scholarly journals Persistent Fever While on Broad-Spectrum Antibiotics in a Patient With Squamous Cell Carcinoma

2021 ◽  
Vol 12 (7) ◽  
Author(s):  
Xin Li, CRNP, AOCNP
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cellular Therapy ◽  
Active Infection ◽  
Tumor Patients ◽  
Infectious Process ◽  
Persistent Fever ◽  
Patients With Cancer ◽  
Atypical Pathogens ◽  
Life Threatening ◽  
Rule Out

For solid tumor patients, acute infectious process is often underestimated, especially when caused by fungal, viral, or other atypical pathogens. Providers should perform a comprehensive infectious workup to rule out uncommon pathogen-induced infection before considering tumor fever. Active infection can be life threatening given most patients with cancer are receiving chemotherapy, immunotherapy, or even cellular therapy, as is the case with the patient discussed in this article.

scholarly journals Hypothetical COVID-19 protection mechanism: hints from centenarians

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Franca Rosa Guerini ◽  
Matteo Cesari ◽  
Beatrice Arosio
Keyword(s):  
Adaptive Immune Response ◽  
Human Leukocyte ◽  
Human Longevity ◽  
Biological Mechanisms ◽  
Protection Mechanism ◽  
Leukocyte Antigen ◽  
Adaptive Immune ◽  
Life Threatening ◽  
Coronavirus Infection ◽  
Rule Out

AbstractThe risk of serious complications and the fatality rate due to COVID-19 pandemic have proven particularly higher in older persons, putting a further strain in healthcare system as we dramatically observed.COVID-19 is not exclusively gerophile (géro “old” and philia “love”) as young people can be infected, even if older people experience more severe symptoms and mortality due to their greater frailty. Indeed, frailty could complicate the course of COVID-19, much more than the number of years lived. As demonstration, there are centenarians showing remarkable capacity to recover after coronavirus infection.We hypothesize that centenarian’s portfolio could help in identifying protective biological mechanisms underlying the coronavirus infection.The human leukocyte antigen (HLA) is one of the major genetic regions associated with human longevity, due to its central role in the development of adaptive immune response and modulation of the individual’s response to life threatening diseases. The HLA locus seems to be crucial in influencing susceptibility and severity of COVID-19.In this hypothesis, we assume that the biological process in which HLA are involved may explain some aspects of coronavirus infection in centenarians, although we cannot rule out other biological mechanisms that these extraordinary persons are able to adopt to cope with the infection.

scholarly journals Unilateral mydriasis in a child with a ventriculoperitoneal shunt for obstructive hydrocephalus: a diagnostic dilemma

2020 ◽  
Vol 13 (12) ◽  
pp. e237257
Author(s):  
Monidipa Banerjee ◽  
Eiman Haj Ahmed ◽  
Kathryn Foster ◽  
Arundoss Gangadharan
Keyword(s):  
Ipratropium Bromide ◽  
Obstructive Hydrocephalus ◽  
Sudden Onset ◽  
Unique Case ◽  
Diagnostic Dilemma ◽  
Vp Shunt ◽  
Life Threatening ◽  
Unilateral Mydriasis ◽  
The Brain ◽  
Rule Out

There are several causes for sudden onset unilateral mydriasis, however impending transtentorial uncal herniation needs to be ruled out. This unique case highlights an uncommon adverse response to a common mode of treatment that leads to a diagnostic dilemma. A 3-year-old boy with a ventriculoperitoneal (VP) shunt for an obstructive hydrocephalus presented with an acute respiratory distress. He developed unilateral mydriasis with absent light reflex during treatment with nebulisers. An urgent CT scan of the brain did not show any new intracranial abnormality. A case of pharmacological anisocoria was diagnosed that resolved completely within 24 hours of discontinuation of ipratropium bromide. Although ipratropium-induced anisocoria has been reported in children, but to our knowledge none in a child with VP shunt for hydrocephalus. This emphasises the urgency in evaluating unilateral mydriasis to rule out life-threatening conditions. Clinicians should remember that ipratropium administered through ill-fitting face masks could cause this completely reversible adverse effect.

The Role of Psilocybin-Assisted Psychotherapy to Support Patients With Cancer: A Critical Scoping Review of the Research

2021 ◽  
pp. 089801012110390
Author(s):  
Rebecca H. Lehto ◽  
Megan Miller ◽  
Jessica Sender
Keyword(s):  
Mental Health ◽  
Health Issues ◽  
Mushroom Species ◽  
Patients With Cancer ◽  
Existential Suffering ◽  
Vulnerable Patients ◽  
Scoping Literature Review ◽  
Life Threatening ◽  
Self Transcendence

