scholarly journals Subcutaneous Magnesium Sulfate to Correct High-Output Ileostomy-Induced Hypomagnesemia

2019 ◽  
Vol 13 (2) ◽  
pp. 280-293 ◽  
Author(s):  
Mark J. Makowsky ◽  
Peter Bell ◽  
Leah Gramlich
Keyword(s):  
Magnesium Sulfate ◽  
Anal Squamous Cell Carcinoma ◽  
Aggressive Management ◽  
Home Based ◽  
Ambulatory Patients ◽  
History Of ◽  
Term Management ◽  
Minor Episode ◽  
High Output

Fluid and magnesium abnormalities are common in patients with high-output stomas. Subcutaneous magnesium administration may be more feasible for long-term management in ambulatory patients, but magnesium sulfate is approved only for intravenous or intramuscular injection. We describe the management of chronic hypomagnesemia and dehydration secondary to a high-output ileostomy following radiation and chemotherapy for anal squamous cell carcinoma with intermittent home-based subcutaneous magnesium infusions in a 61-year-old female with a history of Crohn’s disease and multiple bowel resections. Despite aggressive management with intravenous magnesium sulfate and oral magnesium glucoheptonate over 8 months, 49% of her magnesium concentrations were <0.60 mmol/L (mean 0.61 ± 0.09) necessitating 4 emergency, 1 hospital, and 4 infusion clinic visits. After initiation of subcutaneous magnesium sulfate, all magnesium concentrations were >0.60 mmol/L (mean 0.79 ± 0.08 mmol/L over 9 months). The patient tolerated the infusions well, only developing one minor episode of infusion-related cellulitis. A systematic review of the literature identified 14 reports where subcutaneous magnesium sulfatewas effective and treatment for adults or children with hypomagnesemia was safe. Home-based intermittent administration of subcutaneous magnesium may be a helpful and safe intervention to temporarily prevent and treat select patients with recurrent symptomatic hypomagnesemia.

Other Biological Approaches to OCD

2012 ◽  
Author(s):  
Nicole C. R. McLaughlin ◽  
Benjamin D. Greenberg
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Response To Treatment ◽  
History Of ◽  
Key Issues ◽  
Term Management ◽  
Deep Brain

Interest in psychiatric neurosurgery has waxed and waned since the 1930s. This chapter reviews the history of these methods, with a focus on OCD. This review of lesion procedures and deep brain stimulation includes neuropsychological and neuroimaging research in the context of putative neurocircuitry underlying symptoms and response to treatment. The chapter highlights how an abundance of caution is needed, as well as key issues in long-term management of patients so treated.

scholarly journals Predicting the Long-Term Course of Asthma in Wheezing Infants Is Still a Challenge

ISRN Allergy ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Flore Amat ◽  
Amandine Vial ◽  
Bruno Pereira ◽  
Isabelle Petit ◽  
André Labbe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atopic Dermatitis ◽  
Allergic Sensitization ◽  
Persistent Asthma ◽  
Inclusion Criteria ◽  
Recurrent Wheezing ◽  
History Of ◽  
Airborne Allergens ◽  
Term Management

Background. In recurrent wheezing infants, it is important to identify those likely to remain asthmatic in order to propose appropriate long-term management. Objective. To establish predictive factors for persistent asthma at adolescence in a population of recurrent wheezing infants. Methods. Retrospective study of 227 infants. Inclusion criteria were age under 36 months, a history of at least three wheezing episodes assessed via a doctor-led ISAAC questionnaire and a standardized allergy testing programme. At 13 years, active asthma was assessed by questionnaire. Results. Risk factors for asthma persisting into adolescence were allergic sensitization to multiple airborne allergens (OR 4.6, CI-95% (1.9–11.2) ), initial atopic dermatitis (OR 3.4, CI-95% (1.9–6.3) ), severe recurrent wheezing (OR 2.3, CI-95% (1.3–4.2) ), and hypereosinophilia ≥470/mm3 (OR 2.2, CI-95% (1.07–4.7) ). Conclusion. While it is still difficult to predict the long-term course of asthma, atopy remains the major risk factor for persistent asthma.

