scholarly journals Case Report: Cariprazine in a Patient With Schizophrenia, Substance Abuse, and Cognitive Dysfunction

2021 ◽  
Vol 12 ◽  
Author(s):  
Jose Rodriguez Cruz ◽  
Johan Sahlsten Schölin ◽  
Stephan Hjorth

This case report describes a 30-year old male diagnosed with schizophrenia at the age of 23, and with a long history of drug abuse. He had previously received a wide range of antipsychotic drug treatment regimens, all with some degree of effect, but never with complete symptom relief. He was also suffering from persistent cognitive and negative symptoms. At the time of admission in our clinic, he was on Quetiapine (QUE) and Haloperidol (HAL). It was therefore decided to substitute HAL for Cariprazine (CAR)—an agent with a novel pharmacological and clinical profile—in the hope of gaining increased efficacy, particularly in the cognitive and negative symptom domains. Within 3 weeks of the switch from HAL to CAR the patient clearly improved, and notably so in the aforementioned symptom areas. A number of subsequent adjustments of antipsychotic dosages and adjunct medications during the ensuing months resulted in an apparently more stable alleviation of positive as well as negative and cognitive symptoms, including markedly improved personal and social capabilities. Interestingly, some time after initiating CAR treatment the patient also reported that from being a heavy smoker (60 cig/d) he had cut down and eventually ceased smoking entirely; furthermore, he has remained clean of other substance abuse since his first admission in 2020. The joint treatment with CAR in combination with QUE thus seems to have improved the patient's cognitive functioning as well as possibly his susceptibility to substance abuse.

2021 ◽  
pp. 123-130
Author(s):  
Anker Stubberud ◽  
Emer O’Connor ◽  
Erling Tronvik ◽  
Henry Houlden ◽  
Manjit Matharu

Mutations in the <i>CACNA1A</i> gene show a wide range of neurological phenotypes including hemiplegic migraine, ataxia, mental retardation and epilepsy. In some cases, hemiplegic migraine attacks can be triggered by minor head trauma and culminate in encephalopathy and cerebral oedema. A 37-year-old male without a family history of complex migraine experienced hemiplegic migraine attacks from childhood. The attacks were usually triggered by minor head trauma, and on several occasions complicated with encephalopathy and cerebral oedema. Genetic testing of the proband and unaffected parents revealed a de novo heterozygous nucleotide missense mutation in exon 25 of the <i>CACNA1A</i> gene (c.4055G&#x3e;A, p.R1352Q). The R1352Q <i>CACNA1A</i> variant shares the phenotype with other described <i>CACNA1A</i> mutations and highlights the interesting association of trauma as a precipitant for hemiplegic migraine. Subjects with early-onset sporadic hemiplegic migraine triggered by minor head injury or associated with seizures, ataxia or episodes of encephalopathy should be screened for mutations. These patients should also be advised to avoid activities that may result in head trauma, and anticonvulsants should be considered as prophylactic migraine therapy.


Author(s):  
Balraj Singh ◽  
Sarah Ayad ◽  
Parminder Kaur ◽  
Vinod Kumar ◽  
Sachin Gupta ◽  
...  

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), has caused a global health crisis. COVID-19 can have a multifaceted presentation. A wide range of complications and outcomes can emerge based on the severity and comorbidities of the infected patient.  We report a 42-year-old male with past medical history of CML on Dasatinib (in Major Molecular Response) who was diagnosed with COVID-19 and developed pancytopenia. Our case and review of available reports add to the limited literature available regarding COVID-19 in CML.