Treatments for addressing psychiatric mental health issues in vulnerable patients with cancer are established. Yet, many patients persist with unrelenting psychological difficulties despite intervention. There is growing interest in the role of psilocybin-assisted psychotherapy for managing treatment-resistant mental health challenges in patients with cancer. Psilocybin is a naturally occurring compound derived from certain mushroom species that can induce entheogenic experiences or an altered state of consciousness. Reed's Self-Transcendence Theory provides a holistic lens to examine existential concerns and mental health in individuals who perceive their illness as potentially life threatening, such as those with cancer. This scoping literature review used Arksey and O’Malley's template to evaluate research examining psilocybin-assisted psychotherapy for patients with cancer. Eight articles met inclusion/exclusion criteria (four quantitative, two mixed methods, and two qualitative). Review findings indicated that the majority of patient experiences were positive, centering on themes of death acceptance, reflection, and broadened spirituality. Although psilocybin-assisted psychotherapy is in early stages of clinical testing, it thus shows promise for carefully screened patients with cancer who have persistent existential suffering. It will be critical for investigators to tailor this emerging intervention to select patients and for clinicians to be engaged in assessment of outcomes and efficacy.

scholarly journals Neurobiological Impact of EMDR in Cancer

2016 ◽  
Vol 10 (3) ◽  
pp. 153-161 ◽  
Author(s):  
Sara Carletto ◽  
Marco Pagani
Keyword(s):  
Stress Disorder ◽  
Brain Structures ◽  
Traumatic Experience ◽  
Patients With Cancer ◽  
Posttraumatic Symptoms ◽  
Clinical Level ◽  
Oncological Patients ◽  
Oncological Diseases ◽  
Life Threatening ◽  
Different Populations

The exposure to a life-threatening disease such as cancer may constitute a traumatic experience that in some cases may lead to the development of posttraumatic stress disorder (PTSD). In recent years, several studies investigated this syndrome in patients with cancer, but few focused on the underlying neurobiology. The aim of this work was to review the current literature of neurobiology of PTSD in oncological diseases, focusing on a comparison with the results of neurobiological studies on PTSD in non-oncological patients and on treatments resulted effective for such disorder. Brain structures having a role in the appearance of PTSD in psycho-oncology, and in particular, in intrusive symptoms, seem to be the same involved in non-oncologic PTSD. These findings may have important implications also at clinical level, suggesting that psychotherapies found to be effective to treat PTSD in different populations may be offered also to patients with cancer-induced posttraumatic symptoms. Further studies are needed to deepen our knowledge about cancer-related PTSD neurobiology and its treatment, aiming at transferring the results into clinical practice.

Haemophagocytic lymphohistiocytosis secondary to brucellosis in a young child

2021 ◽  
Vol 14 (3) ◽  
pp. e240759
Author(s):  
Jashan Mittal ◽  
Prawin Kumar ◽  
Jagdish Prasad Goyal ◽  
Abhishek Purohit
Keyword(s):  
Haemophagocytic Lymphohistiocytosis ◽  
Appetite Loss ◽  
Specific Therapy ◽  
Adequate Treatment ◽  
Underlying Condition ◽  
Persistent Fever ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

Brucellosis is a common zoonotic disease worldwide. It has protean clinical manifestation and sometimes may has a life-threatening complication. A 4-year-old boy presented with a history of fever, myalgia and appetite loss for 3 weeks. On examination, he had hepatosplenomegaly. The initial working diagnosis was an infection, autoimmune disease and malignancy. Investigations showed positive Brucella serology, and he was started on rifampicin and cotrimoxazole. He was further investigated because of persistent fever, which revealed evidence of haemophagocytic lymphohistiocytosis (HLH). He continued treatment for brucellosis, except rifampicin which was replaced with doxycyclin due to a worsening liver function. The child showed complete clinical and biochemical improvement after 6 weeks of therapy. HLH is a life-threatening condition and should be suspected in children with brucellosis, who did not respond to appropriate antibiotics treatment. Secondary HLH does not always require specific therapy; it may improve with adequate treatment of the underlying condition.

Methylphenidate-associated Alice in Wonderland syndrome

2020 ◽  
pp. 112067212097888 ◽  
Author(s):  
Artémise Dugauquier ◽  
Sina Bidgoli
Keyword(s):  
Brain Mri ◽  
Ophthalmological Examination ◽  
Case Description ◽  
Single Center ◽  
Potential Side Effect ◽  
Hyperactivity Disorder ◽  
Alice In Wonderland ◽  
First Case ◽  
Life Threatening ◽  
Rule Out

