Mechanistic approach to the management of cancer-related nausea and vomiting in a palliative care resource-limited setting

2021 ◽  
Vol 27 (7) ◽  
pp. 362-366
Author(s):  
GVM Chamath Fernando ◽  
Jayamangala Sampath Kondasinghe
Keyword(s):  
Symptomatic Relief ◽  
Management Plan ◽  
Nausea And Vomiting ◽  
Resource Limited ◽  
Aged Woman ◽  
Mechanistic Approach ◽  
Causative Factors ◽  
Middle Aged Woman ◽  
Therapeutic Measures ◽  
Case Outcome

Background: Nausea and vomiting are two interrelated distressing symptoms experienced by patients with malignancies. They are multifactorial in aetiology. Case presentation: A middle-aged woman diagnosed with bilateral ovarian malignancy had undergone chemotherapy and was suffering nausea and vomiting, and was responding to basic therapeutic measures. Case management: She was resistant to treatment with metoclopramide that was commenced by the oncology team, as for any patient with nausea and vomiting. This report examines a ‘mechanistic’ approach to nausea management and life-style modifications. Case outcome: Within 2 days of the evidence-based revision of her management plan, the patient expressed that she had experienced a significant symptomatic relief and an improvement in her general wellbeing. Conclusion: The early identification of the most probable causative factors of nausea and vomiting in patients with advanced malignancies will lead to significant improvements in their quality of life and save time and resources.

Christmas Surprises

2020 ◽  
pp. 17-26
Author(s):  
Pat Croskerry
Keyword(s):  
Emergency Department ◽  
Cognitive Processes ◽  
Community Hospital ◽  
Rural Hospital ◽  
Middle Aged ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Case Outcome

Case 1 introduces a middle-aged woman with bradycardia who is transferred from a rural hospital to the emergency department of a community hospital. She has an external pacemaker and is unconscious on arrival. An account of the course of her management is provided, along with an exploration of prevailing conditions and cognitive processes and biases that led to the case outcome.

scholarly journals Case Report-An unusual diagnosis of a gastric phytobezoar in a middle aged woman.

2021 ◽  
Author(s):  
Rumbidzai Chineka ◽  
Tongesai Mukosera ◽  
Narcisious Dzvanga ◽  
Brian Gwanda
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Case Report ◽  
Nausea And Vomiting ◽  
Middle Aged ◽  
Aged Woman ◽  
Middle Aged Woman

A phytobezoar occurring in the stomach is uncommon. The most frequent symptoms are dyspepsia, abdominal pain, nausea and vomiting. It is an important differential to remember in those patients with risk factors for developing phytobezoars, as phytobezoars can be managed conservatively in most cases.

A middle aged woman with isolated ACTH deficiency associated with transient GH deficiency

2014 ◽  
Author(s):  
Michelle Mangual ◽  
Jose Hernan-Martinez ◽  
Monica Santiago ◽  
Carlos Figueroa ◽  
Rafael Trinidad ◽  
...  
Keyword(s):  
Gh Deficiency ◽  
Middle Aged ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency ◽  
Aged Woman ◽  
Middle Aged Woman

scholarly journals P.005 Lisdexamfetamine precipitated pathological gambling

2018 ◽  
Vol 45 (s2) ◽  
pp. S17-S17 ◽  
Author(s):  
F Chaudhary ◽  
A Hirsch ◽  
W MacPherson ◽  
J Nayati
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Nucleus Accumbens ◽  
Pathological Gambling ◽  
Risk Taking ◽  
Gambling Behavior ◽  
Hyperactivity Disorder ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
History Of ◽  
Mental Status Examination

Background: Lisdexamfetamine has not heretofore been reported to cause pathological gambling. Such a case is presented. Methods: A middle-aged woman, without past interest in gambling, gaming, or risk taking behavior, with childhood history of attention deficit hyperactivity disorder presented with difficulty focusing and concentrating. Lisdexamfetamine was started at 20 mg daily and gradually escalated due to lack of efficacy. At 70 mg daily, she began binging on sweets and gambling all day, every day at nearby riverboats, which she had never frequented previously. Upon reduction to 60 mg daily, the gambling resolved. Ritalin 20 mg every morning and 50 mg every afternoon was used without gambling reoccurrence. Results: Mental Status Examination: Alert, cooperative and oriented x 3 with good eye contact. Euthymic, without mania, thoughts logical and goal directed. Conclusions: Enhanced dopamine in the nucleus accumbens may induce hedonic activities including gambling, binging on sweets, or sexual activity (Moore et al. 2014). Lisdexamfetamine has been described to induce mania, and pathological gambling may have been an isolated manifestation of early mania. In those who have recently begun lisdexamfetamine, query should be made regarding change in gambling behavior and in those who are pathologically gambling, investigation should be entertained as to whether they are taking lisdexamfetamine.

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