Cases reported "Recurrence"

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1/114. Recurrent toxoplasmosis.

    A case of recurrent toxoplasmosis in a previously healthy 34-year-old woman is reported. Although she was treated 3 times with co-trimoxazole, which in our experience has been efficient in the treatment of toxoplasmosis, and responded to treatment clinically and serologically, she relapsed with clinical symptoms and rise of anti-toxoplasma titres. Hypothetically, toxoplasmosis is a latent infection which can be activated by other diseases and by immunodepression.
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ranking = 1
keywords = depression
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2/114. Primary percutaneous transluminal coronary angioplasty performed for acute myocardial infarction in a patient with idiopathic thrombocytopenic purpura.

    A 72-year-old female with idiopathic thrombocytopenic purpura (ITP) complained of severe chest pain. electrocardiography showed ST-segment depression and negative T wave in I, aVL and V4-6. Following a diagnosis of acute myocardial infarction (AMI), urgent coronary angiography revealed 99% organic stenosis with delayed flow in the proximal segment and 50% in the middle segment of the left anterior descending artery (LAD). Subsequently, percutaneous transluminal coronary angioplasty (PTCA) for the stenosis in the proximal LAD was performed. In the coronary care unit, her blood pressure dropped. Hematomas around the puncture sites were observed and the platelet count was 28,000/mm3. After transfusion, electrocardiography revealed ST-segment elevation in I, aVL and V1-6. Urgent recatheterization disclosed total occlusion in the middle segment of the LAD. Subsequently, PTCA was performed successfully. Then, intravenous immunoglobulin increased the platelet count and the bleeding tendency disappeared. A case of AMI with ITP is rare. The present case suggests that primary PTCA can be a useful therapeutic strategy, but careful attention must be paid to hemostasis and to managing the platelet count.
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ranking = 1
keywords = depression
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3/114. Improvement of depression and parkinsonism during ECT: a case study.

    Improvement in signs of parkinsonism and symptoms of depression was observed in a patient with Parkinson's disease who underwent a course of ECT for depression. Empirically this patient was observed by a blind rater to show a pattern of improvement in parkinsonian signs similar to that observed in parkinsonian patients treated with L-dopa. The time course of improvement of this patient's depression was also seen to parallel improvement in his Parkinson's disease. These results are consistent with the hypothesis that ECT increases catecholamine synthesis and more specifically would be evidence that ECT improves depression by increasing norepinephrine synthesis.
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ranking = 8
keywords = depression
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4/114. Asymptomatic pancreatitis associated with clozapine.

    Besides the well-known adverse effects of clozapine, such as granulocytopenia, tiredness and hypersalivation, acute pancreatitis is known to be a very rare complication of the drug. In the literature a total of five case reports have been published so far. We report a case of asymptomatic pancreatitis subsequent to clozapine treatment at therapeutic doses in a 38-year-old male patient with chronic paranoid-hallucinatory schizophrenia. The patient was rehospitalized after an acute exacerbation of the psychosis subsequent to an attempt to change medication on an outpatient basis. Treatment with clozapine was initiated again. During phases of progressively increasing the clozapine dose, serum levels of amylase and lipase were increased; after maintaining daily doses of clozapine of 300 mg and/or 600 mg the pancreatic enzymes normalized quickly within a few days. The patient did not report any pancreas-related complaints, nor did specific diagnostic studies produce any indicative result, only a minor thickening of the head and body of the pancreas in the ultrasound. It is assumed that the phenomenon of subclinical, asymptomatic pancreatitis during increasing dosage of clozapine occurs more often than previously supposed. The monitoring of serum amylase levels during slow increase in clozapine is recommended; if leukocytosis or eosinophilia is present, the possibility of even a subclinical and asymptomatic pancreatitis should be considered.
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ranking = 11.928096814753
keywords = psychosis
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5/114. psychotropic drugs in acute intermittent porphyria.

    Acute intermittent porphyria is one of a group of metabolic diseases called the porphyrias that may lead to symptoms of the central nervous system during an acute exacerbation. Certain drugs such as barbiturates are known to precipitate attacks of acute intermittent porphyria, but unfortunately there is little information regarding the safety of many psychotropic drugs in this disorder, especially the newer antidepressants and atypical antipsychotics. We report a case of an elderly patient with acute intermittent porphyria who was treated with a variety of psychotropic agents for a severe depression with psychotic features. Although many of the agents did not improve the psychiatric status of the patient, all the drugs were tolerated without precipitating an episode of acute intermittent porphyria. To our knowledge, this is the first report of the safe use of sertraline, venlafaxine, olanzapine, risperidone, clozapine, buspirone, trazodone, lorazepam, and clonazepam in a patient with documented acute intermittent porphyria. Our report also supports the safety of trifluoperazine. Although response and sensitivity to drugs may vary greatly among patients with this disorder, clinicians may want to consider the possibility of the above drugs to treat psychiatric symptoms in patients with acute intermittent porphyria.
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ranking = 1
keywords = depression
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6/114. Recurrent psychogenic coma following tracheal stenosis repair.

