Associated mood changes with naloxegol therapy for opioid-induced constipation in a patient with psychiatric disease

2021 ◽  
Author(s):  
Neil Nagda ◽  
Saba Javed
Keyword(s):  
Case Report ◽  
Psychiatric Illness ◽  
Clinical Case ◽  
Drug Manufacturer ◽  
Psychiatric Disease ◽  
Chronic Pain Management ◽  
Mood Changes ◽  
History Of ◽  
Mood Lability ◽  
Psychiatric Manifestations

The objective of this clinical case report is to highlight unusual adverse effects brought on by Naloxegol therapy in a patient with underlying psychiatric illness. The patient is a 68-year-old female, with a psychiatric history of bipolar disorder, who presented for chronic pain management and opioid-induced constipation. After failing other therapies, she was trialed on Naloxegol on three separate occasions. She experienced mood lability with symptoms including agitation, confusion, irritability, hysteria and unprompted crying spells on each occasion. Notably, the drug manufacturer does not describe mood lability, nor the profound psychiatric manifestations outlined in our case report, as side effects of Naloxegol. Clinicians may consider judicious prescription of Naloxegol when treating opioid-induced constipation in patients with pre-existing psychiatric co-morbidities.

scholarly journals Thrombosis in patients with myeloproliferative neoplasms. Case report

2021 ◽  
Vol 93 (7) ◽  
pp. 800-804
Author(s):  
Anait L. Melikyan ◽  
Irina N. Subortseva ◽  
Elena A. Gilyazitdinova ◽  
Tamara I. Koloshejnova ◽  
Kristina S. Shashkina ◽  
...  
Keyword(s):  
Case Report ◽  
Arterial Hypertension ◽  
Clinical Case ◽  
Myeloproliferative Neoplasms ◽  
Primary Myelofibrosis ◽  
Hemoglobin Level ◽  
History Of ◽  
Thrombotic Complications ◽  
Acquired Thrombophilia ◽  
Significant Factors

Thrombotic complications are the most significant factors determining the prognosis in myeloproliferative neoplasms. Markers for assessing the risk of thrombosis are the number of leukocytes, platelets, hemoglobin level, hematocrit, age, molecular status, history of thrombosis, obesity, arterial hypertension, hyperlipidemia, hereditary or acquired thrombophilia. The pathogenesis of thrombosis in patients with myeloproliferative neoplasms is complex and multifactorial. In most cases, the etiological factor remains unknown. Currently, antiplatelet and anticoagulant therapy is carried out on an individual basis. The algorithm for primary and secondary (after thrombosis) prevention requires development and testing. We present a clinical case of repeated arterial and venous thrombotic complications in a patient with primary myelofibrosis.

scholarly journals Occult insulinoma after oesophagectomy for oesophageal cancer-diagnostic challenges

2021 ◽  
Vol 9 (1) ◽  
pp. 185
Author(s):  
Marta Alexandre Silva ◽  
Maria João Amaral ◽  
Pedro Pinto ◽  
Mónica Martins ◽  
Marco Serôdio ◽  
...  
Keyword(s):  
Case Report ◽  
Male Patient ◽  
Clinical Case ◽  
Gastrointestinal Surgery ◽  
Gastric Surgery ◽  
Diagnostic Investigation ◽  
Post Operative Period ◽  
History Of ◽  
Oesophageal Surgery ◽  
Hyperinsulinemic Hypoglycaemia

Hypoglycaemia in the post-operative period is mainly iatrogenic (related to anti-hyperglycaemic drugs), but can be explained by an endogenous hyperinsulinemic state. In the context of previous gastrointestinal surgery, a form of dumping syndrome can mask hypoglycaemia from an underlying cause, such as an insulinoma. The authors present a clinical case of a male patient who underwent oesophageal surgery for an oesophago-gastric junction adenocarcinoma and developed hypoglycaemic symptoms in the post-operative period, caused by an undiagnosed insulinoma. This case report portraits the diagnostic investigation of a hypoglycaemia state in the post-operative period, narrowing to the workup of an endogenous hyperinsulinemic hypoglycaemia and provides a summary of insulinoma’s treatment. An insulinoma should always be considered in a patient with endogenous hyperinsulinemic hypoglycaemia, even with a history of oesophago-gastric surgery.

