Cases reported "Alcoholism"

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1/24. A case of reversible azoospermia following withdrawal from alcohol consumption.

    Chronic alcohol intake is associated with male reproductive function impairment. However, no longitudinal studies have been carried out to determine the recovery of alcohol-related spermatogenetic failure subsequent to moderate periods of abstinence. The present report describes the achievement of a pregnancy 3 months after withdrawal from alcohol consumption in the partner of a patient with azoospermia secondary to heavy alcoholic intake (mean daily alcohol consumption: 90 g). alcoholism was the putative cause of the infertile condition of this patient because, during alcohol consumption, he first had teratozoospermia characterized by a never reported high percentage of spermatozoa with large heads (associated with a nonmegaloblastic macrocytic anaemia in the blood smear), and subsequently azoospermia.
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keywords = impairment
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2/24. Decision-making capacity and alcohol abuse: clinical and ethical considerations in personal care choices.

    Requests for competency assessment of elderly patients are among the more common referrals that medical and surgical units make to consultation-liaison psychiatrists. Special considerations arise when impairment in cognition, judgment and function arise in the context of substance abuse. At what point during the admission should the evaluation be made? What if the person does well on the cognitive exam but has shown repeated evidence of self-neglect and need for medical care? What role should the medical profession play in mandating that patients give up harmful addictions? In this paper, we describe a case that illustrates these problems, and discuss some of the clinical and ethical considerations involved in the assessment of personal care competence of patients with alcohol abuse, and provide guidelines for these assessments.
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keywords = impairment
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3/24. brain imaging of an alcoholic with MRI, SPECT, and PET.

    A medically healthy chronic alcoholic without evidence of neurological and neuropsychological impairment was studied with magnetic resonance imaging (MRI), single photon emission computerized tomography (SPECT), and positron emission tomography (PET). An age-matched normal volunteer was evaluated with the same scans for comparison. The MRI of the alcoholic revealed prominent ventricles and mild cortical atrophy. SPECT and PET revealed predominant involvement of the frontal cortex as shown by decreased frontal blood flow and metabolism. This case illustrates the sensitivity of brain imaging techniques in detecting cerebral abnormalities even in the absence of neurologic and/or neuropsychological impairments.
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keywords = impairment
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4/24. Alcoholic case of central pontine myelinolysis with mainly cerebellar signs.

    The etiology of central pontine myelinolysis (CPM) is usually related to rapid correction of hyponatremia and alcoholism. Here a case with CPM predominated by cerebellar signs is described, and the neuropsychological assessment of the case is presented as well. blood biochemistry revealed a normal sodium level and neuropsychological examination revealed impairment in attention and concentration, reduced immediate memory span, and impaired delayed recall. Further studies are needed to discover whether these neuropsychological signs are specific for CPM or due to alcoholism in general.
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keywords = impairment
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5/24. transcranial magnetic stimulation shows impaired transcallosal inhibition in Marchiafava-Bignami syndrome.

    A case of Marchiafava-Bignami (MB) syndrome with selective callosal involvement was evaluated by clinical examination and magnetic resonance imaging (MRI) in the acute phase and 6 months after the onset of symptoms; at the same time, the corticospinally and transcallosally mediated effects elicited by transcranial magnetic stimulation (TMS) were investigated. The first MRI study showed the presence of extensive abnormal signal intensity throughout the entire corpus callosum. After high-dose corticosteroid administration her symptoms rapidly resolved, in parallel with the reversion of MRI changes, except for severe cognitive impairment. Follow-up TMS examination revealed persistent transcallosal inhibition (TI) abnormalities. This report indicates that the measurement of TI during the course of MB syndrome is useful for evaluating functional changes to the corpus callosum, including their evaluation with time and after treatment and for elucidating the pathophysiology of MB syndrome.
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ranking = 42.770525916688
keywords = cognitive impairment, impairment
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6/24. Usher syndrome with psychotic symptoms: two cases in the same family.

    Usher syndrome is a heterogeneous autosomal recessive disorder characterized by hearing and visual sensory impairment. retinitis pigmentosa is essential for its diagnosis. There are only a few reports describing patients with Usher syndrome presenting with psychotic features and the etiology of its psychiatric manifestation is still unknown. Herein, the authors report variable congenital hearing impairment and progressive visual loss occurring in five of seven family members and two of them meeting the diagnostic criteria of Usher syndrome with psychotic features. Furthermore, the authors compare their psychiatric symptoms with other reports and the possible etiologies of psychotic symptoms are discussed.
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keywords = impairment
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7/24. A case of alcoholic dementia with hypomagnesemia and hypocalcemia.

    A 47-year-old man with chronic alcoholism was admitted to a psychiatric institution because of his mental symptoms and abnormal behavior. He had dementia, emotional disturbances, muscle cramps (tetanic fits), and impairment of abstract thinking and psychomotor function. The biochemical examination of his blood revealed hypomagnesemia, hypocalcemia and a low level of serum parathyroid hormone. The administration of Ca lactate improved hypocalcemia and muscle cramps, but not the other symptoms. An addition of Mg sulfate did not change the clinical condition and the serum electrolyte level. From these findings a relation of chronic alcohol intake to the imbalance of serum electrolytes as well as a low level of serum parathyroid hormone was discussed, and a pathogenetic mechanism of dementia observed in this case was speculated.
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keywords = impairment
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8/24. Addiction, helplessness, and narcissistic rage.

    In many cases addictive behavior serves to ward off a sense of helplessness or powerlessness via controlling and regulating one's affective state. Addicts have a vulnerability to feelings of powerlessness, which reflects a specific narcissistic impairment. The drive in addiction to re-establish a sense of power is, correspondingly, impelled by narcissistic rage. This rage gives to addiction some of its distinctive clinical properties. The narcissistic vulnerability in addicts is discussed. Several brief clinical cases are provided, and the view proposed is correlated with other psychoanalytic perspectives.
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keywords = impairment
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9/24. Portrait of an impaired physician.

    Since its inception five years ago, The Medical Society of virginia's Impaired Physician Program has evaluated 140 physicians. Of these, 60 have completed treatment and aftercare monitoring, and 80 are being followed. Who are these physicians? the Editors asked Dr. David G. Fluharty, Jr., the program's medical director. What are they like? How about some case reports? The program's confidentiality prevented him from divulging any identifying information, Dr. Fluharty replied. He could say, however, that within the virginia program's experience, impaired physicians fall into two distinct age groups. About a quarter of them are 28 years old /- a few years; these younger doctors usually are dysfunctional due to "hard" drugs. The remaining three-quarters are 42 years old /- a few years; in this group impairment is due most often to alcoholism. As for case reports, Dr. Fluharty continued, the program's compelling experience is that one case is pretty much like another, so similar are the historical patterns of birth, background, and behavior. To illustrate, he drew the following composite picture of an impaired physician in the larger, older, alcoholic group.
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keywords = impairment
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10/24. alprazolam dependence in seven patients.

    The authors report on seven patients who met the DSM-III-R criteria for psychoactive substance (alprazolam) dependence. All had withdrawal symptoms, six demonstrated tolerance, and at least four had substantial social or occupational impairment secondary to drug use. All seven patients had begun taking alprazolam as treatment for anxiety or depression. Six patients abused other drugs or alcohol, either in the past or concurrently. Doses of alprazolam ranged from 2 to 12 mg/day, and duration of use was 6 months to 3 years. The potential for dependence should be considered when prescribing alprazolam.
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ranking = 1
keywords = impairment
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