scholarly journals Suicidal attempt with caffeine overdose treated with dexmedetomidine: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Teppei Kitano ◽  
Masaki Okajima ◽  
Koji Sato ◽  
Toru Noda ◽  
Takumi Taniguchi
Keyword(s):  
Case Report ◽  
Sinus Tachycardia ◽  
Qt Prolongation ◽  
Cardiac Events ◽  
Sympathetic Nerve Stimulation ◽  
Case Presentation ◽  
Japanese Male ◽  
Adverse Cardiac Events ◽  
Old Japanese ◽  
Caffeine Overdose

Abstract Background Caffeine is a widely used dietary stimulant, and cases of caffeine overdoses, sometimes leading to death, are increasing. We encountered a case of caffeine intoxication resolved with administration of the sedative agent dexmedetomidine. Case presentation We administered dexmedetomidine for sedation and to suppress sympathetic nerve stimulation in the case of an 18-year-old Japanese male who ingested a massive dose of caffeine with the intention of committing suicide. The patient was in an excited state and had hypertension, sinus tachycardia, and hypokalemia with prominent QT prolongation. After dexmedetomidine administration, the patient’s mental state, hemodynamics, and electrolyte levels were improved immediately. He was discharged without any sequelae 3 days later. Conclusion Cases of acute caffeine intoxication with agitation, sympathetic overactivity and adverse cardiac events would benefit with dexmedetomidine treatment.

scholarly journals Unicuspid aortic valve concomitant with aortic insufficiency presenting with infectious endocarditis: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Naoko Yuzawa-Tsukada ◽  
Toshikazu D. Tanaka ◽  
Satoshi Morimoto ◽  
Michihiro Yoshimura
Keyword(s):  
Case Report ◽  
Aortic Valve ◽  
Aortic Insufficiency ◽  
Infectious Endocarditis ◽  
Cardiac Abnormality ◽  
Case Presentation ◽  
Old Japanese ◽  
History Of ◽  
Nonbacterial Thrombotic Endocarditis ◽  
High Turbulence

Abstract Background A unicuspid aortic valve is a rare congenital cardiac abnormality. Despite its uncommon finding on an initial presentation, aortic insufficiency is accompanied with unicuspid aortic valve and this might reflect the natural history of progression in the morphology of unicuspid aortic valve. Case presentation We describe a 65-year-old Japanese man who was evaluated for endocarditis and found to have a unicuspid aortic valve concomitant with moderate aortic insufficiency, which was, owing to the lack of evidence of valve membrane destruction, independent of underlying infectious endocarditis. In addition, aortic insufficiency was progressed because of nonbacterial thrombotic endocarditis on the ventricular side, in areas of high turbulence around the heart valve. Conclusions Our case is unusual given the unicuspid aortic valve concomitant with aortic insufficiency, which was presumably independent of underlying infectious endocarditis because of the location of the vegetation and the lack of evidence of valve destruction. Therefore, attention should be paid to a variety of complications in the setting of unicuspid aortic valve.

PISIFORM AND HAMATE COALITION: CASE REPORT AND REVIEW OF LITERATURE

Hand Surgery ◽  
2005 ◽  
Vol 10 (01) ◽  
pp. 101-104 ◽  
Author(s):  
Kenji Kawamura ◽  
Hiroshi Yajima ◽  
Yoshinori Takakura
Keyword(s):  
Case Report ◽  
Rare Condition ◽  
Carpal Bones ◽  
Review Of Literature ◽  
Symptomatic Case ◽  
Rare Anomaly ◽  
Japanese Male ◽  
Old Japanese

Pisiform and hamate coalition is a rare anomaly of the carpal bones; a symptomatic case is an especially rare condition. We report a case of symptomatic pisiform and hamate coalition in a 15-year-old Japanese male. The literature of pisiform and hamate coalition is reviewed.

scholarly journals Pharmacokinetics of Levodopa before and after Gastrointestinal Resection in Parkinson's Disease

2015 ◽  
Vol 7 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Hiroshi Nagayama ◽  
Yusuke Kajimoto ◽  
Tomoaki Kumagai ◽  
Yasuhiro Nishiyama ◽  
Masahiro Mishina ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Outcome ◽  
Drug Concentration ◽  
Area Under The Curve ◽  
Case Presentation ◽  
Time To Peak ◽  
Japanese Male ◽  
Before And After ◽  
Old Japanese

Introduction: Levodopa (LD) is important in the clinical treatment of Parkinson's disease (PD), and the changes of its pharmacokinetics may affect the clinical outcome. LD is mainly absorbed in the upper intestine; thus, the pharmacokinetics of LD may change after gastrointestinal operation. Here, we present the case of a patient who underwent resection of the intestine and compared his LD pharmacokinetics before and after resection. Case Presentation: A 72-year-old Japanese male PD patient developed jaundice and was diagnosed with cholangiocarcinoma. Pancreaticoduodenectomy was performed and part of the stomach, total duodenum, and part of the jejunum were resected. The patient had been treated with LD, and his pharmacokinetics was checked twice at the age of 68 years. Because LD is absorbed in the duodenum and jejunum, we checked his pharmacokinetics again after the operation. The results before the operation were almost similar; however, in comparison, the area under the curve and peak drug concentration was reduced, and the time-to-peak drug concentration and elimination halftime were elongated after the operation. Conclusion: Physicians must pay attention to the change of LD pharmacokinetics after gastrointestinal operation.

