scholarly journals Iatrogenic Chlorpromazine Abuse in a Kitten

2020 ◽  
Vol 52 (3) ◽  
Author(s):  
Erdem Gülersoy ◽  
Mehmet Umut Akgün ◽  
Büşra Burcu Erol ◽  
Mehmet Maden
Keyword(s):  
Motion Sickness ◽  
Activated Charcoal ◽  
Clinical Laboratory ◽  
Heart Rhythm ◽  
Ringer Solution ◽  
P Wave ◽  
Cardiac Monitoring ◽  
Laboratory Findings ◽  
High Doses ◽  
Veterinary Faculty

Chlorpromazine is a sedative effective phenothiazine derivative used to prevent nausea and vomiting, especially in cases of motion sickness in cats. It has serious side effects at high doses, including weakness, tremors, loss of anal sphincter tone and reflexes, hypotension, heart rhythm abnormalities, coma, agitation and seizures. In this case report, chlorpromazine toxicity was defined in a 4-month-old, 1.2 kg male Van kitten brought to Selcuk University Veterinary Faculty Emergency Clinic with complaints of stagnation, tremors, vomiting and excessive sleepiness. Hypothermia (35.2 °C), hyperpnea (88 breaths/min), hypersalivation, constipation, excessive agitation, tremors and incoordination were determined in the clinical examination of the kitten. It was learned from the anamnesis that 100 mg chlorpromazine was given orally before the trip against motion sickness. Electrocardiographic examination determined sinus tachycardia (220 beats/min), increase in P wave amplitude, elevation in ST complex and hypotension (S/MAP/D = 148/124/112). The major laboratory findings were metabolic acidosis (pH 7.278), hypoglycaemia (61 mg/dL), leukocytosis (22.43 m/mm3), increase in blood ured nitrogen (17.7 mg/dL), creatinine (0.6 mg/dL) and ALP (121 U/L) concentrations and hypertriglyceridemia (122 mg/dL). Based on the anamnesis, clinical, laboratory and ECG findings, the kitten was diagnosed with overdose chlorpromazine toxicity and hospitalized, and put under surveillance for continuous cardiac monitoring. Lactated ringer solution, norepinephrine tartrate, furosemide, activated charcoal and oxygen therapy were given. The treatment was successful. In conclusion, it was evaluated that continuous cardiac monitoring and controlling hypotension were important in the management of chlorpromazine toxicity, and fluid therapy, norepinephrine, diuretic and activated charcoal administrations achieve success in treatment.

New Insight for the Prognosis of CCHF: Clinical, Laboratory and Sonography Findings

2020 ◽  
Vol 16 (9) ◽  
pp. 1125-1130
Author(s):  
Hamid Owaysee Osquee ◽  
Sepehr Taghizadeh ◽  
Mehdi Haghdoost ◽  
Hadi Pourjafar ◽  
Fereshteh Ansari
Keyword(s):  
Odds Ratio ◽  
Clinical Laboratory ◽  
Fatal Outcome ◽  
Hemorrhagic Fever ◽  
Demographic Characteristics ◽  
Pelvic Cavity ◽  
Fatal Disease ◽  
Laboratory Findings ◽  
Report Data ◽  
Sistan And Baluchestan

Introduction: In this article, we report data on confirmed CCHF cases from Iran and describe the association between studying factors and outcomes of the disease. Objective: Crimean Congo Hemorrhagic Fever (CCHF) is an acute and fatal disease with various clinical and paraclinical characteristics. Methods: In the Study design, we evaluated demographic characteristics, clinical, laboratory and sonographic findings of 160 CCHF confirmed cases during 2003 and 2012 in Zabol (A city in Sistan and Baluchestan province of Iran). The association between these factors and the fatal outcome was evaluated by regression analysis. Results: The disease had a fatal outcome in 7 (4.4%) of patients. Females had more severe symptoms and higher odds for death (odds ratio11.57, p=0.005). Leukocytosis (p<0.001), PT (p<0.001) and PTT (p=0.008) elongation, AST (p=0.010) and ALT (p<0.001) elevation were significantly associated with fatal outcome. CNS related symptoms (odds ratio 5.9, p=0.027) in clinical examination and ascites (odds ratio 38.4, p=0.012) and liquid in the pelvic cavity (odds ratio 24.2, p=0.004) were also identified as risk factors of death in this study. Conclusions: Our data suggest that in addition to clinical and laboratory findings practitioners consider sonography for CCHF prognosis.

