scholarly journals O Poder Psicoativo dos Alimentos: Análise de um Caso de Intoxicação com Noz-Moscada

2019 ◽  
Vol 33 (13) ◽  
Author(s):  
Desidério Duarte ◽  
Marta Mendonça ◽  
Luís Ramos
Keyword(s):  
Psychotic Episode ◽  
Psychomotor Agitation ◽  
Specialist Consultation ◽  
Delusional Ideation ◽  
Psychoactive Effects ◽  
High Doses ◽  
Disorganized Speech ◽  
One Year ◽  
Clinical Stability

Ingestion of high doses of nutmeg causes potentially serious and disabling medical and psychiatric consequences. No isolated component of nutmeg has been identified as responsible for all symptoms observed during intoxication, however myristicin, one of the essential oil’s components of this spice, is believed to be responsible for most psychoactive effects, although the exact mechanism is not known. Other constituents, such as elemicin, may also be involved. Symptoms of intoxication begin three to six hours after ingestion, resolve within the first 48 hours, and usually leave no sequelae. In this paper we present the case of a patient who after consuming 18 to 28 g of nutmeg developed a severe psychotic episode, with disorganized speech, psychomotor agitation and mystical/grandiose delusional ideation. The symptoms resolved quickly, and after one year of clinical stability without therapy, was discharged from the specialist consultation.

Cognitive impairment in long-term benzodiazepine users

1988 ◽  
Vol 18 (2) ◽  
pp. 365-374 ◽  
Author(s):  
Susan Golombok ◽  
Parimala Moodley ◽  
Malcolm Lader
Keyword(s):  
Neuropsychological Tests ◽  
Matched Control ◽  
Control Group ◽  
Therapeutic Practice ◽  
The Past ◽  
Visual Spatial ◽  
Wide Range ◽  
High Doses ◽  
One Year

SynopsisIn view of the very extensive and often prolonged use of benzodiazepines in therapeutic practice, this study was designed to investigate whether or not cognitive ability is impaired in longterm benzodiazepine users, and to determine the nature and extent of any deficit. Fifty patients currently taking benzodiazepines for at least one year, thirty-four who had stopped taking benzodiazepines, and a matched control group of subjects who had never taken benzodiazepines or who had taken benzodiazepines in the past for less than one year were administered a battery of neuropsychological tests designed to measure a wide range of cognitive functions. It was found that patients taking high doses of benzodiazepines for long periods of time perform poorly on tasks involving visual-spatial ability and sustained attention. This is consistent with deficits in posterior cortical cognitive function.

scholarly journals Cystic Echinococcosis: Late Rupture and Complication of a Stable Pulmonary Cyst

2011 ◽  
Vol 18 (5) ◽  
pp. 258-260 ◽  
Author(s):  
J Fisher ◽  
Y Shargall ◽  
S Krajden ◽  
F Moid ◽  
V Hoffstein
Keyword(s):  
Cystic Echinococcosis ◽  
Bronchogenic Cyst ◽  
Surgical Drainage ◽  
Traditional Management ◽  
Acute Rupture ◽  
Invasive Surgical Approach ◽  
Asymptomatic Individuals ◽  
One Year ◽  
Pulmonary Cyst ◽  
Clinical Stability

Cystic echinococcosis is observed worldwide. Traditional management includes an invasive surgical approach with adjunctive chemotherapy. It has been suggested that observation alone may be appropriate in asymptomatic individuals with stable cysts. A case involving a 38-year-old Peruvian man with an asymptomatic bronchogenic cyst (suspected to be due to echinococcus, but never definitely diagnosed) is presented. The cyst was first noted in 1998, and was followed for 10 years during which time he remained asymptomatic with minimal radiographic change. One year later, in 2009, he presented with acute rupture of the cyst causing empyema. The patient required thoracotomy, decortication and resection of the ruptured cyst. Final pathology showedEchinococcusorganisms. The patient responded well to treatment with albendazole and praziquantel, and became completely asymptomatic within six months.The present case demonstrates that echinococcal cysts may be at risk of spontaneous rupture, even after many years of clinical stability, thus supporting the case for resection of asymptomatic cysts suspected of being echinococcal at the time of diagnosis. In addition, the case illustrates that medical therapy with albendazole and praziquantel, in conjunction with surgical drainage, can be successful in the treatment of echinococcal empyema.