Development of lymphangioleiomyomatosis in a female patient with Sjö gren's disease: a review of literature and a case report

2019 ◽  
Vol 13 (2) ◽  
pp. 119-123
Author(s):  
Yu. I. Khvan ◽  
S. G. Palshina ◽  
V. I. Vasiliev
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Clinical Case ◽  
Young Female ◽  
Renal Angiomyolipoma ◽  
Review Of Literature ◽  
Review Of The Literature ◽  
History Of ◽  
Genetically Determined ◽  
Sjögren’S Disease

Cystic and bullous lung transformation occurs in diseases of various origins: neoplastic, genetically determined, rheumatic, lymphoproliferative, and infectious diseases. The paper presents a review of the literature and a clinical case of a young female patient with a long history of Sjögren's disease. Fifteen years after the onset of the disease, the patient developed cystic and bullous lung transformation and renal angiomyolipoma, which are regarded as a manifestation of probable lymphangioleiomyomatosis.

scholarly journals Invasive cervical resorption: case report

2021 ◽  
Vol 10 (14) ◽  
pp. e39101421787
Author(s):  
Matheus Almeida Rodrigues ◽  
Marcely Reis da Silva ◽  
Adolfo de Matos de Carvalho ◽  
Caio Cesar Souza ◽  
Cesar Augusto Perini Rosas ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Orthodontic Treatment ◽  
Clinical Case ◽  
Cone Beam ◽  
Cervical Region ◽  
Radiographic Examination ◽  
Repair Material ◽  
Tooth Whitening ◽  
History Of

Invasive cervical resorption (ICR) is an insidious, aggressive, and asymptomatic form that can lead to destruction and even loss of the dental unit. ICR is somewhat uncommon, but it can affect any tooth, with the maxillary central incisors being the most affected. Even after numerous studies, the etiology is still unclear. There are some predisposing factors, including orthodontic treatment, trauma, and internal tooth whitening, which may occur in isolation or in conjunction with each other. This article reports a clinical case of ICR class 3 with a rosy discoloration at the cervical margin and the presence of a fistula associated with a history of trauma. This suspicion was raised after radiographic examination and confirmed by cone-beam computed tomography (CBCT), with treatment via an internal approach and endodontic treatment involving debridement of the resorptive areas and filling with a bioceramic repair material and suturing. After treatment, the patient remained asymptomatic, but the fistula was no longer present. Prospective observation at 10 months showed bone formation in the middle third and well-adapted material in the cervical region, with no resorptive tissue present.

Predictors of Suicidal Events

2018 ◽  
Author(s):  
Michael Maksimowski ◽  
Zheala Qayyum
Keyword(s):  
Study Design ◽  
Adolescent Psychiatry ◽  
Psychiatric Illness ◽  
Clinical Case ◽  
Suicide Attempts ◽  
Child And Adolescent Psychiatry ◽  
History Of ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in child and adolescent psychiatry. Youths with a history of psychiatric illness are known to be at greater risk of suicide. What are the predictors of suicidal events and attempts in adolescents with a history of suicide attempts and depression? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. Several characteristics were identified that correlated with subsequent suicidal events. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Psychiatric Manifestations of Frontal Lobe Tumours

1989 ◽  
Vol 155 (6) ◽  
pp. 735-738 ◽  
Author(s):  
M. A. Ron
Keyword(s):  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Correct Diagnosis ◽  
Previous History ◽  
Memory Loss ◽  
Psychiatric Disease ◽  
Surgical Removal ◽  
History Of ◽  
Psychiatric Manifestations ◽  
Made In

In a recent article in the British Medical Journal Maurice-Williams & Dunwoody (1988) reported two patients with frontal meningiomas who presented initially to psychiatrists. The correct diagnosis was made in one of them after prolonged, perhaps unnecessary, psychiatric treatment. In the other the diagnosis was made at autopsy. In this case psychiatrists were only briefly involved and neurosurgical referral had been made promptly. The authors, who treat these reports as a cautionary tale, conclude by warning psychiatrists to pay special attention to a number of features in the history and examination of psychiatric patients. In particular we are told that suspicion should arise in the presence of gradual non-remitting symptoms such as irritability, memory loss, self-neglect, dysphasia or incontinence in patients without a previous history of psychiatric disease or clear precipitating factors. They also suggest that we pay attention to the views of relatives when they feel the patient suffers from a physical rather than a psychiatric illness, and emphasise that early diagnosis leads to easier surgical removal and better outcome.

