scholarly journals Protracted Hiccups Induced by Aripiprazole and Regressed after Administration of Gabapentin

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Manuel Glauco Carbone ◽  
Claudia Tagliarini ◽  
Filippo Della Rocca ◽  
Walter Flamini ◽  
Giovanni Pagni ◽  
...  
Keyword(s):  
Medical Condition ◽  
Case Series ◽  
Nerve Impulse ◽  
Diaphragm Muscle ◽  
Endocrine Disorders ◽  
Complete Regression ◽  
Low Doses ◽  
D3 Receptors ◽  
Reflex Arc ◽  
Low Dosage

Hiccups are sudden, repeated, and involuntary contractions of the diaphragm muscle (myoclonic contraction). It involves a reflex arc that, once activated, causes a strong contraction of the diaphragm immediately followed by the closure of the glottis translating into the classic “hic” sound. Hiccups can be short, persistent, and intractable depending on the duration. The most disabling hiccups often represent the epiphenomenon of a medical condition such as gastrointestinal and cardiovascular disorders; central nervous system (CNS) abnormalities; ear, nose, and throat (ENT) conditions or pneumological problems; metabolic/endocrine disorders; infections; and psychogenic disorders. Some drugs, such as aripiprazole, a second-generation antipsychotic, can induce the onset of variable hiccups. We describe herein the cases of three hospitalized patients who developed insistent hiccups after taking aripiprazole and who positively responded to low doses of gabapentin. It is probable that aripiprazole, prescribed at a low dosage (<7.5 mg/day), would act as a dopamine agonist by stimulating D2 and D3 receptors at the “hiccup center” level—located in the brain stem—thus triggering the hiccup. On the other hand, gabapentin led to a complete regression of the hiccup probably by reducing the nerve impulse transmission and modulating the diaphragmatic activity. The present case series suggests the use of low doses of gabapentin as an effective treatment for aripiprazole-induced hiccups. However, our knowledge of the neurotransmitter functioning of the hiccup reflex arc is still limited, and further research is needed to characterize the neurotransmitters involved in hiccups for potential novel therapeutic targets.

scholarly journals Vitamin C in the Treatment of COVID-19

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1172
Author(s):  
Gregorio Paolo Milani ◽  
Marina Macchi ◽  
Anat Guz-Mark
Keyword(s):  
Clinical Trials ◽  
Vitamin C ◽  
Respiratory Infections ◽  
Medical Condition ◽  
Case Reports ◽  
Case Series ◽  
Theoretical Background ◽  
Current Evidence ◽  
Vitamin C Supplementation ◽  
Essential Nutrient

Vitamin C is an essential nutrient that serves as antioxidant and plays a major role as co-factor and modulator of various pathways of the immune system. Its therapeutic effect during infections has been a matter of debate, with conflicting results in studies of respiratory infections and in critically ill patients. This comprehensive review aimed to summarize the current evidence regarding the use of vitamin C in the prevention or treatment of patients with SARS-CoV2 infection, based on available publications between January 2020 and February 2021. Overall, 21 publications were included in this review, consisting of case-reports and case-series, observational studies, and some clinical trials. In many of the publications, data were incomplete, and in most clinical trials the results are still pending. No studies regarding prevention of COVID-19 with vitamin C supplementation were found. Although some clinical observations reported improved medical condition of patients with COVID-19 treated with vitamin C, available data from controlled studies are scarce and inconclusive. Based on the theoretical background presented in this article, and some preliminary encouraging studies, the role of vitamin C in the treatment of patients with SARS-CoV-2 infection should be further investigated.

