Cases reported "Alcoholism"

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11/24. Benign symmetric lipomatosis Launois-Bensaude. Report of ten cases and review of the literature.

    Benign symmetric lipomatosis Launois-Bensaude is a disease rarely reported in the American literature and not mentioned in the standard English textbooks of dermatology. It seems, however, to be relatively common in europe. Between 1981 and 1985 we examined twelve patients, and a number of case reports have been published in French and German literature. We describe ten typical cases and review the literature. The disease is characterized by massive symmetric fat deposits predominantly in the neck and shoulder girdle area. Pathogenetically, the increase in fatty tissue is assumed to result from a localized defect in catecholamine-induced lipolysis. The disease is frequently associated with alcoholism, hepatopathy, glucose intolerance, hyperuricemia, and malignant tumors of the upper airways, requiring thorough clinical evaluation of all patients. Dietary treatment and weight loss are of limited value in the management of benign symmetric lipomatosis. Surgical removal of lipomatous tissue is frequently followed by recurrence and should be restricted to decompression in patients with functional impairment.
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12/24. Neuropsychologically impaired alcoholics: assessment, treatment considerations, and rehabilitation.

    Recently there has been a resurgence of interest in the neuropsychological status of the alcoholic. The research documenting neuropsychological deficits has consistently shown impairments in abstract reasoning ability, visuospatial and visuomotor ability, and learning and memory skills. Despite these findings, it appears that many alcohol treatment clinicians interpret patient behavior from a psychological perspective and treatment programs make unwarranted assumptions about patients' ability to profit from standard treatment approaches. This paper discusses these issues, and presents an outline of an innovative cognitive rehabilitation program designed specifically to meet the needs of neuropsychologically impaired alcoholic patients.
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13/24. pericardial effusion and left ventricular function in patients with acute alcoholic pancreatitis.

    pericardial effusion as a complication of acute pancreatitis has been described in several isolated case reports. However, the prevalence of pericardial effusion in patients with acute pancreatitis has not been studied. alcoholism and severe acute pancreatitis have been shown to cause left ventricular dysfunction. We studied 15 consecutive patients, hospitalized for the treatment of acute, alcohol-induced pancreatitis, and 28 control subjects by M-mode echocardiography to detect pericardial effusion and to assess left ventricular function. Seven patients (47%) with pancreatitis and three control subjects (11%) had pericardial effusion; the prevalence of pericardial effusion in patients with pancreatitis was significantly greater (Fisher's exact test) than in control subjects. There was no evidence of impairment of left ventricular function in the patients, all of whom had mild acute pancreatitis; the mean fractional systolic shortening of the left ventricle in patients was not significantly different from that of control subjects (38% /- 8.5% vs 37% /- 8.0%), and the mean velocity of left ventricular circumferential shortening in patients was significantly higher than in control subjects (1.58 /- 0.34 circumferences per second vs 1.29 /- 0.32 circumferences per second). We conclude that in patients with mild acute alcohol-induced pancreatitis, pericardial effusion occurs frequently and that left ventricular function is unimpaired.
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14/24. Central pontine myelinolysis.

    A patient is reported whose ailment meets the criteria of CPM. The illness was complicated by pneumonitis, most likely of the aspiration type. Of particular interest was the reversibility of a clinical picture of marked deterioration when attention was paid to fluid and electrolyte balance and maintenance of respiration. This patient's illness appears to meet the criteria of CPM, namely impairment of the facial muscles and tongue with dysphagia and dysarthria, flaccid quadriparesis or quadriplegia, and frequently, lack of response to painful stimuli followed by respiratory paralysis. The presence of peripheral neuropathy has been previously noted in a patient with CPM, but it is not an integral part of the disease.
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15/24. Neuropsychological assessment of substance abusers: review and recommendations.