scholarly journals A Rare Case of Aicardi-Goutières Syndrome Who Showed a Positive Evolution after Being Treated with Growth Hormone, High Doses of Melatonin and Neurorehabilitation

2017 ◽  
Author(s):  
Jesús Devesa ◽  
Alba Alonso ◽  
Patricia Porto ◽  
Ana Quintana ◽  
María Carrillo ◽  
...  
Keyword(s):  
De Novo ◽  
Oral Communication ◽  
Blood Analysis ◽  
De Novo Mutation ◽  
Fine Motor ◽  
Unknown Etiology ◽  
Psychomotor Delay ◽  
Developmental Skills ◽  
High Doses ◽  
One Year

1) Background: The Aicardi-Goutières syndrome (AGS) is a rare congenital disease which courses with severe psychomotor delay in neurodevelopment. We studied a 3-years and 4-months old child with very important growth and weight affectation, microcephaly and loss of his developmental skills from 16-months of age, in which previous metabolic and genetic studies discarded any abnormality. Therefore diagnosis was cerebral palsy of unknown etiology. He presented spastic paraparesia, poor fine motricity, cognitive impairment and absence of oral communication. One year after discharge, a de novo mutation was detected in a single nucleotide in the gene IFIH1: c.2317G>C, being then diagnosed of AGS. 2) Methods: Blood analysis showed very low IGF-1 and slightly elevated liver transaminases. Treatment consisted in GH (0.04 mg/kg/day), melatonin (20 mg/day, and after 3-months 50 mg/day), and daily intense neurorehabilitation (5 days/week). Tests for evaluating childhood developmental milestones (GMFM-88, BDIST and the WeeFim test) were carried out every 3-months. 3) Results: The equivalent age at admission (10-months) increased to 24-months at discharge. There were clear improvements in spasticity, fine motor function, swallowing, cognition and autonomy as well as in communication, growth and weight. 4) Conclusion: Most likely melatonin blocked or decreased the interferon signature, allowing GH and neurorehabiltation to act on neurodevelopment.

scholarly journals Acute Benign Hepatitis Due to Glycogen Hepatopathy

2021 ◽  
pp. 1-2
Author(s):  
Adel Ekladious ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Abdominal Pain ◽  
Type Ii Diabetes ◽  
Liver Enzymes ◽  
Type Ii Diabetes Mellitus ◽  
Timely Manner ◽  
Benign Condition ◽  
High Doses ◽  
One Year

Glycogen hepatopathy is a very rare and forgotten complication of poorly controlled type 1 diabetes mellitus. Glycogen hepatopathy may also present in type II diabetes mellitus, especially when managed with high doses of insulin. Although it is a benign condition, it is rarely diagnosed in a timely manner. It is characterised by hepatomegaly causing abdominal pain due to stretch on the liver capsule causing capsulitis, and derangement of liver enzymes. In this article we report a patient who presented with severe abdominal pain, hepatomegaly and transaminitis, the symptoms persisted for one year before the diagnosis of glycogen hepatopathy was made.

Nicotinamide (NA) Treatment Improves Response to G-CSF in Severe Congenital Neutropenia (SCN) Patients

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 38-38
Author(s):  
Ekaterina Deordieva ◽  
Julia Skokowa ◽  
Anna Shcherbina ◽  
Galina Novichkova ◽  
Alexey Maschan ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Conflicts Of Interest ◽  
Bone Marrow Failure ◽  
Bone Marrow Failure Syndrome ◽  
Cyclic Neutropenia ◽  
Patients Âgés ◽  
Life Threatening ◽  
Leukemia Development ◽  
High Doses ◽  
One Year

