Partial Adrenal Suppression with Prolonged Use of Depo-Provera

2019 ◽  
Vol 4 (1) ◽  
pp. 64
Author(s):  
Nur Aisyah Zainordin ◽  
Fatimah Zaherah Mohamed Shah ◽  
Rohana Abdul Ghani
Keyword(s):  
Weight Gain ◽  
Medroxyprogesterone Acetate ◽  
Side Effect ◽  
Case Reports ◽  
Adrenal Incidentaloma ◽  
Adrenal Suppression ◽  
Private Pharmacy ◽  
Significant Weight Gain ◽  
The Past ◽  
Depo Provera

A 49-year old patient presented with symptoms of adrenal suppression following an attempt to withdraw Depo-Provera or Depot Medroxyprogesterone Acetate (DMPA) injection. She had been receiving DMPA injections for the past 16 years for contraception. She was initially prescribed DMPA by her gynaecologist but later on began obtaining the medication directly from a private pharmacy without prior consultation from her gynaecologist. Clinically, she had been experiencing significant weight gain and appeared cushingoid. Blood investigations confirmed partial adrenal suppression with presence of an adrenal incidentaloma. This case reports a known side effect of DMPA but occurring at a much lower dose than previously described. It also highlights the need to increase the awareness of the insidious side effect of DMPA and to avoid unsupervised use of the drug.

scholarly journals Clozapine-induced stuttering in the absence of known risk factors: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Florence Jaguga
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Side Effect ◽  
Case Reports ◽  
Extrapyramidal Symptoms ◽  
Prior History ◽  
Case Presentation ◽  
Rare Side Effect ◽  
History Of ◽  
Electrophysiological Findings

Abstract Background Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. Case presentation A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. Conclusion Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.

scholarly journals Digital Glomus Tumor: Bibliographic Review of the Studies Published over the Past 10 Years

2021 ◽  
Vol 49 (01) ◽  
pp. 046-055
Author(s):  
Victoria Hernández ◽  
Tania Lena ◽  
Eliana Camacho ◽  
Matías Craviotto
Keyword(s):  
Glomus Tumor ◽  
Case Reports ◽  
Low Frequency ◽  
Benign Neoplasm ◽  
Surgical Excision ◽  
Soft Tissue Tumors ◽  
Glomus Tumors ◽  
The Past ◽  
Pubmed Search ◽  
Magnetic Resonance Imaging Mri

AbstractGlomus tumors are a mostly benign neoplasm that constitutes less than 4% of upper-limb soft-tissue tumors. Its unspecific clinical presentation, added to its low frequency, leads to a late diagnosis.The objective of the present study is to update the clinical-paraclinical approach and the surgical technique used in the treatment.We carried out a literature review from 2014 to 2019 on digital glomus tumor in the hand in adult patients using the PubMed search engine.In most of the publications analyzed, the diagnosis was clinical, with a delay of 1 to 10 years. Plain radiography is the most requested study; of the 16 articles reporting its indication, only half evidenced compatible changes. Magnetic resonance imaging (MRI) was requested in 15 articles, presenting normal results in 3 of them. The treatment of choice was surgical excision using a transungual approach. Only 4 articles report recurrence after excision.Although there is diversity in the approach to these tumors, we conclude that the diagnosis is clinical, and the treatment surgical, and there is no consensus regarding the paraclinical indication. The information available comes mainly from case reports, publications that contribute to the generation of evidence for the clinical practice in rare diseases such as this one.

scholarly journals Role of Ventromedial Hypothalamus in Sucrose-Induced Obesity on Metabolic Parameters

2021 ◽  
pp. 097275312110057
Author(s):  
Archana Gaur ◽  
G.K. Pal ◽  
Pravati Pal
Keyword(s):  
Insulin Resistance ◽  
Weight Gain ◽  
Food Intake ◽  
Ventromedial Hypothalamus ◽  
Female Rats ◽  
Metabolic Parameters ◽  
Male Rats ◽  
Significant Weight Gain ◽  
The Metabolic Syndrome

Background: Obesity is because of excessive fat accumulation that affects health adversely in the form of various diseases such as diabetes, hypertension, cardiovascular diseases, and many other disorders. Our Indian diet is rich in carbohydrates, and hence the sucrose-induced obesity is an apt model to mimic this. Ventromedial hypothalamus (VMH) is linked to the regulation of food intake in animals as well as humans. Purpose: To understand the role of VMHin sucrose-induced obesity on metabolic parameters. Methods: A total of 24 adult rats were made obese by feeding them on a 32% sucrose solution for 10 weeks. The VMH nucleus was ablated in the experimental group and sham lesions were made in the control group. Food intake, body weight, and biochemical parameters were compared before and after the lesion. Results: Male rats had a significant weight gain along with hyperphagia, whereas female rats did not have a significant weight gain inspite of hyperphagia. Insulin resistance and dyslipidemia were seen in both the experimental and control groups. Conclusion: A sucrose diet produces obesity which is similar to the metabolic syndrome with insulin resistance and dyslipidemia, and a VMH lesion further exaggerates it. Males are more prone to this exaggeration.

