Recognition and Treatment of the Catatonic Syndrome

1997 ◽  
Vol 12 (3) ◽  
pp. 135-147 ◽  
Author(s):  
Gregory Fricchione ◽  
George Bush ◽  
Manish Fozdar ◽  
Andrew Francis ◽  
Max Fink
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mental Disorders ◽  
Neuroleptic Malignant Syndrome ◽  
Differential Diagnoses ◽  
Suggested Approach ◽  
Syndrome Diagnosis ◽  
History Of ◽  
Catatonic Syndrome ◽  
Malignant Catatonia

We define the catatonic syndrome and review the history of the concept of catatonia, including its recent acceptance as a syndrome. Diagnosis of the catatonic syndrome, with its associated extensive differential diagnoses related to systemic and mental disorders, is addressed. Catatonia is related to variants of the syndrome, such as lethal (malignant) catatonia and the neuroleptic malignant syndrome (NMS). Medical sequelae of these conditions are outlined. The literature on the treatment of the catatonic syndrome is reviewed, and a suggested approach to treatment and management of catatonic patients in the intensive care unit is provided. An hypothesis regarding the neuropathophysiological basis for the syndrome is also offered.

scholarly journals Infection control by point-of-use water filtration in an intensive care unit – a Hungarian case study

2014 ◽  
Vol 12 (4) ◽  
pp. 858-867 ◽  
Author(s):  
Zsófia Barna ◽  
Katalin Antmann ◽  
Judit Pászti ◽  
Renáta Bánfi ◽  
Mihály Kádár ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Pathogenic Bacteria ◽  
Tap Water ◽  
Point Of Use ◽  
History Of ◽  
Health Care Associated Infections ◽  
Waterborne Infection ◽  
Cost Efficient

Hospital tap water is a potential source of pathogenic bacteria associated with nosocomial infections. Infection control should include preventive measures to reduce the risk of waterborne infection. The efficiency of point-of-use water filters in infection control was assessed in the intensive care unit of a Hungarian hospital with long history of nosocomial Pseudomonas aeruginosa cases. All taps in the unit were fitted with disposable point-of-use filters. The incidence of nosocomial P. aeruginosa infections decreased from 2.71 to 0 cases/100 patient days when the filters were in place. Legionnaires' disease was not observed either during or outside the study period. Before the application of the filters, both P. aeruginosa and Legionella sp. were shown to colonize five of the seven taps. Filtration eliminated both bacteria completely, though secondary contamination was observed. Total genome restriction profiling of environmental and clinical P. aeruginosa isolates have shown the ubiquitous presence of a single genotype. The same genotype was detected in five of the seven previous nosocomial cases, which supports the assumption of water-derived infection. The results demonstrate that point-of-use filters are effective and cost-efficient measures in reducing health-care associated infections.

scholarly journals A Case Report of Post-Operative Jöd-Basedow Phenomennon Following Oral and IV Iodine Contrast Administration

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Maureen Higgs ◽  
Erroll Hull ◽  
Eugenio Lujan
Keyword(s):  
Atrial Fibrillation ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Small Bowel ◽  
Multinodular Goiter ◽  
Subclinical Hyperthyroidism ◽  
Contrast Administration ◽  
Iodinated Contrast ◽  
History Of

This is a case of thyrotoxicosis, due to the Jöd-Basedow phenomenon following administration of oral and IV iodinated contrast in a patient with history of gastrointestinal stromal tumor (GIST) and small bowel obstruction. The patient developed atrial fibrillation and had an extended stay in the intensive care unit. Given the aging population with possible subclinical hyperthyroidism, multinodular goiter, and the rise in contrast administration for routine diagnostic studies, this case serves to raise awareness of the risks of “routine” tests administered to our aging patient population.

scholarly journals Audit of the Wheat Pill Cases at Medicolegal Clinic Mayo Hospital Lahore

2021 ◽  
pp. 86-90
Author(s):  
Kanwal Zahra ◽  
Maryam Shahid ◽  
Waqas Aslam ◽  
Usman Shahid Butt ◽  
Nida Zahra
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Mortality Rate ◽  
Age Groups ◽  
Descriptive Study ◽  
Monthly Basis ◽  
History Of ◽  
Medical University ◽  
Time Of Admission