Design and fabrication of anisotropic textile brace for exerting corrective forces on spinal curvature

2021 ◽  
pp. 152808372110326
Author(s):  
Queenie Fok ◽  
Joanne Yip ◽  
Kit-lun Yick ◽  
Sun-pui Ng
Keyword(s):  
Medical Condition ◽  
Three Dimensional ◽  
Case Series ◽  
The Body ◽  
Spinal Curvature ◽  
Radiographic Examination ◽  
Interface Pressure ◽  
Pressure System ◽  
Case Series Study ◽  
Point Pressure

This study focuses on the fabrication of an anisotropic textile brace that exerts corrective forces based on the three-point pressure system to treat scoliosis, which is a medical condition that involves deformity of the spine. The design and material properties of the proposed anisotropic textile brace are discussed in detail here. A case series study with 5 scoliosis patients has been conducted to investigate the immediate in-brace effect and biomechanics of the proposed brace. Radiographic examination, three-dimensional scanning of the body and interface pressure measurements have been used to evaluate the immediate effect of the proposed brace on reducing the spinal curvature and asymmetry of the body contours and its biomechanics. The results show that the proposed brace on average reduces the spinal curvature by 11.7° and also increases the symmetry of the posterior trunk by 14.1% to 43.2%. The interface pressure at the corrective pad ranges from 6.0 to 24.4 kPa. The measured interface pressure shows that a sufficient amount of pressure has been exerted and a three-point pressure distribution is realized to reduce the spinal curvature. The obtained results indicate the effectiveness of this new approach which uses elastic textile material and a hinged artificial backbone to correct spinal deformity.

THE CORRELATION BETWEEN INTELLIGENCE AND SPEED IN CONDUCTION OF THE NERVE IMPULSE IN A REFLEX ARC

Science ◽  
1928 ◽  
Vol 67 (1724) ◽  
pp. 41-43 ◽  
Author(s):  
L. E. Travis
Keyword(s):  
Nerve Impulse ◽  
Reflex Arc

scholarly journals Applications of Medical Tattooing: A Systematic Review of Patient Satisfaction Outcomes and Emerging Trends

2021 ◽  
Author(s):  
Stacie J Becker ◽  
Jeffrey E Cassisi
Keyword(s):  
Patient Satisfaction ◽  
Medical Condition ◽  
Case Series ◽  
Outcome Data ◽  
Future Research ◽  
Health Service Provider ◽  
Level Of Evidence ◽  
Case Examples ◽  
Areola Complex ◽  
Clinical Series

Abstract Background Medical tattooing is often applied in the context of plastic, aesthetic, and reconstructive surgery to help achieve the best cosmetic outcome. Objectives This article reviews various conditions that medical tattooing have been empirically studied in terms of patient satisfaction outcomes; makes practice recommendations; and suggests future directions for research. Methods This review was performed following the PRISMA guidelines. Studies were included if the tattooing application was associated with a medical condition and if outcome data was provided using at least a case series methodology. Where no cohort or clinical series exist, case examples are used from the literature and the author’s practice to illustrate emerging medical tattooing applications that need further evaluation. Results Eighteen studies met the inclusion criteria and were applied to the following conditions: baldness, vitiligo, scars from incisions, lacerations or burns, and nipple areola complex reconstruction following breast surgery. Conclusions The application of medical tattooing has shown high levels of patient satisfaction across various conditions. The practice recommendation grade is “B” or recommend since the level of evidence for these interventions ranged from III to IV according to the ASPS guidelines. This means clinicians can consider this treatment alternative, but they should be alert to new information and be sensitive to patient preferences. Recommendations are made for reporting future research including clearly describing procedural details, identifying the professional performing the procedure, increased use of standardized outcome measures, and that satisfaction ratings be assessed by someone independent of the health service provider. Further research using RCT methodology with waitlist controls is needed.

scholarly journals PEDIATRIC IDIOPATHIC INTERVERTEBRAL DISC CALCIFICATION: A SINGLE INSTITUTION CASE SERIES OF A RARE DISORDER

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e41-e41
Author(s):  
Molly Dushnicky ◽  
Ronald Laxer ◽  
Abhaya Kulkarni ◽  
Manohar Shroff ◽  
Hidehiro Okura
Keyword(s):  
Intervertebral Disc ◽  
English Language ◽  
Medical Condition ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Spinal Pain ◽  
Single Institution ◽  
Intervertebral Disc Calcification ◽  
Age Range