scholarly journals Relative Frequency and Risk Factors of COVID-19 Related Headache in a Sample of Egyptian Population: A Hospital-Based Study

Pain Medicine ◽  
2021 ◽  
Author(s):  
Mona Hussein ◽  
Wael Fathy ◽  
Ragaey A Eid ◽  
Hoda M Abdel-Hamid ◽  
Ahmed Yehia ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Platelet Count ◽  
Relative Frequency ◽  
Clinical Laboratory ◽  
Primary Headache ◽  
Female Gender ◽  
Imaging Data ◽  
Laboratory Findings ◽  
Neutrophil Lymphocyte Ratio ◽  
The Impact

Abstract Objectives Headache is considered one of the most frequent neurological manifestations of coronavirus disease 2019 (COVID-19). This work aimed to identify the relative frequency of COVID-19-related headache and to clarify the impact of clinical, laboratory findings of COVID-19 infection on headache occurrence and its response to analgesics. Design Cross-sectional study. Setting Recovered COVID-19 patients. Subjects In total, 782 patients with a confirmed diagnosis of COVID-19 infection. Methods Clinical, laboratory, and imaging data were obtained from the hospital medical records. Regarding patients who developed COVID-19 related headache, a trained neurologist performed an analysis of headache and its response to analgesics. Results The relative frequency of COVID-19 related headache among our sample was 55.1% with 95% confidence interval (CI) (.516–.586) for the estimated population prevalence. Female gender, malignancy, primary headache, fever, dehydration, lower levels of hemoglobin and platelets and higher levels of neutrophil/lymphocyte ratio (NLR) and CRP were significantly associated with COVID-19 related headache. Multivariate analysis revealed that female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count were independent predictors of headache occurrence. By evaluating headache response to analgesics, old age, diabetes, hypertension, primary headache, severe COVID-19, steroid intake, higher CRP and ferritin and lower hemoglobin levels were associated with poor response to analgesics. Multivariate analysis revealed that primary headache, steroids intake, moderate and severe COVID-19 were independent predictors of non-response to analgesics. Discussion Headache occurs in 55.1% of patients with COVID-19. Female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count are considered independent predictors of COVID-19 related headache.

scholarly journals Effective Treatment of Neurological Symptoms with Normal Doses of Botulinum Neurotoxin in Wilson’s Disease: Six Cases and Literature Review

Toxins ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 241
Author(s):  
Harald Hefter ◽  
Sara Samadzadeh
Keyword(s):  
Botulinum Neurotoxin ◽  
Wilson’S Disease ◽  
Animal Experiments ◽  
Symptomatic Treatment ◽  
Wilson's Disease ◽  
University Hospital ◽  
Laboratory Findings ◽  
Dose Information ◽  
High Doses ◽  
The University

Background: Recent cell-based and animal experiments have demonstrated an effective reduction in botulinum neurotoxin A (BoNT/A) by copper. Aim: We aimed to analyze whether the successful symptomatic BoNT/A treatment of patients with Wilson’s disease (WD) corresponds with unusually high doses per session. Methods: Among the 156 WD patients regularly seen at the outpatient department of the university hospital in Düsseldorf (Germany), only 6 patients had been treated with BoNT/A during the past 5 years. The laboratory findings, indications for BoNT treatment, preparations, and doses per session were extracted retrospectively from the charts. These parameters were compared with those of 13 other patients described in the literature. Results: BoNT/A injection therapy is a rare (<4%) symptomatic treatment in WD, only necessary in exceptional cases, and is often applied only transiently. In those cases for which dose information was available, the dose per session and indication appear to be within usual limits. Conclusion: Despite the evidence that copper can interfere with the botulinum toxin in preclinical models, patients with WD do not require higher doses of the toxin than other patients with dystonia.