    Neuropsychological assessment of substance abusers frequently proves useful for the evaluation of those aspects of cognitive functioning that may be relevant for optimal therapeutic management and treatment planning. research has demonstrated the presence of neuropsychological impairment in chronic abusers of CNS depressants, including alcohol, as well as opiates and possibly cocaine, especially when such substances are combined in a polydrug pattern of abuse. Clinical neuropsychological evaluation of individual substance abusers should take into account the various personal, demographic and neuromedical background variables that can affect cognitive functioning. Efforts should be made to distinguish between acute drug effects and more longterm stable deficits that may not become apparent for some time. Neuropsychological referrals should be made, and measures selected to answer particular questions about neurocognitive functioning that are relevant to treatment and eventual overall adjustment. A neuropsychological review of systems is likely to show a pattern of impairment in substance abusers that involves the integration of different cognitive functions for effective problem solving. Strongly focal or lateralized deficit patterns are less likely to be the result of drug abuse alone, and should prompt the appropriate neuromedical follow-up.
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16/24. Acute renal failure caused by non-traumatic rhabdomyolysis. case reports.

    Four cases of severe acute renal failure are described in which rhabdomyolysis was a causative or contributory aetiological factor. This diagnosis is worthy of consideration in the alcoholic or drug-overdose patient who presents with renal impairment. The particular biochemical changes are reviewed.
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17/24. Primary hepatic aspergillosis: report of a case.

    The authors describe a case of primary hepatic aspergillosis in an adult patient with no evident immunological impairment. Because the finding is to be regarded as unusual, the possible pathogenetic role of alcohol and long standing exposure to asbestos is discussed.
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18/24. Cognitive impairment associated with acute or chronic disease.

    Cognitive impairment in connection with acute or chronic disease may complicate the disgnosis, management and treatment of general hospital inpatients. Consulting psychiatrists may be called upon to evaluate cognitive and intellectual impairment associated with organic brain syndromes versus psychiatric disorders due to other causes. To assist the psychiatrist in formulating a differential diagnosis, the standard mental status examination and various objective neuropsychologic tests can be used. In addition, the author suggests a method of cognitive measurement using content and form analysis of five-minute speech samples. Impaired cognitive function may be caused or exacerbated by conditions such as alcohol abuse or psychoactive drug abuse which may not be revealed by the patient during the history taking.
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19/24. Persistent duodenal obstruction secondary to pancreatitis. Report of two cases.

    Two male alcoholics with persistent duodenal obstruction due to relapsing acute pancreatitis are reported. Both patients were operated upon with gastrojejunostomy. One of the patients had a transient obstruction of the colon at the left flexure. The gut impairment has been followed roentgenologically and by gastroduodenoscopy. The literature concerning intestinal obstruction caused by pancreatitis is reviewed.
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20/24. The korsakoff syndrome.

    BACKGROUND. Investigations of the korsakoff syndrome by researchers from different disciplines have proliferated in recent years, making it apposite to review the various findings. METHOD. This review is based on the author's knowledge of reports in the major clinical and neuropsychological journals, supplemented by medline searches to update particular subtopics. RESULTS. The korsakoff syndrome is defined as a disproportionate impairment in memory, relative to other aspects of cognitive function, resulting from a nutritional (thiamine) depletion. The initial manifestations of the disorder are variable, and a persistent memory impairment can result from a non-alcoholic aetiology, although this seems to happen much less commonly than in the past - presumably because of generally higher standards of nutrition. Although there is agreement on the underlying neuropathology, the critical lesion sites for memory disorder have been debated. Recent evidence suggests that the circuit involving the mammillary bodies, the mammillo-thalamic tract and the anterior thalamus, rather than the medial dorsal nucleus of the thalamus, is particularly critical in the formation of new memories. The relationship of these deficits to thiamine depletion remains a topic of current investigation, as does the purported role of neurotransmitter depletions in the cholinergic, glutamate/GABA and catecholamine and serotonergic systems. Neuro-imaging studies have confirmed autopsy findings of more widespread structural and metabolic abnormalities, particularly involving the frontal lobes. CONCLUSIONS. The relationship of these neuropathological, neurochemical, and metabolic abnormalities to cognitive functioning, with particular reference to specific aspects of memory processing, has been considered in some detail. Whereas structural and/or neurochemical abnormalities within the limbic/diencephalic circuits account for anterograde amnesia, some other factor, such as frontal lobe dysfunction, must underlie the severe retrograde memory loss which is characteristically found in this syndrome.
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ranking = 2
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