Background: SCN is an inherited bone marrow failure syndrome with markedly reduced granulocyte numbers and functions that often manifests with life-threatening bacterial infections. G-CSF treatment is the primary therapeutic approach, yet some SCN patients require high doses of G-CSF which increases the risk of acute myeloid leukemia development, or do not respond to GCSF at al. We have demonstrated that nicotinamide (NA) treatment increases granulocyte numbers in healthy volunteers. Aim: To asses the effect of NA treatment in SCN and cyclic neutropenia (CyN) patients. Methods: 15 SCN and three CyN patients ages 0.5 to 31 (M-5.47) years were orally treated with 20 mg/kg/day of NA in addition to G-CSF therapy. G-CSF dose varied between 0.6 and 50.8 µg/kg/day before start of NA treatment. Results: After three months of NA treatment, absolute neutrophil counts (ANC) increased from median 0.80 x 109/l (Q1 0.61, Q3 1.29 x 109/l) to 1.77 x 109/l (Q1 1.49, Q3 2.33 x 109/l) (p < 0.001). This allowed G-CSF dose reduction from 15 µg/kg/day (Q1 5, Q3 25 µg/kg/day) to 10 µg/kg/day (Q1 1.77, Q3 15.16 µg/kg/day) in 17 patients, and complete G-CSF tapering in one patient. After one year of observations, ANC were 1.50 x 109/l (Q1 0.99, Q3 2.86 x 109/l), median increase of ANC from start of therapy was 0.89 x 109/l fold (Q1 0.39, Q3 1.57; р = 0.004). NA was well tolerated, without severe adverse events. We also observed a marked reduction of the frequency and severity of bacterial infections upon combination of NA and G-CSF. Conclusions: In our group of SCN/CyN patients, NA treatment led to increased neutrophil counts and decreased required G-CSF doses with continuous clinical and laboratory responses. We also observed a reduction of the frequency and severity of bacterial infections. Therefore, the use of NA in combination with a reduced dose of G-CSF for the treatment of SCN and CyN patients is promising and should be further investigated in a larger cohort of patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals The NIMO Scandinavian Study: A Prospective Observational Study of Iron Isomaltoside Treatment in Patients with Iron Deficiency

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Svein Oskar Frigstad ◽  
Anne Haaber ◽  
Antal Bajor ◽  
Jan Fallingborg ◽  
Per Hammarlund ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Prospective Observational Study ◽  
Intravenous Iron ◽  
Lower Probability ◽  
Significant Treatment ◽  
The Mean ◽  
Clinically Significant ◽  
High Doses ◽  
One Year ◽  
Over Time

Background. Intravenous iron allows for efficient and well-tolerated treatment in iron deficiency and is routinely used in diseases of the gastrointestinal tract. Objective. The aims of this study were to determine the probability of relapse of iron deficiency over time and to investigate treatment routine, effectiveness, and safety of iron isomaltoside. Methods. A total of 282 patients treated with iron isomaltoside were observed for two treatments or a minimum of one year. Results. Out of 282 patients, 82 had Crohn’s disease and 67 had ulcerative colitis. Another 133 patients had chronic blood loss, malabsorption, or malignancy. Patients who received an iron isomaltoside dose above 1000 mg had a 65% lower probability of needing retreatment compared with those given 1000 mg. A clinically significant treatment response was shown, but in 71/191 (37%) of patients, anaemia was not corrected. The mean dose given was 1100 mg, lower than the calculated total iron need of 1481 mg. Adverse drug reactions were reported in 4% of patients. Conclusion. Iron isomaltoside is effective with a good safety profile, and high doses reduce the need for retreatment over time. Several patients were anaemic after treatment, indicating that doses were inadequate for full iron correction. This trial is registered with NCT01900197.

The evolution of cognitive functioning in adolescents with early onset psychosis

2016 ◽  
Vol 33 (S1) ◽  
pp. S345-S346
Author(s):  
A. Bohus
Keyword(s):  
Cognitive Functioning ◽  
Visual Processing ◽  
Early Onset ◽  
Verbal Learning ◽  
Wisconsin Card Sorting Test ◽  
Psychotic Episode ◽  
Control Group ◽  
Spatial Learning And Memory ◽  
Early Onset Psychosis ◽  
One Year

