Recurrent Admissions for Hypothermia From Concomitant Topiramate and Phenobarbital: A Case Report

2017 ◽  
Vol 32 (1) ◽  
pp. 109-112 ◽  
Author(s):  
Alisha M. Mutch
Keyword(s):  
Cerebral Palsy ◽  
Case Report ◽  
Hospital Admissions ◽  
Drug Effect ◽  
Case Series ◽  
White Female ◽  
Dose Increase ◽  
Her 2 ◽  
Phenobarbital Administration ◽  
Community Teaching

Introduction: This article presents an additional case of concomitant topiramate and phenobarbital administration that resulted in 8 hospital admissions for hypothermia that resolved after discontinuation of phenobarbital. Case: A 56-year-old white female with cerebral palsy and quadriplegia, epilepsy, and hypothyroidism was admitted to a community teaching hospital multiple times with documented hypothermia. These admissions followed a subsequent dose increase of topiramate in December 2014. In February 2015, the patient was admitted with 35°C rectal temperature. Her 2 admissions in April were for hypothermia with temperatures of 34.6°C and 33.6°C, respectively. The patient had 5 other admissions with hypothermia through December 2015. All other causes of hypothermia were ruled out. The hypothermia resolved when phenobarbital was discontinued. Discussion: A recent case series noted an association between phenobarbital and topiramate causing hypothermia. The patient’s hypothermia developed while on concomitant phenobarbital and topiramate but only after an increase in topiramate. No other causes for hypothermia were found based upon physical examination or lab work. The Naranjo nomogram noted a probable causation. Conclusion: This case report points to an association of hypothermia with concomitant topiramate and phenobarbital with resolution after phenobarbital discontinuation. Improvement after discontinuation of phenobarbital seems to support a drug-effect relationship.

scholarly journals Effects of the COVID-19 Epidemic on Hospital Admissions for Non-Communicable Diseases in a Large Italian University-Hospital: A Descriptive Case-Series Study

2021 ◽  
Vol 10 (4) ◽  
pp. 880
Author(s):  
Caterina Caminiti ◽  
Giuseppe Maglietta ◽  
Tiziana Meschi ◽  
Andrea Ticinesi ◽  
Mario Silva ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Case Series ◽  
Communicable Diseases ◽  
University Hospital ◽  
Negative Consequences ◽  
Non Communicable Diseases ◽  
Case Series Study ◽  
And Gender ◽  
Long Term Impact ◽  
Series Study

Background: Concern is growing about the negative consequences that response measures to the COVID-19 epidemic may have on the management of other medical conditions. Methods: A retrospective descriptive case-series study conducted at a large University-hospital in northern Italy, an area severely hit by the epidemic. Results: Between 23 February and 14 May 2020, 4160 (52%) COVID-19 and 3778 (48%) non-COVID-19 patients were hospitalized. COVID-19 admissions peaked in the second half of March, a period characterized by an extremely high mortality rate (27.4%). The number of admissions in 2020 was similar to 2019, but COVID-19 patients gradually occupied all available beds. Comparison between COVID-19 and non-COVID-19 admissions in 2020 revealed significant differences concerning all age classes and gender. Specifically, COVID-19 patients were older, predominantly male, and exhibited more comorbidities. Overall, admissions for non-communicable diseases (NCDs) in 2020 vs. 2019 dropped by approximately one third. Statistically significant reductions were observed for acute myocardial infarction (−78, −33.9%), cerebrovascular disease (−235, −41.5%), and cancer (−368, −31.9%). While the first two appeared equally distributed between COVID-19 and non-COVID-19 patients, chronic NCDs were statistically significantly more frequent in the former, except cancer, which was less frequent in COVID-19 patients. Conclusions: Prevention of collateral damage to patients with other diseases should be an integral part of epidemic response plans. Prospective cohort studies are needed to understand the long-term impact.

scholarly journals Injuries, treatment, and impairment caused by different types of fireworks; results of a 10 year multicenter retrospective cohort study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Daan T. Van Yperen ◽  
Esther M. M. Van Lieshout ◽  
J. Niels Dijkshoorn ◽  
Cornelis H. Van der Vlies ◽  
Michael H. J. Verhofstad
Keyword(s):  
Surgical Procedures ◽  
Hospital Admissions ◽  
Case Series ◽  
Secondary Outcome ◽  
Number Of Patients ◽  
Whole Person ◽  
Type Of Injury ◽  
Clear Increase ◽  
Level 1 Trauma Center ◽  
Head Neck

