scholarly journals Adjunctive Clotiapine for the Management of Delusions in Two Adolescents with Anorexia Nervosa

2021 ◽  
Vol 11 (12) ◽  
pp. 173
Author(s):  
Jacopo Pruccoli ◽  
Giulia Joy Leone ◽  
Cristina Di Sarno ◽  
Luigi Vetri ◽  
Giuseppe Quatrosi ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Atypical Antipsychotic ◽  
Current Literature ◽  
Blood Count ◽  
Psychotic Disorders ◽  
Potential Effect ◽  
White Blood Count ◽  
Clinical Use ◽  
Nutritional Interventions

Clotiapine is an atypical antipsychotic indicated for the management of a series of acute psychotic disorders. The current literature lacks evidence concerning the tolerability and clinical use of this drug in the management of individuals with anorexia nervosa (AN). In this study, we report two cases of adolescents with AN, treated with clotiapine. The reason for the administration of clotiapine was, for both patients, the manifestation of bizarre delusions concerning food and calories. Patient 1 presented a presyncope after the first dose of clotiapine, and treatment was rapidly discontinued. Patient 2 was treated with clotiapine for 9 months; doses were titrated from 20 mg/day to 70 mg/day, with an improvement in the reported delusions, which also enhanced compliance with psychological and nutritional interventions. EKG, QTc, white blood count, and red blood count were not relevantly influenced by the introduction of clotiapine in either patient. No extrapyramidal effect was documented. These reports stress the need for further studies assessing the tolerability and potential effect of clotiapine in treating adolescents with AN and delusional symptomatology.

Identifying Targets for the Prevention of Childhood Undernutrition in a Resource-Limited Peri-Urban Ecuadorian Community

2021 ◽  
pp. 037957212098250
Author(s):  
Suzanna L. Attia ◽  
Wolf-Peter Schmidt ◽  
Janeth Ceballos Osorio ◽  
Thomas Young ◽  
Aric Schadler ◽  
...  
Keyword(s):  
Vitamin A ◽  
Blood Count ◽  
Complete Blood Count ◽  
Dietary Diversity ◽  
Demographic Data ◽  
Serum Zinc ◽  
White Blood Count ◽  
Monthly Income ◽  
Vitamin Deficiencies ◽  
Dietary Diversity Score

Background: In middle-income countries, malnutrition concentrates in marginalized populations with a lack of effective preventive strategies. Objective: Identify risk factors for undernutrition in a peri-urban Ecuadorian community of children aged 12 to 59 months. Methods: Data from a cross-sectional survey in 2011 of children 1 to 5 years were analyzed including demographic data, medical history and examination, food frequency questionnaire (FFQ), anthropometric measurements, and blood for complete blood count, C-reactive protein, vitamin A, iron, and zinc levels. Dietary Diversity Score (DDS) was calculated from FFQ. Bivariate and multivariate analysis assessed effects on primary outcome of undernutrition by DDS, vitamin deficiencies, and demographic and nutritional data. Results: N = 67, 52.2% undernourished: 49.3% stunted, 25.4% underweight, and 3% wasted; 74.6% (n = 50) were anemic and 95.1% (n = 39) had low serum zinc. Dietary Diversity Score was universally low (mean 4.91 ± 1.36, max 12). Undernutrition was associated with lower vitamin A levels (20 306, IQR: 16605.25-23973.75 vs 23665, IQR: 19292-26474 ng/mL, P = .04); underweight was associated with less parental report of illness (43.8%, n = 7 vs 80% n = 40, P = .005) and higher white blood count (13.7, IQR: 11.95-15.8 vs 10.9, IQR: 7.8-14.23 × 109/L, P = .02). In multiple regression, risk of undernutrition decreased by 4% for every $10 monthly income increase (95 CI%: 0.5%-7.4%, P = .02, n = 23); risk of underweight decreased by 0.06 for every increased DDS point (adjusted odds ratio: 0.06; 95 CI%: 0.004-0.91, P = .04, n = 23). Conclusions: In this peri-urban limited resource, mostly Indigenous Ecuadorian community, stunting exceeds national prevalence, lower monthly income is the strongest predictor of undernutrition, lower DDS can predict some forms of undernutrition, and vitamin deficiencies are associated with but not predictive of undernutrition.