Objective: To determine the audit of wheat pill cases at medicolegal clinic of Mayo Hospital Lahore. Materials and Methods: This descriptive study was conducted at Department of Forensic Medicine and Toxicology (medicolegal clinic), King Edward Medical University Lahore. This audit was of 9 months from September 2020 to May 2021. Patients presented at emergency department with attempt of wheat pills poisoning of all age groups and both genders were included. Cases were diagnosis via history of wheat pills consumption by the relatives. All the cases were given primary recovery and were shifted to the Intensive Care Unit (ICU). Data was collected on monthly basis form September 2020 to May 2021. All the data was collected via study proforma. Results: Total 49 wheat pill cases were observed during 9 months, their mean age was 29.26±12.68 years. Out of all 51.0% were males and 49.0% were females. Labourer males and housewives were most common 34.7% and 40.8% respectively. Frequency of wheat pill cases were high in months of September, October and May. At the time of admission 59.2% cases were seen conscious, 36.7% were semiconscious and 4.1% were unconscious. Out of all 59.2% were died. Conclusion: This study observed that the wheat pills are highly toxic with the quick and high mortality rate. Strict legislations are recommended to the sale control of these pills all over the country.

scholarly journals Scurvy in the Intensive Care Unit

2021 ◽  
Vol 9 ◽  
pp. 232470962110679
Author(s):  
Amarah Baluch ◽  
David Landsberg
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Alcohol Use ◽  
Vitamin C ◽  
The United States ◽  
Vitamin C Deficiency ◽  
History Of ◽  
Hands And Feet ◽  
Work Up ◽  
Modern Era

Scurvy, caused by vitamin C deficiency, is a forgotten disease in the modern era of medicine. The prevalence of vitamin C deficiency in the United States is reported to be 7.1%. We present a case of a 56-year-old man with a history of chronic alcohol use who was admitted to the intensive care unit due to sepsis. He was found to have a rash on his hands and feet which consisted of palpable lesions as well as petechiae. Work up of the patient’s skin pathology revealed ascorbic acid deficiency, also known as scurvy. This case highlights the importance of considering severe nutritional deficiency in patients with underlying alcohol use who present with skin findings that may mimic those of a vasculitis. Although rare, vitamin C deficiency still exists, and it is important to be aware of presenting signs and identify those who are at risk.

scholarly journals Relationship between perinatal period problems and developmental delay in children aged 4-24 months

2020 ◽  
Vol 37 (4) ◽  
pp. 337-348
Author(s):  
Masoumeh Kaviani ◽  
Zhaleh Ranjbaran ◽  
Roksana Janghorban
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Developmental Delay ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Fetal Distress ◽  
Perinatal Period ◽  
Medical Problems ◽  
History Of

Normal development is one of the reliable criteria for the assessment of children's health status. Perinatal events affect the future development of children. Nevertheless, there are different views on the impact of events in the perinatal period on child development. The aim of this study was to determine the relationship between perinatal period and developmental delay in 4-24-month-old children. Three hundred and thirty children aged 4-24 months who were referred to Imam Reza Clinical Development Center and Shiraz Health Centers were enrolled. Information about perinatal events was collected by a researcher-made questionnaire containing demographic and reproductive information related to pregnancy, delivery and neonatal period. The developmental status of children was evaluated by age and stage questionnaire. Data were analyzed using Chi-square, Mann-Whitney and logistic regression by SPSS version 14. Sex (P = 0.025), maternal medical problems (P = 0.011), fetal distress (P = 0.022), history of hospitalization in the neonatal intensive care unit (P < 0.001), severe neonatal jaundice (P = 0.005) and small for gestational age (P= 0.012) after controlling the confounding of other factors had a significant effect on developmental delay. The results of this study showed that being male, having maternal medical problems, fetal distress, the history of hospitalization in the neonatal intensive care unit, severe neonatal jaundice and small for gestational age can predict developmental delay. Special attention to screening of children who are at risk of developmental delay due to perinatal conditions can be effective in early diagnosis of developmental delay.

scholarly journals Oral Health of COVID-19 Patients Using Extracorporeal Membrane Oxygenation: A Clinical Study of 19 Cases

2021 ◽  
Vol 11 (1) ◽  
pp. 42
Author(s):  
Aya Yoshino ◽  
Yoshihiko Nakamura ◽  
Yuhei Irie ◽  
Taisuke Kitamura ◽  
Tohru Takata ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Oral Health ◽  
Extracorporeal Membrane Oxygenation ◽  
Univariate Analysis ◽  
Membrane Oxygenation ◽  
Health History ◽  
History Of ◽  
Health Deterioration

The oral health of coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU) is an important issue in treatment of respiratory failure. We retrospectively investigated the oral health history of severe COVID-19 patients who received extracorporeal membrane oxygenation (ECMO) from April 2020 to December 2020 using the oral assessment guide from Fukuoka University (OAG-F). Nineteen consecutive patients (median age: 62 years) were divided into two groups according to survival (survivors, n = 12; non-survivors, n = 7). A univariate analysis revealed no significant differences between the groups in sex, age, body mass index (BMI), or the number of remaining teeth, whereas the ECMO assistance of non-survivors (median: 34 days) was prolonged in comparison to survivors (median: 8 days; p < 0.05). Among the factors of OAG-F, significant differences were observed between the groups in the conditions of the saliva, mucous membrane, and gingiva. The total scores in non-survivors (median: 19) were significantly higher in comparison to survivors (Median: 15.5), suggesting that the frequency of oral health deterioration was higher in non-survivors (p < 0.05). Taken together, these findings suggest that poor oral health is associated with mortality in COVID-19 patients receiving ECMO in the ICU.