Abstract Objectives The primary aim of this study was to evaluate the number of patients reported to a hospital with injuries from consumer fireworks in the months December–January in the past 10 years, and to describe the association between the type of fireworks, injury pattern, treatment, and permanent impairment. Methods A multicenter, retrospective, observational case series. Patients were selected from two hospitals in the Southwest Netherlands: a level 1 trauma center and a specialized burn center. All patients with any fireworks-related injuries treated between December 1 and January 31, during 2007 (December) to 2017 (January), were eligible for participation. The primary outcome was the number of patients with any type of injury caused by fireworks. The secondary outcome measures were patient and injury characteristics, treatment details, and whole person impairment (WPI). The percentage WPI expresses a patient’s degree of permanent impairments as a result of fireworks-related injuries. Results Of the 297 eligible patients, 272 patients were included. From 2007 to 2017, between 21 and 40 patients were treated, and no clear increase or decrease was observed in the number of patients and in the number of patients per type of fireworks. Explosive fireworks mainly caused upper extremity (N = 65; 68%) injuries, while rockets (N = 24; 41%) and aerials (N = 7; 41%) mainly affected the head/neck. Decorative fireworks predominantly resulted in burns (N = 82; 68%), and explosive fireworks in soft tissue lacerations (N = 24; 25%), fractures (N = 16; 17%), and amputations (N = 14; 15%). Patients injured by explosive and homemade fireworks were most often admitted to a hospital (respectively N = 24; 36% and N = 12; 80%), and resulted in the highest proportion undergoing surgical procedures (respectively N = 22; 33% and N = 7; 47%). WPI found in this study was between 0 to 95%, with a median of 0%. In 34 (14%) patients, the injuries resulted in a WPI of ≥1%, mostly as a result of explosive fireworks (N = 18; 53%). Conclusion This study found no increase or decrease in the number of patients treated in two specialized hospitals. Explosive and homemade fireworks could be considered as most dangerous, as they result into the most hospital admissions, surgical procedures, and into the most injuries with permanent impairment as a result.

scholarly journals Evaluation of Individualized Functional Electrical Stimulation-Induced Acute Changes during Walking: A Case Series in Children with Cerebral Palsy

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4452
Author(s):  
Nicole Zahradka ◽  
Ahad Behboodi ◽  
Ashwini Sansare ◽  
Samuel C. K. Lee
Keyword(s):  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Case Series ◽  
Phase Detection ◽  
Lower Extremity Muscle ◽  
Children With Cerebral Palsy ◽  
Muscle Groups

Functional electrical stimulation (FES) walking interventions have demonstrated improvements to gait parameters; however, studies were often confined to stimulation of one or two muscle groups. Increased options such as number of muscle groups targeted, timing of stimulation delivery, and level of stimulation are needed to address subject-specific gait deviations. We aimed to demonstrate the feasibility of using a FES system with increased stimulation options during walking in children with cerebral palsy (CP). Three physical therapists designed individualized stimulation programs for six children with CP to target participant-specific gait deviations. Stimulation settings (pulse duration and current) were tuned to each participant. Participants donned our custom FES system that utilized gait phase detection to control stimulation to lower extremity muscle groups and walked on a treadmill at a self-selected speed. Motion capture data were collected during walking with and without the individualized stimulation program. Eight gait metrics and associated timing were compared between walking conditions. The prescribed participant-specific stimulation programs induced significant change towards typical gait in at least one metric for each participant with one iteration of FES-walking. FES systems with increased stimulation options have the potential to allow the physical therapist to better target the individual’s gait deviations than a one size fits all device.

Infant Automobile Restraint Systems: Beware of the Sun

PEDIATRICS ◽  
1980 ◽  
Vol 65 (3) ◽  
pp. 625-626
Author(s):  
Fred Hankin ◽  
Fred Vermeulen
Keyword(s):  
Case Report ◽  
Motor Vehicle ◽  
Female Infant ◽  
Insurance Companies ◽  
White Female ◽  
The Sun ◽  
Adverse Incident ◽  
Infant Safety

The use of infant safety seats in automobiles has become a standard recommendation of physicians, insurance companies, and various organizations. The efficacy of these devices in the prevention of serious motor vehicle trauma is well recognized.1-7 We report an adverse incident involving such a restraining device. CASE REPORT J.R. is a 12-week-old white female infant who was secured in such a restrainer seat in the recommended manner. The day of admission was an unusually sunny spring afternoon and the child was wearing only a T-shirt and a diaper. Persistent crying by the child for 15 minutes led to the discovery of a blister 3 cm in diameter on the exposed portion of the patient's anterior right thigh (Figure).

scholarly journals Giant retroperitoneal lipoma: a case report

2003 ◽  
Vol 40 (4) ◽  
pp. 251-255 ◽  
Author(s):  
Carlos Augusto Real Martinez ◽  
Rogério Tadeu Palma ◽  
Jaques Waisberg
Keyword(s):  
Case Report ◽  
Histological Study ◽  
Abdominal Mass ◽  
Benign Neoplasm ◽  
Large Mass ◽  
White Female ◽  
Ascending Colon ◽  
Abdominal Ultrasonography ◽  
History Of ◽  
History Of Pain

BACKGROUND: Retroperitoneal lipoma is an extremely rare neoplasm. AIMS: The authors report a case of giant retroperitoneal lipoma in a 32-year-old white female, with a history of pain and an abdominal mass over a 2-year period. Total abdominal ultrasonography and barium enema showed a large mass located in the retroperitoneal space behind the ascending colon. Laparotomy showed a large encapsulated tumor measuring 20 x 13 x 10 cm and weighing 3.400 g. The histological study revealed a benign neoplasm of fatty cells. CONCLUSION: The patient remains well 17 years after surgery, without recurrentce of the disease.

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