scholarly journals Clinical Characteristics, Treatments and Outcomes of 18 Lung Transplant Recipients with COVID-19

2021 ◽  
Vol 2 (2) ◽  
pp. 229-245
Author(s):  
René Hage ◽  
Carolin Steinack ◽  
Fiorenza Gautschi ◽  
Susan Pfister ◽  
Ilhan Inci ◽  
...  
Keyword(s):  
Lung Transplant ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Case Series ◽  
Outcome Data ◽  
Transplant Recipients ◽  
Retrospective Case ◽  
Laboratory Findings ◽  
Case Series Study ◽  
Lung Transplant Recipients

We report clinical features, treatments and outcomes in 18 lung transplant recipients with laboratory confirmed SARS-CoV-2 infection. We performed a single center, retrospective case series study of lung transplant recipients, who tested positive for SARS-CoV-2 between 1 February 2020 and 1 March 2021. Clinical, laboratory and radiology findingswere obtained. Treatment regimens and patient outcome data were obtained by reviewing the electronic medical record. Mean age was 49.9 (22–68) years, and twelve (67%) patients were male. The most common symptoms were fever (n = 9, 50%), nausea/vomiting (n = 7, 39%), cough (n = 6, 33%), dyspnea (n = 6, 33%) and fatigue (n = 6, 33%). Headache was reported by five patients (28%). The most notable laboratory findings were elevated levels of C-reactive protein (CRP) and lactate dehydrogenase (LDH). Computed Tomography (CT) of the chest was performed in all hospitalized patients (n = 11, 7%), and showed ground-glass opacities (GGO) in 11 patients (100%), of whom nine (82%) had GGO combined with pulmonary consolidations. Six (33%) patients received remdesivir, five (28%) intravenous dexamethasone either alone or in combination with remdesivir, and 15 (83%) were treated with broad spectrum antibiotics including co-amoxicillin, tazobactam-piperacillin and meropenem. Four (22%) patients were transferred to the intensive care unit, two patients (11%) required invasive mechanical ventilation who could not be successfully extubated and died. Eighty-nine percent of our patients survived COVID-19 and were cured. Two patients with severe COVID-19 did not survive.

scholarly journals Retrospective analysis of pleural effusion in cats

2018 ◽  
Vol 21 (12) ◽  
pp. 1102-1110 ◽  
Author(s):  
Alla König ◽  
Katrin Hartmann ◽  
Ralf S Mueller ◽  
Gerhard Wess ◽  
Bianka S Schulz
Keyword(s):  
Pleural Effusion ◽  
Clinical Laboratory ◽  
Serum Alkaline Phosphatase ◽  
Small Animal ◽  
Underlying Disease ◽  
Serum Alkaline Phosphatase Activity ◽  
Laboratory Findings ◽  
Glucose Levels ◽  
Cell Counts ◽  
Lower Protein