Author(s):  
Hosam Abdullah Alsulami, Sonia Mezghani Ben Salah

Patients with chronic obstructive pulmonary disease (COPD) and bronchiectasis are considered at risk of non-tuberculous mycobacterial lung disease especially those on inhaled corticosteroids. We described a case of a 69-year-old male, Ex. a heavy smoker with past history of pulmonary tuberculosis, COPD with diffuse centro lobular emphysema; status post left thoracotomy for hydropneumothorax, left-sided bullectomy done 8 months back. Patient admitted in our hospital " King Fahad General Hospital, Jeddah " with a history of chronic productive cough with an increased SOB, on/ off fever, night sweats and loss of weight in the last 3 months. No hemoptysis. On examination, he was conscious, oriented, afebrile, positive clubbing. Vitally stable. Chest examination showed a scare of left thoracotomy clean with small chest wall bulge; decreased breath sounds with bilateral ronchi and dullness in the left lower chest. Laboratory investigations showed hyperleukocytosis of 14.6 and serology for HIV was negative. CT scan chest showed left lobulated pleural effusion with empyema necessities, a diffuse emphysematous lung disease with bilateral thick wall cavities and pulmonary nodules as well as left bronchiectasis changes with underlying consolidation collapse. US-guided left pleural aspiration done showed exudative polymorph inflammation. Pleural fluid AFB and PCR was negative and two samples of AFB sputum were positive (2+), PCR was negative, 2 Bactec cultures were positives with the rapid growth of MOTT. Mycobacterial Avium Complex has been identified (Mayoclinic lab. in USA) which is sensitive to Rifampicin*, Clarithromycin* and Ethambutol* but resistant to Moxifloxacin and to Linozelid*. Patient treated with a combination of Rifampicin + Ethambutol* +Clarithromycin* for 18 months with clinical and radiologic improvement and good tolerance. This Study is a "case report study" aimed to report a very rare case, to report a new case of MOTT in Saudi Arabia for the purpose of statistics and for scientific benefit.


2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Anna Maria Szota ◽  
Aleksander Araszkiewicz

AbstractParanoid schizophrenia is a chronic, psychotic disorder which can be treated with long-acting injectable (LAI) antipsychotic drugs. There are risperidone (Risperdal Consta®), olanzapine (Zypadhera®), paliperidone (Xepilon®) and aripiprazole (Abilify Maintena®) currently available.The aim of this study was to present a case history of the patient to whom monthly injections of aripiprazole effectively prevented both relapses of psychotic symptoms and hospitalizations.Case report: A 55-year-old male patient with a 13-year history of paranoid schizophrenia has been effectively treated with aripiprazole (LAI) (400mg, every 4 weeks). During the last 8 years of treatment his mental state has been stabilized, without any acute psychotic symptoms and without any anxiety, or violent behaviours. Moreover, there have been no psychotic symptoms, or suicidal thoughts, or tendencies recordered. Therefore, no hospitalization has been required. However, despite the treatment, negative symptoms such as blunted affect, cognitive dysfunction and social withdrawal have been sustained.Discussion: The available articles on aripiprazole (LAI) treatment indicate that it was effective in reducing the positive and negative symptoms of schizophrenia, as well as reducing the frequency and duration of hospitalization. However, the case report of a patient who has not had relapses of psychotic symptoms and suicidal thoughts and has not been hospitalized during 8 years of treatment with aripiprazole (LAI) has not yet been reported.Conclusions: Regular, long-term injections of aripiprazole (LAI) are very effective at preventing positive symptoms of schizophrenia development and preventing both suicidal thoughts and hospitalizations. Therefore, treatment with this drug in everyday practice should be increased.


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huifang Wang ◽  
Hui Liu

Abstract Background MCA has several anomalies, such as accessory MCA, duplicated MCA and twig-like MCA, up to now all these reported anomalies were hypothesized to due to the failure in fusion of the primitive arterial network. No anomaly of over fused MCA has been reported. Case presentation A 59- year- old male was hospitalized with a history of paroxysmal slurred speech and left side headache for a week, his blood pressure was 160/80 mmHg and he manifested mild incomplete motor aphasia at the time of admission. The head and neck CTA and DSA all presented a huge and tortuous left MCA, we diagnosed it an anomaly and termed it over-fused MCA. The patient’s speech impairment and headache were relieved by controlling his blood pressure. Conclusions Such an anomaly of over-fused MCA is reported for the first time, it’s not needed to put special intervention on the anomaly of the patient temporarily, but more observation are needed.


2018 ◽  
Vol 7 ◽  
pp. e1086
Author(s):  
Elham Akbarzadeh ◽  
Mojtaba Heydari ◽  
Fatemeh Atarzadeh ◽  
Amir Mohammad Jaladat

Background: Although ginger is considered a harmless remedial substance for a wide range of medical complaints, according to Persian medicinal texts, its long-term or high-dose consumption is potentially harmful. Case Report: The case of a 43-year-old man, with a complaint of urinary stream interruption, dysuria, and flank pain, following a non-prescribed use of ginger was reported. The symptoms were reported to persist for four years, despite some medical referrals. Remarkably, the symptoms were attested to be shrinking eight weeks after ginger-intake cessation; besides, no further intervention was asserted. Conclusion: The history of herbal remedies use should be considered in patients with any unexplained urinary symptoms. [GMJ.2018;7:e1086]


2020 ◽  
Author(s):  
Shuai Hao ◽  
Miao Huang ◽  
Wuguo Tian ◽  
Jianjie Zhao ◽  
Bo Gao ◽  
...  