IntroductionCognitive deficits (executive functions, verbal and spatial learning and memory, visual processing and attention) are a fundamental trait of schizophrenia.ObjectiveThe main objective of this study is to compare the cognitive functioning in psychotic adolescents at the psychosis onset and after one year, using psychological tests.MethodsThis is a longitudinal study, during a period of two years and a half. Twenty-eight patients with first psychotic episode agreed to participate to this study and were assessed during their hospitalization in a university clinic for child and adolescent psychiatry in Cluj-Napoca, Romania. The diagnosis was based on DSM-IV criteria. All the patients were initially assessed for intelligence level using Raven Test and those with mental retardation were excluded. After one year, sixteen adolescents from the initial group were reassessed. The cognitive functioning was assessed with Trail Making A and B, verbal fluency tasks, Wisconsin Card Sorting Test and Rey Auditory Verbal Learning Test. The results from patients group were compared with those from healthy controls.ResultsThe results show weaker global cognitive performance from adolescents with early onset psychosis, initially and at one-year evaluation, than the healthy adolescents from the control group.ConclusionsThis results are consistent with those of previous studies. The adolescents with early onset psychosis show multiple cognitive impairments initially and one year after the psychosis onset.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The relevance of Paraphrenia: Case report

2017 ◽  
Vol 41 (S1) ◽  
pp. S699-S699
Author(s):  
M. Peixoto ◽  
M.M. Oliveira ◽  
M. Bragança
Keyword(s):  
Case Report ◽  
Psychotic Episode ◽  
Psychiatric Ward ◽  
Cognitive Deterioration ◽  
Medical Work ◽  
First Psychotic Episode ◽  
Not Otherwise Specified ◽  
Personality Changes ◽  
Competing Interest ◽  
Disorganized Speech

IntroductionParaphrenia is a chronic psychotic disorder with a better-preserved affect and minimal disturbances of emotion and volition and a much less cognitive deterioration and personality changes.Objectives/aimsTo report a case with probable Paraphrenia and to highlight the importance of the differential diagnosis in a first psychotic episode.MethodsCase report and systematic review of the literature.ResultsWe report a case of a 41-year-old man without a past psychiatry history that was led to the psychiatry emergency department (PED), by officers, because of strange behaviour and aggressiveness towards his family. In the PED the patient said that his real father was his father-in-law and that his ex-wife was his sister. His mental exam revealed disinhibition, disorganized speech with slightly mood elation, persecutory, mystic and influential delusions with various delusional interpretations. After being admitted to the psychiatric ward, in compulsatory care, he began treatment and a medical work up was completed. According to the family the patient had begun this strange behaviour four years prior. During the hospitalization it became clear that the patient was experiencing imaginative-confabulatoric multi-thematic delusions, sometimes interviewer guided, without showing cognitive deterioration and retaining his personality.ConclusionsThe diagnosis of atypical psychosis or psychosis not otherwise specified is not satisfactory since it agglutinates different conditions together. Paraphrenia is a well-established concept and should be used in order to define a group of psychotic patients who exhibited characteristic symptoms of schizophrenia, minus personality impairment and slower cognitive decline.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Gram negative rod meningitis due to Strongyloides stercoralis

2017 ◽  
Vol 4 (2) ◽  
pp. 28
Author(s):  
Nicholas S. Hendren ◽  
Shahzad Chindhy ◽  
Kaylee Shepard
Keyword(s):  
Strongyloides Stercoralis ◽  
Altered Mental Status ◽  
Chronic Infections ◽  
Travel History ◽  
Gram Negative ◽  
Immunosuppressive Medications ◽  
Dexamethasone Therapy ◽  
Immunosuppressed Patients ◽  
High Doses ◽  
One Year

A 57-year-old male Mexican immigrant living in Dallas presented with altered mental status, progressive confusion, mild headache and fevers. He was diagnosed with embryonal liver sarcoma one year prior to admission and had recently started dexamethasone therapy for metastatic spinal lesions. Blood and cerebrospinal fluid cultures from a lumbar puncture were both positive for Escherichia coli. He was diagnosed with spontaneous gram negative rod (GNR) meningitis. Given his travel history, immunosuppression and GNR meningitis, a stool ova and parasite sample was obtained to screen for Strongyloides stercoralis. His stool was markedly positive for Strongyloides stercoralis larvae and he was further diagnosed with Strongyloides hyperinfection syndrome. Strongyloides is capable of chronically re-infecting human hosts without an external life cycle via autoinfection. In chronic infections, hyperinfection can be triggered with immunosuppressive medications, especially steroids. Disseminated Strongyloides should be considered as the source for unexplained GNR bacteremia or meningitis especially in immunosuppressed patients. Our patient likely had a chronic asymptomatic Strongyloides infection acquired in Mexico that became a hyperinfection resulting in GNR meningitis after starting high doses of dexamethasone.

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