Objectives Pleural effusion is a common presenting cause for feline patients in small animal practice. The objectives of this study were to identify possible correlations between the aetiology of effusion and clinical and laboratory findings. Methods In this retrospective study of 306 cats diagnosed with pleural effusion of established aetiology, cats were divided into six major groups: cardiac disease (CD), feline infectious peritonitis (FIP), neoplasia, pyothorax, chylothorax and miscellaneous. Clinical, laboratory and radiographic parameters were compared between groups. Results CD was the most common aetiology (35.3%), followed by neoplasia (30.7%), pyothorax (8.8%), FIP (8.5%), chylothorax (4.6%) and miscellaneous diseases (3.7%). In 26 (8.5%) cats, more than one underlying disease was diagnosed as a possible aetiology for pleural effusion. Cats with FIP were significantly younger than those with CD ( P <0.001) and neoplasia ( P <0.001). Cats with CD were presented with a significantly lower body temperature compared with cats with FIP ( P = 0.022). Cats with CD had significantly higher serum alanine aminotransferase activity compared with all other cats (FIP and pyothorax, P <0.001; neoplasia and chylothorax, P = 0.02) and serum alkaline phosphatase activity compared with the pyothorax ( P <0.001) and FIP groups ( P = 0.04), and significantly lower protein concentrations (FIP, pyothorax and neoplasia, P <0.001; chylothorax, P = 0.04) and nucleated cell counts in the effusion than all other groups (pyothorax and neoplasia, P <0.001; chylothorax, P = 0.02; FIP, P = 0.04). The glucose level in the effusion of cats with pyothorax was significantly lower than glucose levels in patients with CD, neoplasia and chylothorax ( P <0.001). Of 249 cats with a follow-up of at least 10 days, 55.8% died or were euthanased during that time. Conclusions and relevance CD and neoplasia were the most common causes for feline pleural effusion. Age, liver enzymes, as well as cell count, protein and glucose levels in the effusion can aid in the investigation of underlying aetiologies.

scholarly journals Immunotherapy in the treatment of chronic cystitis

2018 ◽  
Vol 4 (4) ◽  
pp. 65-77
Author(s):  
Yana Kulintsova ◽  
Andrey Zemskov ◽  
Tatyana Berezhnova
Keyword(s):  
Conventional Therapy ◽  
Clinical Laboratory ◽  
Metabolic Stress ◽  
Risk Groups ◽  
Average Weight ◽  
Chronic Cystitis ◽  
Laboratory Findings ◽  
Flow Cytofluorometry ◽  
Immune Therapies ◽  
Immune Globulins

Introduction: The article deals with to the new approaches to the immunotherapy of chronic cystitis. Cystitis appears to be a disease linked to the decreased immunity of the population. Materials and Methods: The study included 200 patients with chronic cystitis, and was performed in three stages. At the first stage, all 200 patients were questioned to determine whether they do or do not have the basic immunopathological syndromes. At the second stage, the patients of 6 clinical groups underwent a routine immunologic examination using tests to evaluate basic populations, lymphocyte subpopulations, immune globulins, circulating immune complexes, average weight molecules, absorbing and metabolic phagocytic ability, pro- and anti-inflammatory cytokines by using flow cytofluorometry methods. The third stage included distribution of the major group of patients with chronic cystitis in the relapse stage into subgroups of 25 patients each who received conventional therapy. Results and Discussion: The study has the following findings: the formation of risk groups depends on immunopathological syndromes and clinical-laboratory markers of disease peculiarities; signal tests of immunologic disorders and their correlative links with metabolic stress parameters were specified and formalized as diagnostic formulas; high clinical-bacteriological and low hemato-immunological efficacy of the conventional therapy patients with chronic cystitis and the capacity of the local and systemic modulators, such as kipferon, superlimf and imunofan, galavit, and their combinations, to normalize the parameters under study during 7-10 days were demonstrated. When combining the correctors, it was possible to achieve new quality independent of the properties of individual agents included in the composition; the reveal targets of various immune therapies were conditioned by the treatment provided, the characteristics of the correctors, the identification period – 7-10 days – 3-4 months. The analysis of the formulas of modulator targets made it possible to identify laboratory findings for their selection. Conclusion: The data obtained during the study support the fact that there was no clinical efficacy of the conventional therapy for patients; this efficacy was maintained through to the administration of the combination of modulators in the acute period. Substantiated differentiated immunotherapy resulted in implementing the proper algorithm of observations, which prevented recurring of chronic cystitis in 3-4 months.