Introduction: We describe the case of a child affected by typical symptoms of Alice in Wonderland syndrome (AIWS), related to the methylphenidate treatment he was taking for an attention deficit hyperactivity disorder (ADHD). To our knowledge, this is the first case of methylphenidate-associated AIWS. Methods: Retrospective single center observational case report. Case description: A 12-year-old boy was complaining of micropsias and macropsias. Except a disruptive ADHD treated by methylphenidate for 2 years, his medical history was banal. His symptoms coincided with a change in his treatment regimen and ceased with methylphenidate discontinuation. Unfortunately, they recurred when the medication was reimplemented by his psychiatrist. The ophthalmological examination was unremarkable. We concluded to an AIWS and prescribed ancillary testing (including blood work, electroencephalogram, and brain MRI) to rule out conditions known to be associated with this syndrome. In the meanwhile, the methylphenidate dosage was readapted, and the symptoms disappeared again. Seen this clear dechallenge and rechallenge effect and the fact that all additional tests returned normal results, we deduced that our patient’s symptoms were associated to methylphenidate. Conclusion: AIWS could be a potential side effect of methylphenidate. Given the frequency of methylphenidate prescription for ADHD and its widespread misuse, it is important to consider this peculiar adverse effect. Every physician should be aware of the condition to offer reassurance and to prescribe the appropriate additional examinations, as life-threatening disorders can cause this syndrome.

Chemotherapy Acute Infusion Reactions: A Qualitative Report of the Perspectives of Patients With Cancer

2018 ◽  
Vol 35 (11) ◽  
pp. 1384-1389
Author(s):  
David J. Bartlett ◽  
Daniel S. Childs ◽  
Carmen Radecki Breitkopf ◽  
Megan E. Grudem ◽  
Jessica L. Mitchell ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Antineoplastic Agents ◽  
Qualitative Methodology ◽  
Infusion Reaction ◽  
Care Providers ◽  
Patients With Cancer ◽  
Life Threatening ◽  
Infusion Reactions

Objective: A growing number of cancer antineoplastic agents can cause life-threatening acute infusion reactions. Because previous studies have not studied these reactions from the perspective of patients, this study was undertaken with that objective in mind. Methods: Patients who had an acute infusion reaction were interviewed based on the Leventhal model. Once saturation of content was achieved, interviews were transcribed and analyzed with qualitative methodology. Results: Twenty-one patients were enrolled. Most were women (n = 15); the median age was 58 years, and paclitaxel was the most common inciting agent. Three themes emerged. First, these reactions are frightening; patients made remarks such as “I was just thinking oh my God, I am dying.” Second, prior education about these reactions seemed to mitigate this fear, “Basically everything the nurses told me potentially could happen, like happened. So, I was prepared.” Third, when health-care providers were prompt and attentive during the reaction, patients described less fear with future chemotherapy, “So no, I’m really not fearful about going in tomorrow because I know they’ll be there and they’ll be watching me.” Conclusion: These reactions evoke fear which can be mitigated with education prior to and with prompt responsiveness during the acute infusion reaction.

Oncologic Emergencies (DRAFT)

2018 ◽  
Author(s):  
Harry S. Rafkin
Keyword(s):  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Cord Compression ◽  
Initial Assessment ◽  
High Morbidity ◽  
Patients With Cancer ◽  
Oncologic Emergencies ◽  
Life Threatening ◽  
Vena Cava Syndrome

Oncologic emergencies are potentially life-threatening syndromes that occur in patients with cancer, and are either directly or indirectly related to the patient’s tumor. The clinical progression of these syndromes is rapid and the initial assessment of the patient must be done quickly, as without immediate therapy, high morbidity and mortality results. The oncologic emergency may be due to the tumor, the treatment given to control the tumor, or it may be due to a previously existing condition. This chapter reviews the clinical presentation, treatment, and management of tumor lysis syndrome, hypercalcemia, hyponatremia, disseminated intravascular coagulation, hyperviscosity syndrome, spinal cord compression, and superior vena cava syndrome.

A phase II evaluation of mitolactol in patients with advanced squamous cell carcinoma of the cervix: a Gynecologic Oncology Group Study.

1989 ◽  
Vol 7 (12) ◽  
pp. 1892-1895 ◽  
Author(s):  
F B Stehman ◽  
J A Blessing ◽  
R McGehee ◽  
R J Barrett
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Gynecologic Oncology ◽  
Complete Response ◽  
Gynecologic Oncology Group ◽  
Advanced Squamous Cell Carcinoma ◽  
Level Of Activity ◽  
Life Threatening ◽  
Tolerable Dose

Sixty patients with advanced squamous cell carcinoma of the cervix (SCC) who had received no prior chemotherapy were entered onto a study of mitolactol (dibromodulcitol [DBD]). The drug was administered orally at an initial dose of 180 mg/m2 per day for 10 days and repeated every 4 weeks. There were 55 evaluable patients, of whom one (2%) had a complete response (CR), and 15 (27%) had a partial response (PR), (CR plus PR, 29%). A 95% confidence interval for the true response rate is 18.8% to 42.1%. Myelosuppression was appreciable at this dose and schedule, with 13 patients experiencing life-threatening thrombocytopenia and two drug-related deaths. The level of activity in this disease encourages us to determine a tolerable dose of this drug in combination with cisplatin for further study.

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