scholarly journals Cherubism - Clinical case report and narrative review

2021 ◽  
Vol 10 (2) ◽  
pp. 22510212085
Author(s):  
Leonardo Alan Delanora ◽  
Ana Maira Pereira Baggio ◽  
Nathália Januario de Araujo ◽  
Idelmo Rangel Garcia-Junior ◽  
Sabrina Ferreira
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Family History ◽  
Bone Disease ◽  
Clinical Characteristics ◽  
Clinical Case ◽  
Giant Cells ◽  
Brown Tumor ◽  
Review Of The Literature ◽  
History Of

Cherubism is described as a rare and benign hereditary bone disease, characterized by a bilateral volumetric increase in the maxillary bones, with a greater predilection for males in childhood. Clinically, it presents as a volumetric enlargement of the mandible and, maxilla, which is generally painless, firm on palpation and varies in relation to size and extension. Its differential diagnosis is the Brown Tumor of Hyperparathyroidism and the Central Lesion of Giant Cells. The diagnosis is based on the assessment of clinical characteristics together with complementary exams. The objective of this study was to carry out a brief review of the literature and report a clinical case of this pathology in a 9-year-old child with a family history of cherubism, assessed through imaging, histopathological and karyotype exams, which continues to be assisted by the oral and maxilofacial surgery team of the Faculdade de Odontologia de Araçatuba - FOA Unesp since the treatment of the cherubism still does not have a definitive protocol.

Delayed cerebellar ataxia as a rare late presenting feature of falciparum malaria – A Case report

2020 ◽  
pp. 004947552096949
Author(s):  
Saurabh Gupta ◽  
Shikha Gupta
Keyword(s):  
Plasmodium Falciparum ◽  
Differential Diagnosis ◽  
Case Report ◽  
Cerebral Malaria ◽  
Falciparum Malaria ◽  
Cerebellar Ataxia ◽  
Prior History ◽  
Neurological Manifestations ◽  
History Of ◽  
Psychiatric Manifestations

The majority of malarial neurological manifestations are due to plasmodium falciparum and the most dreaded is cerebral malaria. Post-malarial neurological syndrome (PMNS) is rarely reported in adults (<3%) and children (>10%) and includes a wide variety of neuro-psychiatric manifestations including the rare delayed cerebellar ataxia. We report a case of 60-year-old woman who had a prior history of fever and presented with cerebellitis. The importance of highlighting this case is because in malaria endemic regions awareness of neurological manifestations of malaria must be included in the differential diagnosis of cerebellar ataxia.

scholarly journals A Subset of Primary Polydipsia, “Dipsogneic Diabetes Insipidus”, in Apparently Healthy People Due to Excessive Water Intake: Not Enough Light to Illuminate the Dark Tunnel

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 406
Author(s):  
Krishnaraju Venkatesan ◽  
Kumarappan Chidambaram ◽  
Premalatha Paulsamy ◽  
Ramasubbamma Ramaiah ◽  
Ali Al-Qahtani ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
Psychiatric Illness ◽  
Case Reports ◽  
Treatment Options ◽  
Urine Osmolality ◽  
Healthy People ◽  
Psychiatric Disease ◽  
Primary Polydipsia ◽  
History Of ◽  
Excessive Intake

Dipsogenic diabetes insipidus (DDI) is a subtype of primary polydipsia (PP), which occurs mostly in healthy people without psychiatric disease. In contrast, PP is characterized by a polyuria polydipsia syndrome (PPS) associated with psychiatric illness. However, the pathogenesis of DDI is not well established and remains unexplored. In order to diagnose DDI, the patient should exhibit excessive thirst as the main symptom, in addition to no history of psychiatric illness, polyuria with low urine osmolality, and intact urine concentrating ability. Treatment options for DDI remain scarce. On this front, there have been two published case reports with successful attempts at treating DDI patients. The noteworthy commonalities in these reports are that the patient was diagnosed with frequent excessive intake of water due to a belief that drinking excess water would have pathologic benefits. It could therefore be hypothesized that the increasing trend of excessive fluid intake in people who are health conscious could also contribute to DDI. Hence, this review provides an overview of the pathophysiology, diagnosis, and treatment, with a special emphasis on habitual polydipsia and DDI.

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