scholarly journals Clinical Manifestations of Orbital Involvement in IgG4-Related Disease: A Retrospective Study of 573 Patients

2021 ◽  
Author(s):  
Linyang Gan ◽  
Xuan Luo ◽  
Yunyun Fei ◽  
Linyi Peng ◽  
Jiaxin Zhou ◽  
...  
Keyword(s):  
Lacrimal Gland ◽  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Chinese Patients ◽  
Laboratory Findings ◽  
Male Predominance ◽  
Orbital Involvement ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Serum Igg4

Abstract Purpose: To investigate the clinical manifestations of orbital involvement in a large cohort of Chinese patients with IgG4-related disease (IgG4-RD). Methods: A total of 573 patients with IgG4-related disease were included. We described and compared the demographic, clinical, laboratory and histopathologic findings from 314 patients with IgG4-related ophthalmic disease (IgG4-ROD) and 259 with extra-ophthalmic IgG4-RD.Results: Male predominance was found significant in extra-ophthalmic IgG4-RD only. Patients with IgG4-ROD showed younger age at diagnosis and longer duration from onset till diagnosis. In patients with extra-ophthalmic IgG4-RD, the most commonly involved extra-ophthalmic organ was pancreas; while in IgG4-ROD patients, salivary gland was most frequently affected. Multivariate analysis exhibited IgG4-ROD was associated with allergy history, higher serum IgG4/IgG ratio, multiple organs involvement and sialoadenitis. Orbital images were reviewed in 173 (55.1%) IgG4-ROD patients. Fifty-one (29.5%) patients had multiple lesions. Lacrimal gland involvement was detected in 151 (87.3%) patients, followed by extraocular muscles (40, 23.1%), other orbital soft tissue (40, 23.1%) and trigeminal nerve (8, 4.6%). Biopsy was performed from various organs in 390 cases. A dense lymphoplasmacytic infiltration and fibrosis were the main feature in orbital specimens. Storiform fibrosis and obliterative phlebitis were absent in lacrimal gland.Conclusions: Lacrimal gland involvement was the most common orbital manifestation of IgG4-ROD. Patients with IgG4-ROD showed different characteristic in demographic, clinical, laboratory findings compared to patients with extra-ophthalmic IgG4-RD. These features might indicate potential differences in the pathogenesis of these two subgroups of IgG4-RD.

scholarly journals Does Pulmonary Embolism Differ Between Genders in Terms of Clinical, Laboratory Findings, Prognosis and Mortality?

2020 ◽  
Author(s):  
Damla Serçe Unat ◽  
Aysu Ayrancı ◽  
Gulru Polat ◽  
Gülistan Karadeniz ◽  
Fatma Demirci Üçsular ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Laboratory ◽  
Severity Index ◽  
Early Mortality ◽  
European Respiratory Society ◽  
Laboratory Findings ◽  
Significant Difference ◽  
Male Patients ◽  
European Society Of Cardiology

INTRODUCTION: Pulmonary thromboembolism (PTE) is a disease that mortal and hardly diagnosed. Since findings of PTE are nonspesific diagnosed can be so hard sometimes. Major risk factors are malignancy, immobility, previous surgery, thrombophilia, advanced age, and genetic factors. Studies on the relationship between gender and prognosis in PTE have very different results. In this study, we aimed to evaluate gender differences in terms of prognosis, intensive care admission, laboratory, and radiological tests. METHODS: We retrospectively analyzed the data of 348 patients diagnosed with Acute PTE between January 2012 and December 2015. All of these patients were patients who applied to the emergency department of our center, which is a third step chest diseases hospital. We used the PTE guideline jointly designed by the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) for prognosis classifications. RESULTS: The mean age of the patients was 62.7, while the male patients were younger. Women's sPESI scores and mean ages were observed higher than men. Although women had more bad prognostic factors, no significant difference was found between both genders in terms of early mortality. DISCUSSION AND CONCLUSION: Although there is a difference between mean age and simplified Pulmonary Embolism Severity Index (sPESI) scores; no difference in early mortality between men and women. Gender studies in PTE are an area that is open to new studies, since the studies conducted on this subject give quite different results and these results may affect the follow-up protocols.

