller sized aneurysms. However, very rapid growth of aneurysm within less than 2 weeks with methamphetamine abuse is very rarely observed or reported. In this report, we present a patient with repeated and recurrent meth abuse who demonstrated rapid growth of a pericallosal aneurysm over the period of less than two weeks. The pathophysiology of stroke related to meth and ATS abuse is multifactorial with hypertension, tachycardia, and vascular disease postulated as major mechanisms. The rapid growth of an aneurysm has a high risk of aneurysmal rupture and SAH, which is a neurosurgical emergency and therefore warrants careful consideration and close monitoring. This case confirms the dynamic temporal effects of methamphetamine use on intracranial vessels and this specific neurostimulants association to rapid aneurysmal formation. In light of vascular pathologies the possibility of drug-induced pseudoaneurysm should also be considered in young patients with history of meth abuse.


2015 ◽  
Vol 31 (2) ◽  
pp. 56-64
Author(s):  
Mostafa Hosen ◽  
Md Rafiqul Islam ◽  
Abu Nasir Rizvi ◽  
Moniruzamman Bhuyian

Background: The relation between serum lipids and ischemic stroke remains controversial in young patients. The aim was to determine the serum lipid profile and the vascular risk factors for ischaemic stroke in a series of patients under 45 with an ischemic stroke and to compare them with a series of controls of the same age. Material and method: This case-control study was conducted in the Department of Neurology and Department of Biochemistry of BSMMU, Dhaka, between the period of July 2007 and June 2009 for duration of two years. A total number of 50 patients presented with recent ischemic stroke and 50 control person were enrolled in this study. All patients of both sexes, aged between 15 to 45 years presented with ischemic stroke, from 0 day to 1 month that was confirmed by CT scan of head/MRI of brain. Vascular risk factors were recorded and blood sample was collected from the cases and the controls and analyzed at the Dept. of Biochemistry, BSMMU for estimation of serum fasting lipid profile. Result: Multivariate analyses showed that other than serum lipids- family history of dyslipidaemia, family history of stroke or TIA, history of HTN and smoking habit are found significant risks for stroke in young adult. Conclusion: The present study does not confirm the role of serum lipids as risk factors for ischemic stroke in young adult. Other than serum lipids- family history of dyslipidaemia, family history of stroke or TIA, history of HTN and smoking habit are found significant risks for stroke in young adult. Bangladesh Journal of Neuroscience 2015; Vol. 31 (2): 56-64


2022 ◽  
Vol 2022 ◽  
pp. 1-5
Author(s):  
Bryan Roberts

Takayasu arteritis is a rare disease mostly found in Asian populations. Cases have been reported in patients with inflammatory bowel disease, suggesting possible genetic linkage. The objective of this clinical case report is to highlight a rare finding of arteritis signs and symptoms in a 32-year-old Caucasian woman (likely early that it did not yet meet classification for official diagnosis as Takayasu arteritis) who subsequently was diagnosed with ulcerative colitis a few months later. The patient presented to the hospital with throbbing neck pain and tenderness around the area of her right carotid artery distribution, nonspecific visual changes, and bilateral upper extremity paresthesia, with significant findings of 50-69% right carotid artery stenosis on a recent outpatient carotid Doppler ultrasound. Based on additional laboratory, clinical, and advanced imaging findings at the hospital, a diagnosis of arteritis not yet classifiable as Takayasu arteritis was made, and the patient was treated with corticosteroids. Unfortunately, she developed bradycardia that was later attributed to the corticosteroid regimen and the medication was discontinued. By follow-up in the clinic, the patient’s carotidynia improved, but now, she reported a three-month history of bloody stools. Colonoscopy and pathology findings were consistent with ulcerative colitis, and the patient was started on mesalamine. The association of inflammatory bowel disease and Takayasu arteritis should not be overlooked, as future treatment methods and early, continuous surveillance may be critical in improving quality of life and avoiding serious complications.