Vertebral Artery-Posteroinferior Cerebellar Artery Aneurysms: Clinical and Lower Cranial Nerve Outcomes in 52 Patients

Neurosurgery ◽  
2005 ◽  
Vol 56 (1) ◽  
pp. 2-11 ◽  
Author(s):  
Hisham Al-khayat ◽  
Haitham Al-Khayat ◽  
Joseph Beshay ◽  
David Manner ◽  
Jonathan White ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Natural History ◽  
Vertebral Artery ◽  
Nosocomial Pneumonia ◽  
Cranial Nerve ◽  
Lower Cranial Nerve ◽  
Cerebellar Artery ◽  
History Of ◽  
Pica Aneurysms

AbstractOBJECTIVE:To identify factors predictive of postoperative lower cranial nerve palsy (LCNP) among patients undergoing surgery for vertebral artery (VA)- posteroinferior cerebellar artery (PICA) aneurysms. The natural history of this LCNP is defined, and its effect on postoperative patient course is analyzed. No similar study has been described in the literature.METHODS:Fifty-two patients with VA-PICA aneurysms, who were treated surgically between 1996 and 2002, were retrospectively studied to identify factors contributing to postoperative LCNP. The effect of LCNP on intensive care unit stay and development of nosocomial pneumonia also was analyzed. All analyses were performed with Fisher's exact test.RESULTS:Postoperative LCNP occurred in 25 patients (48.1%) with VA-PICA aneurysms. Of the factors investigated, the use of temporary or total occlusion was associated with increased incidence of postoperative LCNP (P &lt; 0.001). The average length of stay in the intensive care unit was 13.8 days for patients with LCNP defined as moderate to severe, compared with 7.92 days for patients with LCNP defined as none or mild (P = 0.0014). Nosocomial pneumonia occurred only in patients with moderate to severe LCNP (P = 0.022). Postoperative LCNP resolved completely within 3 months in 12 patients (48%) and within 6 months in 19 patients (76%).CONCLUSION:The results of this study can help to identify the effect and natural history of LCNP after surgical clipping of VA-PICA aneurysms. This information may assist neurosurgeons in expediting treatment, decrease the cost and length of hospital stays, and result in improved outcomes.

Malignant catatonia and neuroleptic malignant syndrome: How different/similar are they?

2016 ◽  
Vol 33 (S1) ◽  
pp. S640-S640 ◽  
Author(s):  
P. Sales ◽  
M. Bernardo ◽  
A. Lopes ◽  
E. Trigo
Keyword(s):  
Supportive Care ◽  
Neuroleptic Malignant Syndrome ◽  
Specific Treatment ◽  
Hemodynamic Instability ◽  
Psychotic Symptoms ◽  
Muscle Rigidity ◽  
Life Threatening ◽  
History Of ◽  
Competing Interest ◽  
Malignant Catatonia

IntroductionCatatonia is a neuropsychiatric syndrome that appears in medical, neurological or psychiatric conditions. There are presentation variants: “malignant catatonia” (MC) subtype shares many characteristics with the neuroleptic malignant syndrome (NMS), possibly reflecting common pathophysiology.Objectives/methodsWe present a clinical vignette and review the literature available on online databases about MC/NMS.ResultsWe present a man, 41-years-old, black ethnicity, with no relevant medical history. He had two previous episodes compatible with brief psychosis, the last one in 2013, and a history of adverse reactions to low doses of antipsychotics. Since the last episode he was asymptomatic on olanzapine 2.5 mg id. He acutely presented to the Emergency Room with mutism, negativism, immobility and delusional speech, similar to the previous episodes mentioned and was admitted to a psychiatric infirmary, where his clinical condition worsened, showing muscle rigidity, hemodynamic instability, leukocytosis, rhabdomyolysis and fever. Supportive care was provided, olanzapine was suspended and electroconvulsive therapy (ECT) was initiated. After two months, he was discharged with no psychotic symptoms. He is still under ECT and no antipsychotic medication was reintroduced.Discussion/conclusionMany studies suggest that clinical or laboratory tests do not distinguish MC from NMS and that they are the same entity. These two conditions are life-threatening and key to treatment is a high suspicion level. There is no specific treatment; supportive care and stopping involved medications are the most widely used measures. ECT is a useful alternative to medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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