Abstract 003: Change in Cardiovascular Risk Factors Associated with Weight Gain in the Dallas Heart Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Tiffany M Powell ◽  
Colby R Ayers ◽  
James A de Lemos ◽  
Amit Khera ◽  
Susan G Lakoski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Weight Gain ◽  
Cardiovascular Risk Factors ◽  
Average Weight ◽  
Men And Women ◽  
Significant Weight Gain ◽  
Heart Study ◽  
Dallas Heart Study ◽  
The Impact

Background: Concerning trends in weight gain from 2000-2009 exist in the Dallas Heart Study (DHS), a probability-based sample of Dallas County residents aged 30-65. However, the impact of significant weight gain (≥ 5% increase in body weight) on cardiovascular risk factors (CVRF) in this contemporary, multi-ethnic population is not known. Methods: We measured weight, LDL-c, blood pressure (SBP and DBP), and fasting glucose (FG) in 2,022 DHS participants (58% female) at study entry in 2000 and in 2009. Using logistic regression stratified by sex and race/ethnicity, we determined the age-adjusted odds of worsening CVRF (any increase in LDL-c, SBP, DBP or FG) for people who gained significant weight compared to those who did not. Results: Among women, 43% (N=500) gained significant weight, compared to 42% of men (N=355). Despite similar average weight gain (9.7±5.8 kg for women vs. 10±5.6 kg for men, p=0.4), women who gained significant weight had almost twice as large an increase in LDL-c (14±34 vs. 8±39 mg/dl, p=0.01) and SBP (12±18 vs. 6±19 mmHg, p<0.001) compared with men who gained significant weight. Increases in DBP (5±10 vs. 4±11 mmHg, p=0.05) and FG (4±29 vs. 2±32 mg/dl, p=0.30) were not significantly different between men and women. Among those with significant weight gain who were not on medications, SBP and LDL-c increases were higher in women compared with men (p<0.05). Differences in the amount of weight gained stratified by race and sex were modest (Table). Black women who gained significant weight were likely to have a worsening of all CVRF, while Hispanic women had the highest likelihood of having an increase in SBP associated with weight gain. In contrast, significant weight gain among men was not associated with worsening CVRF. Conclusions: Significant weight gain was associated with a deleterious impact on CVRF among women but not men. Disparate effects of weight gain between men and women highlight the importance of targeting aggressive weight control interventions toward women to help prevent adverse cardiac outcomes.

Increase in Cell Number as a Factor in the Growth of the Organs and Tissues of the Young Male Rat

Development ◽  
1962 ◽  
Vol 10 (4) ◽  
pp. 530-562
Author(s):  
M. Enesco ◽  
C. P. Leblond
Keyword(s):  
Body Weight ◽  
Weight Gain ◽  
Room Temperature ◽  
Young Male ◽  
Cell Number ◽  
The Body ◽  
Male Rat ◽  
The Past ◽  
Old Rats ◽  
Young Rat

While the organs and tissues of the young rat are known to increase in size with age (Donaldson, 1924), little is known of the role played by the component cells in this increase. There is evidence that cells enlarge (Levi, 1906; Plenk, 1911) and new cells are added (Strasburger, 1893), but we do not know to what extent the enlargement and proliferation of the cells cause the growth of organs and tissues. The present work is an attempt to clarify this problem. In the past, the growth of organs and tissues has often been measured by weight gain (Donaldson, 1924). However, this approach might be misleading, since the body-weight may increase in the absence of growth, for instance as a result of fat-storage in old rats, of pregnancy in females, and even of changes in room temperature.

scholarly journals Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies

Materials ◽  
2019 ◽  
Vol 12 (9) ◽  
pp. 1524 ◽  
Author(s):  
Gabriele Cervino ◽  
Luca Fiorillo ◽  
Ines Paola Monte ◽  
Rosa De Stefano ◽  
Luigi Laino ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Oral Surgery ◽  
Case Reports ◽  
Case Series ◽  
Antiplatelet Agents ◽  
Preventive Therapy ◽  
Antiplatelet Drugs ◽  
Risk Of Bleeding ◽  
The Past ◽  
Increased Risk