2020 ◽  
Vol 62 (1) ◽  
pp. 38-42
Author(s):  
Anna Kostiukow ◽  
Wojciech Strzelecki ◽  
Mateusz W. Romanowski ◽  
Marta Rosołek ◽  
Ewa Mojs ◽  
...  

Introduction: The study is aimed at drawing the attention of the medical environment to the mental health aspects of young patients as a factor that significantly influences the efficiency of their rheumatic disease treatment. Aim: This paper is to check the risk of depression among a group of adolescents and young adults with rheumatic diseases. Material and Methods: The study was conducted among a group of 68 late adolescents and young adults (18-22 years old) with rheumatic diseases. The control group consisted of 102 young people (18-22 years old) without a diagnosed chronic disease. Risk of depression was measured using a screening tool – the Kutcher Adolescent Depression Scale (KADS). Results: The analysis showed that the probability of depression in the study group was 35.3%. In the control group, this rate was 19.6%. The results were statistical significance (p=0.028). Conclusions: The results of this study prove that the risk of depression among adolescents and young adults with rheumatic diseases is significantly higher than in healthy young people. The highest risk of depression is related to feeling tired, fatigue, low energy levels and lack of motivation as well as feeling worried, nervous, panicky, tense, keyed-up and anxious.


2018 ◽  
Vol 69 (2) ◽  
pp. 375-378
Author(s):  
Catalin Pricop ◽  
Ileana Adela Vacaroiu ◽  
Daniela Radulescu ◽  
Daniel Andone ◽  
Dragos Puia

In the literature, occurrence of acute kidney injury (AKI) in young patients with unilateral ureteral lithiasic obstruction and without previous renal impairment is not very often reported, and the underlined pathophysiological mechanisms are poorly known; according to some studies, it is a false kidney failure, the increase in serum creatinine being due to absorbtion of obstructed urine in the affected kidney. We have conducted a retro and prospective study in order to identify the possible risk factors that can cause renal function impairment in young patients (18-40 years) with unilateral ureteral lithiasis obstruction and a normal contralateral kidney. Results. From 402 patients included in the study, 20.64% (83 cases) presented with serum creatinine ] 1.3 mg/dL. In patients with renal impairment, prevalence of male gender and history of NSAIDS use before admission were significantly higher than in non-AKI group. Serum urea/creatinine ratio, and estimated glomerular filtration rate (MDRD formula) were significantly higher, and respectively lower in AKI group. We found no significant differences between the two groups regarding age, prevalence of urinary tract infection after relief of obstruction, C-reactive protein value, and the duration of hospitalization. Conclusions. AKI in young patients with unilateral ureteral lithiasis obstruction and normal contralateral kidney is not quite a rare finding in our region. NSAIDs use can influence development of AKI, and should be used cautiously even in young patients with renal colic. In our opinion, the presence of AKI in patients with unilateral hydronephrosis demands urgent endourological intervention. Choosing conservative therapy in these patients, especially treatment with NSAIDS may aggravate the renal dysfunction.


