Modafinil Augmentation of Mirtazapine in a Failure-to-Thrive Geriatric Inpatient

2002 ◽  
Vol 32 (4) ◽  
pp. 405-410 ◽  
Author(s):  
Jason E. Schillerstrom ◽  
Jeff S. Seaman

The failure-to-thrive syndrome in geriatric patients is marked by social withdrawal, apathy, depression, anorexia, and cognitive impairment. For therapy to be effective, the treatment plan must target several of these areas. This case report describes one such course of treatment for a patient with multiple myeloma with failure-to-thrive who was successfully treated with modafinil and mirtazapine. By using combination pharmacotherapy, we were able to achieve immediate results in a gravely ill patient.

2020 ◽  
Vol 23 (2) ◽  
pp. 28-33
Author(s):  
Indira Apriantika ◽  
Agung Krismariono

A healthy and beautiful smile can affect appearance and confidence. One of the aesthetic problems in dentistry that is often complained of by patients is excessive gingival display (gummy smile). The excessive gingival display can be caused by several factors, one of which is altered passive eruption (APE). One of the treatments to correct gummy smile related to APE is crown lengthening. Crown lengthening can be with bone reduction (gingivectomy with bone reduction) or without bone reduction (gingivectomy). Crown Lengthening with bone reduction is a surgical procedure that aims to maintain the dentogingival complex and to improve smile aesthetics. The purpose of this case report is to determine the crown lengthening with bone reduction (gingivectomy with bone reduction) procedure as a gummy smile treatment related to APE .A23-year-old female patient, came to Dental Hospital of Universitas Airlangga with complaints of her upper gum which not in the same length and the teeth looked short, she considered her smile was less aesthetic. After conducting analyses relating to aesthetics and periodontal tissue, crown lengthening with bone reduction was chosen for this patient treatment. The treatment results are quite good, visible gingival margins that matched the gingival zenith and improved patient's smile profile. APE as the etiology of patient's gummy smile can be corrected. There are no post-surgical complications such as excessive pain and infection. A proper diagnosis, treatment plan, and good techniques can produce a harmonious smile on the patient.


2017 ◽  
Vol 1 (1) ◽  

Aim: The aim of this report is to describe the management of a prosthodontic patient expressing unrealistic expectations with respect to the transition to edentulousness. Objectives: To outline (1) the diagnosis and explicit expectations of the patient on presentation (2) considerations made during treatment planning to address the wishes of the first time prosthodontic patient (3) a sequential treatment plan utilizing transitional partial removable dentures to manage the change to edentulousness (4) functional and aesthetic result achieved. Results: Delivery of immediate removable partial dentures retaining key abutment teeth in upper and lower arches was a viable prosthodontic solution in the transition to edentulousness of a patient expecting unrealistic treatment outcomes. Conclusions: Addressing impractical expectations and devising a treatment plan amenable to both clinician and patient is difficult. Strategies to manage these wishes in prosthodontic dentistry can include transitional partial dentures. Clinical relevance: Practitioners who encounter similar situations may consider this report valuable.


2019 ◽  
Author(s):  
Eithar Deyab ◽  
Muhammad Esakji ◽  
Neil Rabin ◽  
Ravi Menon ◽  
Girish Rayanagoudar

2020 ◽  
Vol 12 (45) ◽  
pp. 24-33
Author(s):  
Fábio Shiniti Mizutani ◽  
Atila de Freitas ◽  
Adriano Sapata ◽  
Claudio Sato

Keeping in mind the final result is the basis of any type of treatment, especially those in which the morphology, size and proportion of the anterior teeth will be changed. This is where a good treatment plan based on a diagnostic wax-up tested with a mock-up and approved by the patient becomes crucial. This case report aims to exemplify how to transfer the diagnostic information to the patient’s mouth and direct it not only to the restorative dentistry, but also to the surgeon when performing the crown length. Diagnostic waxing was performed by the laboratory technician, obeying anterior posterior incisal and gingival criteria and curvatures, which were transported to an aesthetic guide through mock up to mark the surgical points. Then, surgery to increase the clinical crown with bone access and after healing, direct venners in composite resin also guided by waxing. In conclusion, a workflow can be established using the wax-up / mock-up that serves as a guide for the periodontist in the approach to surgical lengthening of the crown and for the rehabilitator who uses it to produce changes in the shape of dental dimensions .


2015 ◽  
pp. 280-289

Background: It is known that traumatic brain injury (TBI), even of the mild variety, can cause diffuse multisystem neurological damage. Coordination of sensory input from the visual, vestibular and somatosensory pathways is important to obtain proper balance and stabilization in the visual environment. This coordination of systems is potentially disrupted in TBI leading to visual symptoms and complaints of dizziness and imbalance. The Center of Balance (COB) at the Northport Veterans Affairs Medical Center (VAMC) is an interprofessional clinic specifically designed for patients with such complaints. An evaluation entails examination by an optometrist, audiologist and physical therapist and is concluded with a comprehensive rehabilitative treatment plan. The clinical construct will be described and a case report will be presented to demonstrate this unique model. Case Report: A combat veteran with a history of a gunshot wound to the skull, blunt force head trauma and exposure to multiple explosions presented with complaints of difficulty reading and recent onset dizziness. After thorough evaluation in the COB, the patient was diagnosed with and treated for severe oculomotor dysfunction and benign paroxysmal positional vertigo. Conclusion: Vision therapy was able to provide a successful outcome via improvement of oculomotor efficiency and control. Physical therapy intervention was able to address the benign paroxysmal positional vertigo. The specific evaluation and management as pertains to the aforementioned diagnoses, as well as the importance of an interprofessional rehabilitative approach, will be outlined.


2019 ◽  
Vol 13 (1) ◽  
pp. 371-376
Author(s):  
Abduljabbar Mohammed Alsameai ◽  
Basema Abdullah Khabaz ◽  
Mohammed Abdo Alraawi ◽  
Mohammed M Al Moaleem

Introduction: Maxillary canines play strategic roles in maintaining the normal function and visibility of teeth. However, rare cases of bilateral permanent congenitally missing maxillary canines were occurring. Replacing these missing canines with dental implant prostheses is an optimal treatment plan for aesthetics and functions. Case Report: In this case report, we described the replacement of bilateral maxillary canines with osseointegrated implants to support all-ceramic prostheses for a young female patient. This treatment avoids the conventional preparation of adjacent teeth as a part of prosthetic reconstructions. In addition to that, all-ceramic crowns are biocompatible with oral cavity structures. Conclusion: The stable short-term result has been achieved with the replacement of the bilateral congenitally missed canines with an implant and cemented all-ceramic crowns, with 3-years cumulative success rate.


2020 ◽  
Vol 13 (12) ◽  
pp. e233179
Author(s):  
Eric Garrels ◽  
Fawziya Huq ◽  
Gavin McKay

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.


Author(s):  
Roberto Mina ◽  
Francesca Bonello ◽  
Francesca Gay ◽  
Elena Zamagni ◽  
Mario Boccadoro

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