Abstract BACKGROUND Paediatric idiopathic intervertebral disc calcification (PIIVDC) is a rare, poorly understood condition with just over 300 reported cases in the literature since the first report in 1924. The condition is characterized by calcification of an intervertebral disc which can progress to inflammation or extrusion and lead to neck or spinal pain in some patients. OBJECTIVES We report a series of patients seen at a single institution with PIIVDC and outline the disease course, management and outcome and review the literature. DESIGN/METHODS A retrospective chart review was performed at a single institution spanning the period between January 2001 and February 2016 for diagnoses of PIIVDC. Patient age, gender, symptoms, and medical history and physical and neurologic findings were reviewed. Laboratory and imaging findings, management, follow-up, and outcome were also studied. A literature review was carried out by MEDLINE and Embase, using the search terms “pediatric disc calcification” and “disc calcification in children” between the years 1997 and 2017, in the English language. Articles were reviewed and data was extracted. RESULTS Nine cases of PIIVDC were identified (6 males, 3 females) with an age range of 1 to 14 years. Two patients were asymptomatic and PIIVDC was discovered incidentally. Of the remaining patients, five presented with neck/back pain, one painless torticollis, and one painful torticollis. One patient was noted to have pain radiating along one dermatome. Disc spaces affected were five cervical, five thoracic, and two lumbar, with two patients having more than one space affected. All patients were managed conservatively. In one case, symptoms and lesions persisted after 5-years, but the remainder had complete symptom resolution, generally within 6 months. CONCLUSION Although the etiology of PIIVDC remains unknown it appears to occur spontaneously, without preceding trauma or underlying medical condition. A conservative approach to patients without severe neurologic deficit with out-patient close follow-up is supported.

High Response Rates and Prolonged Survival in Patients With Corticotroph Pituitary Tumors and Refractory Cushing Disease From Capecitabine and Temozolomide (CAPTEM)

Neurosurgery ◽  
2013 ◽  
Vol 74 (4) ◽  
pp. E447-E455 ◽  
Author(s):  
Brad E. Zacharia ◽  
Anthony P. Gulati ◽  
Jeffrey N. Bruce ◽  
Arthur S. Carminucci ◽  
Sharon L. Wardlaw ◽  
...  
Keyword(s):  
Cranial Nerves ◽  
Case Series ◽  
Pituitary Tumors ◽  
Immunohistochemical Analysis ◽  
Neurological Deficits ◽  
Complete Regression ◽  
Cushing Disease ◽  
Chemotherapeutic Regimen ◽  
Hormonal Therapies

ABSTRACT BACKGROUND AND IMPORTANCE: Rarely, corticotrophic pituitary tumors take on an aggressive form characterized by rapid growth, invasion into local structures, compression of cranial nerves, and possible spread to distant sites. When conventional surgery, radiation therapy, and hormones fail to control progression and symptoms, alternative therapies are needed. A novel chemotherapeutic regimen of capecitabine and temozolomide (CAPTEM), originally designed in our laboratory, demonstrated dramatic antineoplastic effects against corticotrophic pituitary tumors. CLINICAL PRESENTATION: We present a case series of 4 patients with aggressive, adrenocorticotrophic hormone--producing pituitary tumors who had previously depleted all surgical, radiation, and hormonal therapies and were then treated with CAPTEM. Dramatic clinical improvements in neurological deficits and Cushing symptoms were evident in all patients after treatment was initiated. Confirmed by radiographic imaging, 2 of 4 patients demonstrated complete regression of disease, 1 patient had a 75% regression, and the fourth patient has ongoing stable disease for &gt; 4.5 years at the time of this writing. Immunohistochemical analysis of patients' tumor samples showed low O6-methyguanyl methyltransferase expression and adequate levels of mismatch repair enzymes (MLH-1, MSH-2, MSH-6, and PMS-2), which are important for the in vivo efficacy of CAPTEM. CONCLUSION: This is the first report of prolonged antitumor response to and radiographic complete remissions as a result of CAPTEM in patients with aggressive pituitary tumors who had exhausted all other therapies.

scholarly journals Measurement of normal optic nerve for Sudanese pediatric using magnetic resonance imaging