scholarly journals Facial onset sensory and motor neuropathy in a pain clinic outpatient: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hiroki Hanawa ◽  
Ryo Nagaoka ◽  
Yuya Fukuda ◽  
Kazuya Akutsu ◽  
Teppei Yamada ◽  
...  
Keyword(s):  
Case Report ◽  
Nerve Palsy ◽  
Pain Clinic ◽  
Motor Neuropathy ◽  
Cervical Pain ◽  
Case Presentation ◽  
Previous Diagnosis ◽  
Old Japanese ◽  
Cervical Facet ◽  
Facet Arthropathy

Abstract Background Facial onset sensory and motor neuropathy is a very rare sensorimotor disorder characterized by facial onset and gradual progression, with approximately 100 cases reported worldwide in 2020. We report on our experience with a facial onset sensory and motor neuropathy case in our outpatient pain clinic. Case presentation A 71-year-old Japanese man with a previous diagnosis of trigeminal nerve palsy complained of facial paresthesia, cervical pain, and arm numbness. Cervical facet arthropathy was diagnosed initially, but neither pharmacotherapy nor nerve blocking alleviated his symptoms. We suspected bulbar palsy based on the presence of tongue fasciculation, which prompted referral to a neurologist. Based on a series of neurological examinations, facial onset sensory and motor neuropathy was ultimately diagnosed. Conclusions Pain clinicians must be mindful of rare diseases such as facial onset sensory and motor neuropathy; if they are unable to make a diagnosis, they should consult with other competent specialists.

scholarly journals Fibrolamellar Carcinoma of The Liver — A Case Report From Japan and a Review of The Literature

HPB Surgery ◽  
1988 ◽  
Vol 1 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Hitoshi Kohno ◽  
Naofumi Nagasue ◽  
Hiroyuki Taniura ◽  
Teruhisa Nakamura ◽  
Sabro Nagaoka
Keyword(s):  
Hepatocellular Carcinoma ◽  
Case Report ◽  
Review Of The Literature ◽  
Palliative Operation ◽  
Japanese Case ◽  
Japanese Male ◽  
Old Japanese ◽  
Fibrolamellar Carcinoma

The first Japanese case of fibrolamellar carcinoma (FLC) of the liver is described. The 17-year-old Japanese male affected died of the disease 25 months after palliative operation. The diagnosis of FLC had not been confirmed before autopsy. Pre-operative diagnosis of FLC is important to surgeons. Acccording to the literature, FLC is rare in Asia. The endemic discrepancy may suggest that the carcinogenic factors are different from those of general hepatocellular carcinoma.

An Obscure Colon Dilatation and its Underlying Cause: Case Report and Literature Review

2020 ◽  
pp. 1-5
Author(s):  
Anton Stift ◽  
Kerstin Wimmer ◽  
Felix Harpain ◽  
Katharina Wöran ◽  
Thomas Mang ◽  
...  
Keyword(s):  
Case Report ◽  
Sigmoid Colon ◽  
Immunohistochemical Staining ◽  
Late Onset ◽  
Hirschsprung Disease ◽  
Endoscopic Examination ◽  
Case Presentation ◽  
Idiopathic Megacolon ◽  
History Of ◽  
Cells Of Cajal

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.

Descending Cervical-Sacral Pain after the Administration of Antivenom to the Scorpion Sting Poisoning: A Case Report

2020 ◽  
Vol 2 (2) ◽  
pp. 93-96
Author(s):  
Josué Saúl Almaraz Lira ◽  
Alfredo Luis Chávez Haro ◽  
Cristian Alfredo López López ◽  
Remedios del Pilar González Jiménez
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Case Report ◽  
Signs And Symptoms ◽  
Cervical Region ◽  
Scorpion Sting ◽  
Case Presentation ◽  
Sacral Region ◽  
Scorpion Stings

Introduction. Scorpion stings occur mainly in spring and summer, with an estimate of 1.2 million cases per year worldwide. About 300,000 poisonings occur within a year, primarily affecting children and adults older than 65 years. In 2019, Guanajuato (Mexico) ranked third in poisoning by scorpion sting with a total of 43,913 cases. The intoxication grades are three where the signs and symptoms are varied. There are two types of antivenom in the Mexican market, and we use Alacramyn® in our case. Case presentation. A 70-year-old female —with grade 1 scorpion sting poisoning, 30 minutes of evolution, with type 2 diabetes and high blood pressure— received two vials of antivenom according to current regulations. She presented transient vagal reaction and subsequent transient pain in the cervical region that radiates to the sacral region. At discharge, there are no data compatible with scorpion sting poisoning. Conclusions. Transient pain in the cervical region to the sacral region may be secondary to an anxiety crisis, hypersensitivity to IgG, or secondary reaction to administration in less time than recommended by the provider. The benefit was greater than the reactions that occurred.

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