Massive Eosinophilic Reaction to Desipramine in Conjunction with Pneumonia*

1984 ◽  
Vol 29 (2) ◽  
pp. 142-144 ◽  
Author(s):  
R.P. Kraus ◽  
R.J. Clarke ◽  
R.A. Remick
Keyword(s):  
Affective Disorder ◽  
Female Patient ◽  
Blood Count ◽  
Bipolar Affective Disorder ◽  
Dry Mouth ◽  
White Blood Count ◽  
Medication Change ◽  
Supportive Management

The authors report on a female patient with bipolar affective disorder who presented with marked eosinophilia in conjunction with pneumonia five days after a medication change from amitriptyline to desipramine (for intolerable dry mouth). She improved with discontinuance of medications and supportive management, and her eosinophilia normalized. Reinstitution of desipramine was followed by prompt appearance of asymptomatic eosinophilia, which resolved with discontinuation of desipramine. A subsequent depression managed with amitriptyline was followed by no abnormal white blood count findings. Eosinophilia is occasionally encountered in imipramine or desipramine therapy and, although usually asymptomatic, appears to be manageable by switching to amitriptyline or nortriptyline.

OLANZAPINE POISONING IN CHILDREN : A CASE SERIES

2021 ◽  
pp. 32-33
Author(s):  
Syed Idrees Hassan Sajjad ◽  
Dandu Venkata Satya Sanjay Varma
Keyword(s):  
Atypical Antipsychotic ◽  
Psychotic Disorders ◽  
Case Series ◽  
Altered Sensorium ◽  
Poisoning In Children

Olanzapine is a readily available atypical antipsychotic usually prescribed in adults for psychotic disorders. Olanzapine overdose or poisoning is rarely seen in children. It is often due to accidental intake of drug and sometimes suicidal.We are reporting two case of olanzapine poisoning in children presenting with altered sensorium and pinpoint pupils. The mainstay of treatment of olanzapine poisoning is supportive and symptomatic measures. Both children recovered well and were discharged.

P5610Inflammatory response after ExoVasc personalized external aortic root support (PEARS) procedure in patients with Marfan syndrome or non-Marfan genetic aortopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Kockova ◽  
J Maly ◽  
A Krebsova ◽  
M Labos ◽  
J Pirk
Keyword(s):  
Aortic Root ◽  
Hospital Readmission ◽  
Blood Count ◽  
White Blood Count ◽  
Recurrent Fever ◽  
C Reactive Protein ◽  
Recurrent Pericarditis ◽  
Reactive Protein ◽  
Aortic Root Surgery ◽  
St Elevation