Background: Nowadays, patients involved in antiplatelet therapy required special attention during oral surgery procedures, due to the antiplatelet drugs assumption. The motivations of the assumption may be different and related to the patient’s different systemic condition. For this reason, accordingly to the current international guidelines, different protocols can be followed. The aim of this work is to analyze how the dentist’s approach to these patients has changed from the past to the present, evaluating the risk exposure for the patients. Methods: This review paper considered different published papers in literature through quoted scientific channels, going in search of “ancient” works in such a way as to highlight the differences in the protocols undertaken. The analyzed manuscripts are in the English language, taking into consideration reviews, case reports, and case series in such a way as to extrapolate a sufficient amount of data and for evaluating the past therapeutic approaches compared to those of today. Results: Colleagues in the past preferred to subject patients to substitution therapy with low molecular weight anticoagulants, by suspending antiplatelet agents to treatment patients, often for an arbitrary number of days. The new guidelines clarify everything, without highlighting an increased risk of bleeding during simple oral surgery in patients undergoing antiplatelet therapy. Conclusion: Either patients take these medications for different reasons, because of cardiovascular pathologies, recent cardiovascular events, or even for simple prevention, although the latest research shows that there is no decrease of cardiovascular accidents in patients who carry out preventive therapy. Surely, it will be at the expense of the doctor to assess the patient’s situation and risk according to the guidelines. For simple oral surgery, it is not necessary to stop therapy with antiplatelet agents because the risk of bleeding has not increased, and is localized to a post-extraction alveolus or to an implant preparation, compared to patients who do not carry out this therapy. From an analysis of the results it emerges that the substitutive therapy should no longer be performed and that it is possible to perform oral surgery safely in patients who take antiplatelet drugs, after a thorough medical history. Furthermore, by suspending therapy, we expose our patients to more serious risks, concerning their main pathology, where present.

scholarly journals Paraneoplastic glomerular disease: The struggle is real

2019 ◽  
Vol 3 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Pooja Amarapurkar ◽  
Salim Bou-Slaiman ◽  
Bianca Madrid ◽  
Marco Ladino
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Cancer Treatment ◽  
Side Effect ◽  
Kidney Injury ◽  
Glomerular Diseases ◽  
The Past ◽  
Underlying Malignancy ◽  
Paraneoplastic Diseases

Over the past decade, the relationships between various kidney disease and cancer have been established, but not fully elucidated. Development of acute kidney injury or chronic kidney disease as a side effect of cancer treatment is not uncommon. However, renal paraneoplastic diseases are rather unique and less known examples of the association between kidney disease and cancer. These conditions are of importance to the nephrologist as they may be the initial presentation of an underlying malignancy and may not respond to the usual therapies used for their non-paraneoplastic variants. This article will discuss the pathogenesis and challenges in management of paraneoplastic glomerular diseases.

Removal of Gastric Band Does Not Always Lead to Significant Weight Gain

2020 ◽  
Vol 15 (2) ◽  
pp. 102-105
Author(s):  
Zubaidah Nor Hanipah ◽  
Suriya Punchai ◽  
Heath J. Antoine ◽  
Stacy A. Brethauer ◽  
Philip R. Schauer ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gastric Band ◽  
Significant Weight Gain

scholarly journals Segmental Arterial Mediolysis: An Under-Recognized Cause of Chronic Abdominal Pain

2020 ◽  
Author(s):  
Tulika Chatterjee ◽  
Johnathon Stephens ◽  
Moni Roy
Keyword(s):  
Abdominal Pain ◽  
Medical Management ◽  
Surgical Intervention ◽  
Case Reports ◽  
Healthcare Providers ◽  
Chronic Abdominal Pain ◽  
Segmental Arterial Mediolysis ◽  
The Past ◽  
Missed Diagnosis ◽  
Abdominal Arteries

Segmental arterial mediolysis (SAM) is a non-inflammatory, non-atherosclerotic vasculopathy mostly involving the abdominal arteries. SAM was recently recognized as a more prevalent aetiology of abdominal pain than initially thought by healthcare providers. It is still a commonly missed diagnosis in patients with recurrent emergency room (ER) visits for abdominal pain. Most published case reports in the past have highlighted catastrophic sequelae such as intra-abdominal haemorrhage requiring surgical intervention. We report a case of SAM where the diagnosis was initially missed. After diagnosis, conservative medical management was offered which led to clinical improvement.

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