scholarly journals Chronic, Recreational Chloroform-Induced Liver Injury

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Emily A. Minor ◽  
Mackenzie S. Newman ◽  
Justin T. Kupec
Keyword(s):  
Emergency Department ◽  
Central Nervous System ◽  
Nervous System ◽  
Liver Injury ◽  
Halogenated Hydrocarbon ◽  
Severe Hepatotoxicity ◽  
Central Nervous System Depression ◽  
History Of ◽  
Work Up ◽  
Scleral Icterus

Historically used as an anesthetic, chloroform is a halogenated hydrocarbon that is associated with central nervous system depression, arrhythmias, and hepatotoxicity. It is no longer used clinically, but accidental and intentional poisonings still occur. We report a case of chronic chloroform abuse leading to severe hepatotoxicity in a 26-year-old male graduate student. The patient presented to the emergency department with a three-day history of abdominal pain, dehydration, and scleral icterus. He drank several beers the night before the onset of symptoms, but denied taking acetaminophen, ibuprofen, or other drugs. An extensive work-up revealed an aspartate aminotransferase (AST) of 13,527 U/L and alanine aminotransferase (ALT) of 8,745 U/L, but the cause of his liver injury could not be determined. It was not until many months later that the patient admitted to inhaling chloroform in the weeks leading up to his illness.

scholarly journals Benzodiazepine use, misuse, and abuse: A review

2016 ◽  
Vol 6 (3) ◽  
pp. 120-126 ◽  
Author(s):  
Allison Schmitz
Keyword(s):  
Emergency Department ◽  
Central Nervous System ◽  
Substance Use ◽  
Nervous System ◽  
Elevated Risk ◽  
Emergency Department Visits ◽  
Prescription Drug Abuse ◽  
Benzodiazepine Use ◽  
History Of ◽  
Poor Outcomes

Abstract Benzodiazepine (BZD) abuse has reached epidemic levels and results in poor outcomes, particularly when combined with concomitant central nervous system depressants. BZDs are abused most commonly in combination with opioids and alcohol. Emergency department visits and related deaths have soared in recent years. In the absence of other medications or illicit substances, BZDs are rarely the sole cause of death. Prescription drug abuse has received more attention in recent years, yet much remains unknown about BZD abuse. BZDs have low abuse potential in most of the general population. A subset is at elevated risk of abuse, especially those with a history of a substance use disorder. Education, prevention, and identification are vital in reducing BZD abuse.

scholarly journals Acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM) associated with choroidal melanoma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Aluisio Rosa Gameiro Filho ◽  
Guilherme Sturzeneker ◽  
Ever Ernesto Caso Rodriguez ◽  
André Maia ◽  
Melina Correia Morales ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Serous Retinal Detachment ◽  
Central Nervous System Involvement ◽  
Choroidal Melanoma ◽  
Posterior Pole ◽  
Pancreatic Metastasis ◽  
Small Areas ◽  
History Of ◽  
The Right

Abstract Background To report a case of acute exudative polymorphous paraneoplastic vitelliform maculopathy in a patient with a history of choroidal melanoma, with metastases to the pancreas, liver, and central nervous system. Case presentation A 63-year-old patient, with a history of enucleation of the right eye due to choroidal melanoma, complained of progressive visual loss during a follow-up visit. Fundoscopic examination revealed multiple small areas of serous retinal detachment scattered throughout the posterior pole and ancillary tests confirmed the diagnosis of acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM). Screening for systemic metastases showed pancreatic, hepatic, and central nervous system involvement. Conclusions We describe a rare case of acute exudative polymorphous paraneoplastic vitelliform maculopathy, which should be considered in patients with or without a history of melanoma, who have vitelliform retinal detachments. Nevertheless, no previous reviews of literature have shown a correlation between AEPPVM and pancreatic metastasis.

scholarly journals Natural history of central nervous system acute leukemia in adults

Cancer ◽  
1981 ◽  
Vol 47 (1) ◽  
pp. 184-196 ◽  
Author(s):  
David J. Stewart ◽  
Michael J. Keating ◽  
Kenneth B. McCredie ◽  
Terry L. Smith ◽  
Eshan Youness ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Natural History ◽  
Acute Leukemia ◽  
History Of

THE FAMILY HISTORY OF SPINA BIFIDA CYSTICA

PEDIATRICS ◽  
1965 ◽  
Vol 35 (4) ◽  
pp. 589-595
Author(s):  
John Lorber
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Spina Bifida ◽  
Index Case ◽  
Progressive Increase ◽  
Point Of View ◽  
The Family ◽  
History Of ◽  
The Central Nervous System ◽  
Spina Bifida Cystica