Port Hope Area Initiative

2003 ◽  
Author(s):  
Peter Brown ◽  
David McCauley
Keyword(s):  
Waste Management ◽  
Federal Government ◽  
Environmental Remediation ◽  
Local Community ◽  
Lessons Learned ◽  
Local Participation ◽  
History Of ◽  
The Government ◽  
Term Management

The Port Hope Area Initiative involves a process that will lead to the cleanup of low-level radioactive wastes in two communities in Southern Ontario and the construction of three new long-term waste management facilities in those communities. The history of the Initiative provides important insights into local participation and the successes and failures of siting efforts. The wastes resulted from the operations of an industrial process in Port Hope that began in the 1930s. Initially, wastes (contaminated with radium, uranium, and arsenic) from radium processing were deposited in a relatively uncontrolled manner at various locations within the town. By the 1940s, uranium processing wastes were deposited at nearby purpose-built radioactive waste management facilities. The problem of contamination was first recognized in 1974 and the worst cases quickly cleaned up. However, large volumes of contamination remained in the community. There were three successive efforts to develop an approach to deal with the area’s contamination. In the early to mid 1980s, a standard approach was employed; i.e. indentifying the most technically appropriate local site for a disposal facility, proceeding to evaluate that site, and communicating the benefits of the chosen approach to the local community. That approach was resoundingly rejected by local citizens and government representatives. The second effort, an innovative and consultative voluntary siting effort carried out during the late-1980s and early to mid-1990s involved the solicitation of other municipalities to volunteer to host a facility for the disposal of the Port Hope areas wastes. That effort resulted in the identification of a single volunteer community. However, negotiations between the federal government and the municipality were unable to reach an acceptable agreement establishing the conditions for the community to host the waste management facility. The third effort, a community-driven approach, was undertaken in the late-1990s and resulted in an agreement in 2001 between the Government of Canada and the local communities that sets in motion a process for the cleanup of the local wastes and long-term management in new local waste management facilities. This paper provides insights into the history of the problem, the efforts of the federal government over the last two decades to deal with the issue, how local participation and decision-making processes affected the successes of the various siting approaches, and lessons learned that might be of interest to others who must deal with environmental remediation situations that involve siting long-term management facilities.

scholarly journals The history, status and trends of the Endangered Seychelles Magpie-robin Copsychus sechellarum

2016 ◽  
Vol 26 (4) ◽  
pp. 505-523 ◽  
Author(s):  
APRIL J. BURT ◽  
JULIE GANE ◽  
IAIN OLIVIER ◽  
LICIA CALABRESE ◽  
ARJAN DE GROENE ◽  
...  
Keyword(s):  
Social Conflict ◽  
Critically Endangered ◽  
Population Increase ◽  
Founder Population ◽  
Status And Trends ◽  
History Of ◽  
Steep Decline ◽  
Term Management ◽  
Unpublished Information

SummaryThe once ‘Critically Endangered’ Seychelles Magpie-robin was down to just 12 individuals in 1960 on one island of the granitic Seychelles. In 2015, due to intensive long-term management the population stands at around 280 birds on five islands, marking a significant success for this species. Translocations to the islands of Cousin and Cousine have led to population saturation and stability, a translocation to Denis Island has resulted in a continuing population increase and the founder population on Frégate Island is likewise increasing. The latest translocation to Aride Island in 2002 resulted in population increase then stability but is now showing a steep decline throughout 2014 into 2015. Reasons for this decline are yet unknown though disease, lack of recruitment, the impacts of social conflict and the possibility of genetic issues are discussed. This report summarises the history of management for this species, compiling all available published and unpublished information, to provide a comprehensive account of the Seychelles Magpie-robin recovery.

scholarly journals Successful management of refractory cough with the leukotriene receptor antagonist zafirlukast in a dog with chronic bronchitis: a case report