Author(s):  
KA Mogan ◽  
U Venkatesh ◽  
Richa Kapoor ◽  
Mukesh Kumar

AbstractIntroductionSubstance abuse remains one of the major challenges in young people, as it is one of the top five causes of disability-adjusted life years (DALY). The present study aims to find the prevalence and determinants of substance use among young people attending an urban primary health center in Delhi.MethodologySystematic random sampling was used to enroll the calculated sample size of 190. Substance use was assessed using ASSIST (an Alcohol Smoking Substance Involvement Screening Tool) and brief intervention was given based on the standard guidelines of ASSIST. The total score among the substance users is calculated and divided into Grades 1, 2 or 3. Log binomial regression was performed to quantify the association between substance use and covariates such as age, sex, education, occupation, family history of substance use, socio-economic status and family type. The association was expressed in odds ratio (OR) with 95 percent confidence interval (CI).ResultThe mean age of study participants was 18.6 ± 4.1, ranges from 10 to 24 years. Out of 48 substance users, 43.7% were consuming only tobacco, 22.9% were consuming only alcohol and 33.3% were polysubstance users. The history of substance use among family members of participants was found to be 46.3%. Median substance involvement score of tobacco, alcohol and cannabis users was 19 (IQR: 14.5–22), 19 (IQR: 13.5–25) and 22.5 (IQR: 22–23), respectively. Among tobacco users, 2.7% were Grade 1 and 7.2% were Grade 2. Four (16%), 20 (80%) and one (4%) of alcohol users were Grades 1, 2 and 3, respectively. Among the cannabis users, four (100%) were in the Grade 2 category. The median age of initiation of substance use among users was 16 (range 13–21) years. The analysis shows substance use was almost 25 times (adjusted OR = 25.84, 95% CI 5.65–118.09) more common among males and it increase by 2.5 times with a decrease in socio-economic status (adjusted OR = 2.52, 95% CI 1.27–5.02) and the result is significant. The substance use was almost 7 times higher when there is a family history of substance usage (adjusted OR = 7.40, 95% CI 2.15–25.4). Residential and marital status were not significantly associated with substance use.ConclusionMale sex, lower socio-economic status, participants currently not going to school/college, family history of substance use were found to be significant predictors of substance use among the study participants.


2020 ◽  
pp. 103985622097005
Author(s):  
Oliver Smith ◽  
Jessica Bergmann ◽  
Ulrich Schall

Objective: General practitioners (GPs) are key health professionals for referrals to mental health specialists. Youth mental health issues are particularly challenging, requiring a competent assessment and understanding of appropriate referral pathways. We surveyed local GPs about their understanding of youth mental health problems and needs to competently look after young patients. Methods: GPs working in the Hunter region were contacted via email, fax and post over a 6-month period in 2019. Results: Seventy-five GPs participated. They reported 577 of 1698 (34%) of young people seen 2 weeks prior to being surveyed presented with a mental health problem. Predominantly, referrals were to private practice psychologists and Headspace. Almost a third (31%) reported having limited understanding of ‘at-risk mental state’ and are ‘not always comfortable’ when facing a young person with a mental health problem. Nearly all (95%) expressed interest in attending specialised training. GPs identified treatment costs, scarce access to psychiatrists and limited patient engagement as the main obstacles to help young people. Conclusions: Effective treatment of a mental health problem relies on early identification. GPs are seeing young people on a regular basis but don’t feel well equipped for this task and are keen to up-skill, which needs to be addressed by targeted training.


Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 135
Author(s):  
Antonello Sica ◽  
Caterina Sagnelli ◽  
Beniamino Casale ◽  
Gino Svanera ◽  
Massimiliano Creta ◽  
...  

Background: The t (2; 5) chromosomal rearrangement of the ALK gene with nucleophosmin 1 gene (NPM1), resulting in an NPM1–ALK fusion, was first demonstrated in 1994 in anaplastic large cell lymphoma, (ALCL), a T-cell lymphoma responsive to cyclophosphamide, abriblastine, vincristine and prednisone in approximately 80% of cases; refractory cases usually respond favorably to brentuximab vedotin. These treatments are regarded as a bridge to allogeneic hematopoietic stem cell transplantation (allo-SCT). Nowadays, transplant procedures and the monitoring of chemotherapy patients proceed very slowly because the SARS-CoV-2 pandemic has heavily clogged the hospitals in all countries. Results: A 40-year-old Caucasian woman was first seen at our clinical center in June 2020. She had ALCL ALK+, a history of failure to two previous therapeutic lines and was in complete remission after 12 courses of brentuximab, still pending allo-SCT after two failed donor selections. Facing a new therapeutic failure, we requested and obtained authorization from the Italian drug regulatory agency to administer 250 mg of crizotinib twice a day, a drug incomprehensibly not registered for ALCL ALK +. Conclusions: The response to crizotinib was optimal since no adverse event occurred, and CT-PET scans persisted negative; this drug has proved to be a valid bridge to allo-SCT.


Sign in / Sign up

Export Citation Format

Share Document