2020 ◽  
Vol 8 (11) ◽  
pp. 3799
Author(s):  
Rihab A. Yousif Ahmed ◽  
Awadia G. Suliman ◽  
Abdulmalek Y. Abdullah ◽  
Alrayah A. Mohammed ◽  
Amna R. Abdulghani ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Medical Condition ◽  
Medical Center ◽  
Endocrine Disorders ◽  
Resonance Imaging ◽  
Data Collection Sheet ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri

Background: Much congenital and intracranial pathology may affect optic nerve (ON) and caused increased or decreased in size, so the measurement is crucial and aiding in diagnosed of some neurogenic and endocrine disorders. The aim of this study was to measure the normal ON length and diameter by magnetic resonance imaging among pediatric at Khartoum state Sudan.Methods: This was descriptive, cross section study,  done in 100 Sudanese pediatrics with age from 1 month to 15 years came to Magnetic resonance imaging (MRI) department for MRI brain at three hospitals in Khartoum state  (Al-Amal national hospital, Al-Zaitona hospital and Modern Medical Center) during the period from December 2019 to March 2020, all of patients had no pathological or medical condition that may affect the orbits and optic nerve (OON), any child with and medical condition or pathology related to orbits excluded from study sampling. The data were collected by data collection sheet designed especially for this study then analyzed.Results: The study found that the mean diameter of ON was 2.06±0.44 mm, the mean length of right ON was 31.54±4.11 mm, there is no significant different in measurement between males and females (p>0.05), there was strong significant correlation between ON length and diameter with children age (r=0.592**, 0.654**, p<0.001 respectively).Conclusions: The study concluded that there was strong correlation between right and left ON diameter and length with age.

scholarly journals Neurogenic Bladder Dysfunction in Cancer Patients after Operations on the Pelvic Organs

2019 ◽  
Vol 4 (3) ◽  
pp. 89-95
Author(s):  
V. F. Onopko ◽  
E. A. Zagainova ◽  
E. A. Kirilenko
Keyword(s):  
Cancer Patients ◽  
Malignant Tumors ◽  
Endocrine Disorders ◽  
Parasympathetic Ganglia ◽  
Pelvic Organs ◽  
Urological Complications ◽  
Reflex Arc ◽  
Tissue Changes ◽  
Soft Tissue Changes ◽  
Neurogenic Dysfunction

The review is devoted to the generalization and analysis of domestic and foreign works describing the mechanism of development of neurogenic dysfunction of the bladder after surgery on the pelvic organs in cancer patients. All modern authors agree that the cause of these disorders is trauma of the pelvic nerves and interruption of the reflex arc. Unfortunately, when removing malignant tumors of the pelvic organs, urological complications are difficult and often impossible to avoid. This is due to the complex neuroanatomy of the bladder, its proximity to the rectum, the uterus, as well as the volume and radicality of cancer operations. The article shows that if the parasympathetic ganglia are damaged, there is a violation of the evacuation function of the bladder and a weakening or absence of the urge to urinate. If the sympathetic nervous system is damaged in isolation, on the contrary, an increase in the detrusor tone, intravesical pressure and a decrease in the capacity of the bladder is observed, which is in conditions of low bladder sphincter tone causes imperative urges, frequent urination and incontinence. Prior radiation therapy also affects the development of urological complications. Postradiated soft tissue changes, ischemia, fibrosis lead to great technical difficulties during surgery. In addition, factors that are important in the development of pelvic disorders in this category of patients include urinary system diseases and metabolic – endocrine disorders in case history.

scholarly journals Adenoviral Respiratory Infection-Associated Mortality in Children: A Retrospective Case Series

2020 ◽  
Author(s):  
Michael C. Spaeder ◽  
Claire Stewart ◽  
Matthew P. Sharron ◽  
Julia R. Noether ◽  
Natalia Martinez-Schlurman ◽  
...  
Keyword(s):  
Respiratory Infection ◽  
Medical Condition ◽  
Case Series ◽  
The United States ◽  
Chronic Medical Condition ◽  
Icu Admission ◽  
Increased Risk ◽  
Immunocompromised State ◽  
To Receive ◽  
Viral Respiratory