    Medication, intracranial hemorrhage, infarction, infection, hypoxia, organ failure, and nutritional deficiency may cause unconsciousness following successful emergence from anesthesia. A 39-year-old woman with a history of tracheal stenosis, depression, and anxiety had complete unconsciousness on 3 separate occasions following surgical repair of her tracheal stenosis. In each case, the patient's endotracheal tube had been removed; she was alert and oriented to person, time, and place; and she was admitted to the hospital for observation. Within a few hours after the tube was removed, the patient became abruptly unconscious for periods of 36, 18, and 30 hours. Each time, the results of cardiac, pulmonary, metabolic, and neurologic examinations and radiological studies were normal. We hypothesize that the patient's apparent comas were the result of an underlying conversion disorder precipitated by unresolved psychological conflict surrounding a long history of abuse in which she was repeatedly smothered by a pillow.
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ranking = 1
keywords = depression
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7/114. "It isn't fair": postoperative depression and other manifestations of survivor guilt.

    The objective of this paper is to demonstrate and explain an array of phenomena, clinical and social, that share a common dynamic although they seem to be quite disparate. These experiences range from combat neuroses to postoperative depressions. Situations and case histories demonstrating this dynamic are presented, namely, the guilt of getting more than one's share of life, material possessions, or physical gifts than the people one loves. The relationship of this getting more and the concept of the "zero-sum game" is discussed. Suggestions are presented for the treatment of depressions resulting from this conflict. Survivor guilt is a common theme, running through our society in both dramatic and subtle ways. An awareness of this can help us explain certain phenomena and deal with some types of depression in our psychiatric work.
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ranking = 7
keywords = depression
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8/114. clozapine in the treatment of neuroleptic-induced blepharospasm: a report of 4 cases.

    BACKGROUND: blepharospasm, the forcible closure of eyelids, is an infrequent consequence of neuroleptic treatment that, when severe, can interfere with the ability to walk, drive, or work. Like tardive dyskinesia, blepharospasm can be disfiguring and aesthetically distressing, contributing to the increased stigmatization of patients. case reports: We report 4 patients with DSM-IV schizoaffective disorder, paranoid schizophrenia, or chronic undifferentiated schizophrenia who developed neuroleptic-induced blepharospasm. In all patients, blepharospasm remitted without the reemergence of psychosis within 3 to 5 months of treatment with clozapine, 100-200 mg/day. CONCLUSION: The results suggest that clozapine may successfully treat neuroleptic-induced blepharospasm without the reemergence of psychosis in patients with schizophrenia, schizoaffective disorder, or schizophreniform disorder.
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ranking = 25.042664846676
keywords = psychosis, affective
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9/114. Neuro-psychological discorders and renal cell carcinoma: a case report and a psychological study of urological cancer patients.

    Several pathways for immunodepression induced by stress and injury have been speculated, with precise analysis regarding out correlations between sympathetic nerve system and immunodepressive cytokines. Here, we show an interesting case and a clinical study of psychological disorders of urological advanced cancer patients. In the case report, a male renal-cell cancer patient whose disease disappeared following interferon therapy is presented whose disease relapsed five years after therapy and eight months after a traffic injury. Careful observation of the history suggests that severe pain could destruct patient's own anti-cancer mechanisms. In the clinical study on psychological disorders of the 131 patients, a higher rate (28%) of disorders was recognised in renal-cell cancer patients than in other cancer patients. serum CRP values of the renal-cell cancer patients with the disorders was significantly higher than those of the same cancer patients without the disorders. A complicated inter-relationship between the central nercous system, various external forces, the cancer itself and the immune system may exist and have an influence on the efficacy of biotherapy.
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ranking = 1
keywords = depression
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10/114. electroconvulsive therapy for elderly patients with multiple system atrophy: a case series.

    multiple system atrophy (MSA) is a progressive neurological illness associated with parkinsonism. electroconvulsive therapy (ECT) improves motor function in Parkinson's disease and, thus, might be beneficial in MSA. Three cases of MSA treated with ECT are described. All patients improved neurologically, but none regained independent ambulation. A review, including previously reported cases, demonstrates that ECT can be safe and effective for depression associated with MSA. Reduced tremor and rigidity may occur, but substantial gait improvement cannot be expected.
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ranking = 1
keywords = depression
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