Abstract Background External aortic root support (PEARS) is a novel prophylactic aortic root surgery. Purpose The study aimed to determine the severity of inflammatory response after the personalized external aortic root support (PEARS) procedure in comparison to after the standard prophylactic aortic root surgery (SPARS). Materials and methods The study was a single-centre, retrospective, based on hospital record analysis of patients who underwent the PEARS procedure (PEARS group) or SPARS (SPARS group) during 1998–2017. C-reactive protein (CRP), white blood count (WBC), and echocardiography were routinely obtained. Fever was defined as body temperature ≥38°C. Diagnosis of pericarditis included a minimum of three signs from chest pain, pericardial effusion, ST elevation, elevated CRP, and body temperature. Results PEARS and SPARS groups consisted of 13 and 14 patients, respectively, scheduled for prophylactic aortic root surgery. A majority of patients in both groups had Marfan syndrome with causal mutation in the fibrillin 1 (FBN1) gene (62% vs 79%). Patient baseline characteristics were similar in the two groups, except aortic root was significantly larger in the SPARS group than in the PEARS group (60±12 mm vs 48±5 mm; P=0.003). All surgical procedures were successful and without major complications. The peak values of CRP and WBC were significantly higher in the PEARS group (264.5±84.4 mg/L vs 184.6±89.6 mg/L; P=0.034 and 15.2±3.8 109/L vs 11.9±3.3 109/L; P=0.029). Early and recurrent fever requiring hospital readmission was significantly more frequent in the PEARS group (77% vs 36%; P=0.032 and 46% vs 7%; P=0.020). Early and recurrent pericarditis requiring hospital readmission was also more frequent in the PEARS group (31% vs 0%; P=0.024 and 31% vs 0%; P=0.024). Inflammatory characteristics Postprocedural inflammatory characteristics PEARS group SPARS group P value (N=13) (N=14) Peak level of CRP (mg/L) 264.5±84.4 184.6±89.6 0.034 Peak WBC (109/L) 15.2±3.8 11.9±3.3 0.029 ST elevation (N) 11 (85) 6 (43) 0.024 Early fever (N) 10 (77) 5 (36) 0.032 Recurrent fever (N) 6 (46) 1 (7) 0.020 Early pericarditis (N) 4 (31) 0 (0) 0.024 Recurrent pericarditis (N) 4 (31) 0 (0) 0.024 CRP, C-reactive protein; WBC, white blood count. Echocardiography-signs of inflammation Conclusions The PEARS procedure is an extremely promising surgical technique, but the postoperative inflammatory response occurs frequently and more severely in comparison to SPARS. Clearly, these findings warrant further investigation.

Compact Fluorescent Lamps and Risk of Skin Cancer

2013 ◽  
Vol 17 (5) ◽  
pp. 308-312 ◽  
Author(s):  
Kaveri Korgavkar ◽  
Michael Xiong ◽  
Martin A. Weinstock
Keyword(s):  
Skin Cancer ◽  
Cancer Risk ◽  
Adverse Effects ◽  
Human Skin ◽  
Uv Radiation ◽  
Current Literature ◽  
Potential Effect ◽  
Fluorescent Lamps ◽  
Compact Fluorescent Lamps ◽  
Significant Damage

Background: Previously considered safe for typical use, concerns have recently been expressed regarding the potential effect of compact fluorescent lamps (CFLs) on human skin and, in particular, on skin cancer risk. Objective: We sought to address this concern by reviewing the current literature on CFLs, ultraviolet (UV) radiation, and photocarcinogenic exposure. Results: On average, the UV radiation from CFLs and subsequent carcinogenic exposure is lower than that from incandescent bulbs. However, defective bulbs can emit higher levels of UV radiation, which may cause significant damage. Conclusion: Our review calls for further investigation to determine how frequently these bulbs are sufficiently defective to lead to adverse effects.

scholarly journals Acute myeloid leukaemia: an unusual cause of biliary strictures

2019 ◽  
Vol 12 (3) ◽  
pp. e227821
Author(s):  
Adele Beck ◽  
Hannah Hunter ◽  
Simon Jackson ◽  
David Sheridan
Keyword(s):  
Bone Marrow ◽  
Obstructive Jaundice ◽  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Blood Count ◽  
Extrahepatic Bile Duct ◽  
White Blood Count ◽  
Full Blood Count ◽  
Significant Past Medical History ◽  
Acute Myeloid

A 17-year-old man with no significant past medical history presented with a 2-week history of worsening jaundice, lethargy, anorexia and progressive right upper quadrant abdominal pain. There were no stigmata of chronic liver disease. Initial investigations were suggestive of cholangitis with large intrahepatic and extrahepatic bile duct strictures but otherwise normal hepatic and splenic appearances. A percutaneous transhepatic cholangiogram with the positioning of drains was performed to alleviate the obstructive jaundice. Within 2 weeks of the first presentation, full blood count revealed a significantly raised white blood count and a subsequent peripheral blood smear and bone marrow were consistent with a diagnosis of acute myeloid leukaemia. Chemotherapy was started after partial improvement of his obstructive jaundice. Complete morphological and cytogenetic remission was obtained 4 weeks after the first cycle of chemotherapy (half dose of daunorubicin and full dose of cytarabine, treated off trial) on control bone marrow. The patient remains in remission.

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