1. The family histories of 722 infants who were born with spina bifida cystica were studied. 2. The index cases were referred for surgical treatment and were not selected in any way from the genetic point of view. 3. Intensive inquiries were made to obtain a complete family pedigree, including a prospective follow-up of siblings born after the index case. 4. Of 1,256 siblings 85 or 6.8% had gross malformation of the central nervous system: spina bifida cystica in 54, anencephaly in 22, and uncomplicated hydrocephalus in 9. 5. Of 306 children born after the index case 25 (8%) or 1 in 12 were affected. 6. There was a progressive increase in multiple cases in the family with increasing family size. In sibships of five or more, multiple cases occurred in 24.1%. 7. In 118 families cases of gross malformation of the central nervous system were known to have occurred among members of the family other than siblings. Cases occurred in three generations. 8. It is possible that spina bifida cystica might be a recessively inherited condition.

Primary leptomeningeal lymphoma masquerading as infectious tubercular meningitis

2021 ◽  
Vol 14 (9) ◽  
pp. e243574
Author(s):  
Salini Sumangala ◽  
Thidar Htwe ◽  
Yousuf Ansari ◽  
Lidia Martinez- Alvarez
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Correct Diagnosis ◽  
Central Nervous System Lymphoma ◽  
Final Diagnosis ◽  
Csf Analysis ◽  
Antitubercular Treatment ◽  
Lymphoma Treatment ◽  
Work Up ◽  
Timely Treatment

Primary central nervous system lymphoma (PCNSL) is infrequent and often poses diagnostic conundrums due to its protean manifestations. We present the case of a South Asian young man presenting with raised intracranial pressure and a lymphocytic cerebrospinal fluid (CSF) with pronounced hypoglycorrhachia. Progression of the neuro-ophthalmic signs while on early stages of antitubercular treatment led to additional investigations that produced a final diagnosis of primary leptomeningeal lymphoma. Treatment with chemoimmunotherapy (methotrexate, cytarabine, thiotepa and rituximab (MATRix)) achieved full radiological remission followed by successful autologous transplant. This case highlights the difficulties and diagnostic dilemmas when PCNSL presents as a chronic meningeal infiltrative process. While contextually this CSF is most often indicative of central nervous system tuberculosis and justifies empirical treatment initiation alone, it is essential to include differential diagnoses in the investigation work-up, which also carry poor prognosis without timely treatment. High suspicion, multidisciplinary collaboration and appropriate CSF analysis were the key for a correct diagnosis.

scholarly journals The life history of Hepatozoon leptodactyli (Lesage, 1908) Pessoa, 1970: a parasite of the common laboratory animal: the frog of the genus Leptodactylus

1973 ◽  
Vol 71 (1-2) ◽  
pp. 1-8 ◽  
Author(s):  
Sylvio Celso Goncalves da Costa ◽  
Samuel B. Pessoa ◽  
Neize de Moura Pereira ◽  
Tania Colombo
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Life History ◽  
Laboratory Animal ◽  
Peripheral Circulation ◽  
Experimental Conditions ◽  
History Of ◽  
The Central Nervous System ◽  
The Common ◽  
Common Laboratory

The main object of the present paper is to furnish a brief account to the knowledgement of Protozoa parasitic in common Brazilian frog of the genus Leptodactylus for general students in Zoology and for investigators that use this frog as a laboratory animal. Hepatozoon leptodactyli (Haemogregarina leptodactyli) was found in two species of frogs - Leptodactylus ocellatus and L. pentadactylus - in which develop schizogony whereas sporogony occurs in the leech Haementeria lutzi as was obtainded in experimental conditions. Intracellular forms have been found in peripheral circulation, chiefly in erythrocytes, but we have found them in leukocytes too. Tissue stages were found in frog, liver, lungs, spleen, gut, brain and heart. The occurence of hemogregarine in the Central Nervous System was recorded by Costa & al,(13) and Ball (2). Some cytochemical methods were employed in attempt to differentiate gametocytes from trophozoites in the peripheral blood and to characterize the cystic membrane as well. The speorogonic cycle was developed in only one specie of leech. A brief description of the parasite is given.