2018 ◽  
Vol 63 (No. 4) ◽  
pp. 181-186
Author(s):  
IH Yoon ◽  
HJ Han ◽  
JH Kim
Keyword(s):  
Case Report ◽  
Receptor Antagonist ◽  
Chronic Bronchitis ◽  
Imaging Findings ◽  
Leukotriene Receptor Antagonist ◽  
Successful Management ◽  
History Of ◽  
Leukotriene Receptor ◽  
Term Management

A 7-year-old spayed female Pomeranian dog was evaluated for a 6-month history of intractable coughing and dyspnoea. The cough was unresponsive to antibiotics and a bronchodilator medication prescribed by the previous animal hospital. No abnormalities were identified on the blood work, echocardiography and radiography. However, computed tomography revealed mild bronchiectasia. Based on the history, physical examination and non-specific diagnostic imaging findings, the dog was diagnosed with chronic bronchitis. The cough failed to resolve, despite an attempt to manage it with prednisolone, theophylline, codeine and N-acetylcysteine. With the owner’s consent, we stopped all previous medications and finally tried the leukotriene receptor antagonist zafirlukast. The cough progressively improved and had mostly resolved four weeks after starting the administration of zafirlukast. The dog remained in complete remission without recurrence for seven months. This case report is the first to describe the successful long-term management of chronic cough with zafirlukast in a dog.

Benzodiazepines and Catatonia: A Case Report*

1989 ◽  
Vol 34 (7) ◽  
pp. 725-727 ◽  
Author(s):  
Dale Harris ◽  
Matthew A. Menza
Keyword(s):  
Case Report ◽  
Case History ◽  
Neuroleptic Therapy ◽  
History Of ◽  
Term Management

The case history of a patient with presumed psychogenic catatonia who responded dramatically to two mg of IM lorazepam is presented. This patient, who had been largely mute and immobile for over a week despite neuroleptic therapy, became freely conversant and mobile within 30 minutes of the administration of lorazepam. This response was repeated the next day after the patient had again become mute and immobile. Catatonia and its diverse etiologies are discussed, with an emphasis on its syndromic nature. The literature on the response of catatonia to the benzodiazepines is reviewed and it is suggested that a trial of benzodiazepines may be helpful in both the evaluation and long term management of patients with catatonia.

Recurrent single oesophageal stricture treated with a self-expanding stent in a cat

2008 ◽  
Vol 10 (5) ◽  
pp. 505-509 ◽  
Author(s):  
Barbara Glanemann ◽  
Nicolai Hildebrandt ◽  
Matthias A. Schneider ◽  
Andreas Moritz ◽  
Reto Neiger
Keyword(s):  
Oral Treatment ◽  
Balloon Dilation ◽  
Clinical Signs ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Oesophageal Stricture ◽  
Endoscopic Gastrostomy ◽  
History Of ◽  
Post Implantation ◽  
Term Management

A 1-year-old, female spayed domestic shorthair cat was presented with a 4-week history of dysphagia and regurgitation soon after oral treatment with clindamycin. Fluoroscopic and endoscopic examinations confirmed the presence of a single cervical oesophageal stricture 4 cm caudal to the pharynx. A fluoroscopically and endoscopically guided balloon dilation was performed six times consecutively over a period of 3 weeks as reformation of the stricture appeared within 3–7 days. Feeding via percutaneous endoscopic gastrostomy-tube as long-term management of the condition was declined by the owner. A self-expanding metal oesophageal stent with the following dimension was subsequently implanted: fully open diameter 16 mm, length 30 mm. After stent implantation, the cat was fed on mashed canned food and did not show any clinical signs for 12 months. Twelve months post-implantation the cat was no longer able to eat even liquid food, became lethargic and the owner opted for euthanasia. On post-mortem examination the stent surfaces were overgrown by oesophageal mucosa by approximately 50%. Stent obstruction was detected and caused by swallowed hair which also seemed to have hampered mucosal integration in the distal part of the stent.

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