scholarly journals Clinical Characteristics and Outcomes of Diabetic COVID-19 patients in Kuwait

2020 ◽  
Author(s):  
Abdullah Alshukry ◽  
Mohammad Bu Abbas ◽  
Yaseen Ali ◽  
Barrak Alahmad ◽  
Abdullah A. Al-Shammari ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Fasting Blood Glucose ◽  
List Type ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Patients With Diabetes ◽  
Laboratory Investigations ◽  
Insight Into ◽  
Variable Clinical Presentation

AbstractBackgroundCOVID-19 has a highly variable clinical presentation, ranging from asymptomatic to severe respiratory symptoms and death. Diabetes seems to be one of the main comorbidities contributing to a worse COVID-19 outcome.ObjectiveIn here we analyze the clinical characteristics and outcomes of diabetic COVID-19 patients.MethodsIn this single-center, retrospective study of 417 consecutive COVID-19 patients, we analyze and compare disease severity, outcome, associated complications, and clinical laboratory findings between diabetic and non-diabetic COVID-19 patients.ResultsCOVID-19 patients with diabetes had more severe outcomes and higher mortality than non-diabetic COVID-19 patients. Diabetic COVID-19 patients had significantly higher prevalence of comorbidities, such as hypertension. Laboratory investigations also highlighted notably higher levels of C-reactive protein in diabetic COVID019 patients and lower estimated glomerular filtration rate. They also showed a higher incidence of complications.ConclusionDiabetes could be a major contributor to worsening outcomes in COVID-19 patients. Understanding the pathophysiology underlining these findings could provide insight into better management and improved outcome of such cases.Highlights of the StudyA significantly higher proportion of Diabetic COVID-19 patients required admission to the ICU.Higher fasting blood glucose was associated with higher risk of COVID-19 associated mortality.Diabetic COVID-19 patients had significantly higher incidence of complications including sepsis, ARDS, cardiac failure and renal failure.

scholarly journals Adult T-cell leukemia/lymphoma: report of two cases

2008 ◽  
Vol 41 (3) ◽  
pp. 288-292 ◽  
Author(s):  
Ricardo Aparecido Olivo ◽  
Fabrício Frederico Mendes Martins ◽  
Sheila Soares ◽  
Helio Moraes-Souza
Keyword(s):  
T Cell ◽  
Clinical Laboratory ◽  
Skin Lesions ◽  
Type I ◽  
T Cell Leukemia ◽  
Cell Leukemia ◽  
Laboratory Findings ◽  
Adult T Cell Leukemia ◽  
Human T Cell ◽  
Disease Case

Adult T-cell leukemia/lymphoma is a lymphoproliferative disorder of mature T lymphocytes associated with infection with human T-cell lymphotrophic virus type I (HTLV-I). Adult T-cell leukemia/lymphoma is characterized by clinical and laboratory polymorphism that allows it to be classified into four distinct subgroups: smoldering, chronic, acute and lymphomatous types. We present here two cases of adult T-cell leukemia/lymphoma, respectively in the acute and lymphomatous forms of the disease. Case 1 was a 35-year-old woman who presented abdominal distension accompanied by hepatosplenomegaly, adenomegaly, skin lesions, positivity for anti-HTLV-I antibodies and leukocytosis with the presence of flower cells. Case 2 was a 38-year-old man who was admitted with generalized lymphadenomegaly, positivity for anti-HTLV-I antibodies, hypercalcemia and osteolytic lesions. In this paper, we correlate the clinical-laboratory findings of these two cases with data in the literature.

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