Opioids for Anesthesia and Postoperative Pain Control

2019 ◽  
Author(s):  
Bryan Cook ◽  
Krystina Geiger ◽  
Megan Barra
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pain Management ◽  
Respiratory Depression ◽  
Acute Pain ◽  
Patient Controlled Analgesia ◽  
Opioid Agonist ◽  
Duration Of Action ◽  
Central Nervous System Depression ◽  
Organ Systems

Opioid agonists are frequently used to provide anesthesia in combination with sedatives and hypnotic agents and manage postoperative acute pain. There are many different opioid agents available that differ in their potency, onset and duration of action, metabolism, drug interactions, and side-effect profile. All opioids have distinct effects upon various organ systems, including central nervous system depression, respiratory depression, and decreased gastrointestinal motility. Fentanyl and fentanyl-derived agents (alfentanil, sufentanil, remifentanil) are most frequently used in the intraoperative period due to their quick onset and duration of action, allowing them to be easily titrated and discontinued at the completion of a procedure. Oral opioids with moderate durations of action, such as oxycodone, hydrocodone, and morphine, are commonly used for acute pain management in the postoperative setting. When oral analgesics cannot be used, intravenous patient-controlled analgesia is another option for pain management. This review contains 5 figures, 11 tables, and 59 references. Key Words: analgesia, anesthesia, central nervous system depression, fentanyl, morphine, opioid agonist, pain management, patient-controlled analgesia, perioperative, respiratory depression

Venous Thromboembolism Prophylaxis with Low-Molecular-Weight Heparin in Primary Central Nervous System Lymphoma

2020 ◽  
pp. 1-6
Author(s):  
Stav Gazal ◽  
Eyal Lebel ◽  
Yosef Kalish ◽  
Chen Makranz ◽  
Moshe E. Gatt ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Central Nervous System ◽  
Nervous System ◽  
Venous Thromboembolism ◽  
Low Molecular Weight Heparin ◽  
Bleeding Event ◽  
Central Nervous System Lymphoma ◽  
B Cell Lymphoma ◽  
Low Molecular Weight ◽  
History Of

<b><i>Background:</i></b> Venous thromboembolism (VTE) is a frequent, potentially lethal complication in individuals with cancer. Patients with brain tumors are at particularly high risk for VTE. Primary central nervous system lymphoma (PCNSL) is a rare subtype of diffuse large B cell lymphoma, involving the craniospinal axis. The incidence of VTE in patients with PCNSL was reported as very high, occurring mostly in the early period of therapy. <b><i>Objectives:</i></b> We aimed to evaluate the efficacy and safety of prophylactic low-molecular-weight heparin (LMWH) throughout the treatment of PCNSL. <b><i>Patients:</i></b> All patients &#x3e;18 years of age diagnosed and treated for PCNSL at our institution in 2005–2017 were included. <b><i>Results:</i></b> There were 44 patients; mean age at diagnosis was 61.5 years. Three patients (6.8%) had a personal history of thrombosis, 11 (25%) had a history of diabetes or smoking, and 32 (72%) had an Eastern Cooperative Oncology Group performance status of 0–1 at diagnosis. During treatment with LMWH, no VTE events were recorded; 2 (4.5%) patients experienced a minor bleeding event and 1 (2.3%) a major bleeding event. <b><i>Conclusions:</i></b> Among our 44 patients with PCNSL treated with prophylactic LMWH, no VTE events were recorded, and only 1 (asymptomatic) intracranial bleed was recorded. Within the limitations of a retrospective nonrandomized study, our findings suggest that VTE prophylaxis may be beneficial for individuals with PCNSL.

scholarly journals Ecstasy-Associated Pneumomediastinum

2007 ◽  
Vol 89 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Silvana F Marasco ◽  
H Kiat Lim
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Young Adults ◽  
Inner City ◽  
Physical Exertion ◽  
Pharmacological Effect ◽  
Valsalva Manoeuvre ◽  
The Hours ◽  
History Of ◽  
The Central Nervous System

INTRODUCTION Ecstasy, also known as MDMA (3,4, methylenedioxymethamphetamine), is a popular illicit party drug amongst young adults. The drug induces a state of euphoria secondary to its stimulant activity in the central nervous system. PATIENTS AND METHODS A database review at two major inner city hospitals was undertaken to identify patients presenting with pneumomediastinum and their charts reviewed. A Medline review of all reported cases of pneumomediastinum associated with ecstasy abuse was undertaken. RESULTS A total of 56 patients presenting with pneumomediastinum were identified over a 5-year period. Review of the charts revealed a history of ecstasy use in the hours prior to presentation in six of these patients, representing the largest series reported to date. CONCLUSIONS Review of previously reported cases reveals the likely mechanism is due to Valsalva manoeuvre during periods of extreme physical exertion, and not a direct pharmacological effect of the drug.

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