AbstractViral respiratory infections are a leading cause of illness and hospitalization in young children worldwide. Case fatality rates in pediatric patients with adenoviral lower respiratory tract infection requiring intensive care unit (ICU) admission have been reported between 7 and 22%. We investigated the demographics and clinical characteristics in pediatric mortalities associated with adenoviral respiratory infection at 12 academic children's hospitals in the United States. There were 107 mortality cases included in our study, 73% of which had a chronic medical condition. The most common chronic medical condition was immunocompromised state in 37 cases (35%). The incidences of pediatric acute respiratory distress syndrome (78%) and multiple organ dysfunction syndrome (94%) were profound. Immunocompetent cases were more likely to receive mechanical ventilation within the first hour of ICU admission (60 vs. 14%, p < 0.001) and extracorporeal membrane oxygenation (27 vs. 5%, p = 0.009), and less likely to receive continuous renal replacement therapy (20 vs. 49%, p = 0.002) or have renal dysfunction (54 vs. 78%, p = 0.014) as compared with immunocompromised cases. Immunocompromised cases were more likely to have bacteremia (57 vs. 16%, p < 0.001) and adenoviremia (51 vs. 17%, p < 0.001) and be treated with antiviral medications (81 vs. 26%, p < 0.001). We observed a high burden of nonrespiratory organ system dysfunction in a cohort of pediatric case fatalities with adenoviral respiratory infection. The majority of cases had a chronic medical condition associated with an increased risk of complications from viral respiratory illness, most notably immunocompromised state. Important treatment differences were noted between immunocompromised and immunocompetent cases.

scholarly journals Eruptive Seborrheic Keratoses Are Associated With a Co-Occurring Malignancy in the Majority of Reported Cases: A Systematic Review

2021 ◽  
pp. 120347542110351
Author(s):  
Sara Mirali ◽  
Asfandyar Mufti ◽  
Rafael Paolo Lansang ◽  
Muskaan Sachdeva ◽  
Jensen Yeung
Keyword(s):  
Systematic Review ◽  
Medical Condition ◽  
Case Reports ◽  
Healthcare Providers ◽  
Case Series ◽  
Latency Period ◽  
Skin Condition ◽  
Case Control Studies ◽  
Drug Induced ◽  
Seborrheic Keratoses

Background Eruptive seborrheic keratoses (ESK) is a benign skin condition that has been associated with malignant and nonmalignant diseases. We conducted a systematic review of reported cases of ESK to identify and summarize associated comorbidities. Methods MEDLINE and Embase were searched from database inception (1946) to July 31, 2020 for original articles describing ESK with or without a co-occurring condition. Subject demographics, as well as details of ESK and associated diagnoses were extracted from 76 articles (70 case reports, 3 case series, 3 case control studies) representing 92 patients. Results In total, 76.1% ( n = 70/92) of patients with ESK had a co-occurring malignancy, 4.3% ( n = 4/92) presented with a nonmalignant condition, 9.8% ( n = 9/92) experienced ESK as an adverse drug reaction, and 9.8% ( n = 9/92) did not report any underlying medical condition. ESK preceded a cancer diagnosis in 76.1% ( n = 70/92) of patients with a mean latency period of 4.0 months (range: 0.25-9 months). The most common malignancies associated with ESK were cutaneous T-cell lymphoma ( n = 10/70, 14.3%) and gastrointestinal adenocarcinoma ( n = 9/70, 12.9%). ESK preceded nonmalignant conditions or no disease in 14.1% ( n = 13/92) of patients with a mean latency period of 3.1 months (range: 0.75-6 months). Drug-induced ESK occurred in 9.8% ( n = 9/92) of patients with a mean latency period of 7.1 weeks after changing medication. Conclusion Although the role of ESK as a paraneoplastic cutaneous marker is debated, healthcare providers should consider screening for underlying malignancy in patients presenting with ESK. Larger studies are needed to confirm its role as a marker for disease.

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