Abstract Background Primary thyroid leiomyosarcoma(LMS) is very rare, with only 30 cases reported worldwide. Thyroid LMS should be diagnosed with caution and comprehensively evaluated considering clinical, imaging, and pathological data. It is a kind of fatal tumor with an extremely poor prognosis and lacks effective treatment regimens, and most patients die within 1 year of diagnosis. Here, we present a case report on a patient with Primary thyroid LMS. Case presentation A 76-year-old woman presented with hoarseness, dysphagia, and dyspnea when lying down for the past 1 month visited our hospital. She had a history of right neck masses in the past 2 years. A hard, irregular tumor of approximately 8 cm × 5 cm × 5 cm was observed on the right lobe of the thyroid, the boundary between which and the surrounding tissues was unclear. The tumor anteriorly invaded the cervical muscles and interiorly invaded the right walls of the trachea and esophagus. Most tumor tissues were excised, a curative operation seemed impossible. Immunohistochemically, the tumor cells were positive for Calponin, vimentin and SMA, but negative for EMA, CK, P53, Desmin and S-100. Tumor recurrence and progression were considered two months after surgery, the patient refused follow-up treatment for personal reasons and died 4 months after surgery. Conclusion Thyroid LMS accounting for merely 0.014% of primary thyroid tumors of unknown etiology. The diagnosis can only be confirmed upon a lack of evidence regarding epithelial differentiation or other types of sarcoma differentiation and when immunohistochemistry yields positive smooth muscle markers. Primary thyroid LMS is primarily surgically resected and no other effective treatment currently available. Disease progression is rapid, the prognosis is poor, and the 1-year survival rate is <10%. In the present study, a rare case of a 76-year-old female patient diagnosed with thyroid LMS was reported and a review of the literature is presented.


2021 ◽  
pp. 43-48
Author(s):  
Dany K. Aouad ◽  
Rayane Rahi ◽  
Joseph Maalouly ◽  
Rami A. Ayoubi ◽  
Jamal Saade ◽  
...  

Sciatica is a common syndrome mostly affecting adults. It has a wide range of etiologies, classified into intra- and extra-spinal, with intra-spinal being the most common, usually due to lumbar disc herniation causing nerve root compression. Sacroiliac (SI) joint pathologies are a known cause of extra-spinal sciatica syndrome, following multiple possible mechanisms. We report a case of a 33-year-old female patient who presented for non-resolving sciatica symptoms, found to have an inferior SI joint osteophyte compressing the sciatic nerve, who underwent surgical excision due to failure of conservative measures. All causes of sciatica related pain should be subjected to further investigations if not attributed clinically and radiologically to intra-spinal etiologies. SI joint imaging play an important role in the diagnosis of SI joint related sciatica, with the gold standard being an intra-articular anesthetic injection, to monitor for symptom relief in order to confirm the diagnosis, and choose the optimal treatment modality.


2019 ◽  
Vol 62 (12) ◽  
pp. 4335-4350 ◽  
Author(s):  
Seth E. Tichenor ◽  
J. Scott Yaruss

Purpose This study explored group experiences and individual differences in the behaviors, thoughts, and feelings perceived by adults who stutter. Respondents' goals when speaking and prior participation in self-help/support groups were used to predict individual differences in reported behaviors, thoughts, and feelings. Method In this study, 502 adults who stutter completed a survey examining their behaviors, thoughts, and feelings in and around moments of stuttering. Data were analyzed to determine distributions of group and individual experiences. Results Speakers reported experiencing a wide range of both overt behaviors (e.g., repetitions) and covert behaviors (e.g., remaining silent, choosing not to speak). Having the goal of not stuttering when speaking was significantly associated with more covert behaviors and more negative cognitive and affective states, whereas a history of self-help/support group participation was significantly associated with a decreased probability of these behaviors and states. Conclusion Data from this survey suggest that participating in self-help/support groups and having a goal of communicating freely (as opposed to trying not to stutter) are associated with less negative life outcomes due to stuttering. Results further indicate that the behaviors, thoughts, and experiences most commonly reported by speakers may not be those that are most readily observed by listeners.


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