scholarly journals Body integrity identity disorder: clinical features and ethical dimensions

2018 ◽  
Vol 25 (3) ◽  
pp. 187-195
Author(s):  
Emma Barrow ◽  
Femi Oyebode
Keyword(s):  
Clinical Features ◽  
Physical Disability ◽  
Parietal Lobe ◽  
Case Reports ◽  
Treatment Options ◽  
List Type ◽  
Bodily Integrity ◽  
Body Integrity Identity Disorder ◽  
History Of ◽  
Self Harm

SUMMARYBody integrity identity disorder (BIID) is a rare and complex identity disorder described by the desire to acquire a physical disability and an associated sense of incompleteness at being able-bodied. Individuals with the disorder often delay presentation until later in life because of perceived stigma about wishing to acquire a physical disability, and may have sought amputation already through ‘underground’ means or self-harm (attempts at self-amputation). In this article we present an account of the recent history and origins of the disorder, from its early descriptions and case reports through to the current neuropsychiatric theory of right superior parietal lobe dysfunction as basis for the disorder. We consider the epidemiology, pathogenesis and clinical features of this identity disorder of bodily integrity, highlighting the associations with conditions such as gender identity disorder. With this we then discuss the ethical considerations for available treatment options, mainly elective surgical amputation.LEARNING OBJECTIVES•Understand the current definition and clinical features of body integrity identity disorder•Be familiar with the conceptual history of the disorder, epidemiology and current neuropsychiatric perspective•Be aware of the ethical aspects of elective surgical amputation as a treatment for the disorderDECLARATION OF INTERESTNone.

scholarly journals Evaluation of Nail Findings in Patients with COVID-19 History and Wood’s Lamp Examination

2021 ◽  
pp. 1-6
Author(s):  
Irem Yanatma ◽  
Hulya Cenk
Keyword(s):  
Titanium Dioxide ◽  
Ferric Oxide ◽  
Case Reports ◽  
Treatment Options ◽  
History Of ◽  
Day By Day ◽  
Shed Light

<b><i>Introduction:</i></b> Various skin findings due to coronavirus have been identified. There are a few case reports on nail findings after coronavirus (COVID-19) infection. We aimed to document the nail findings of the COVID-19 survivors and shed light on the interesting luminescence seen under the Wood’s light. <b><i>Methods:</i></b> One hundred and seventy-four patients diagnosed with COVID-19 infection in the last 100 days were grouped in terms of the agents used in the treatment. Fifty-seven volunteers without a history of infection were included. <b><i>Results:</i></b> Patients treated with favipiravir had a significantly higher positivity of luminescence (<i>p</i>: 0.0001). The most common nail findings in patients were splinter hemorrhage (13%), followed by leukonychia (12%) and longitudinal ridges (7.9%). <b><i>Discussion/Conclusions:</i></b> The luminescence may be seen due to the accumulation of favipiravir or its excipients (titanium dioxide and yellow ferric oxide) on the nails. Wood’s lamp examination of the plasma taken from a patient after favipiravir’s first dose revealed the same luminescence as we saw on the nails. Accordingly, this accumulation may be seen in the vital organs. Although our knowledge about the virus increases day by day, the potentially hazardous effects of the virus and long-term complications of the treatment options are still being investigated.

Mania and Down's Syndrome

1993 ◽  
Vol 162 (6) ◽  
pp. 739-743 ◽  
Author(s):  
Sally-Ann Cooper ◽  
Richard A. Collacott
Keyword(s):  
Learning Disabilities ◽  
Family History ◽  
Affective Disorder ◽  
Clinical Features ◽  
Case Reports ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Atypical Presentation ◽  
Rapid Cycling ◽  
History Of

Until recently, it was considered that Down's syndrome precluded a diagnosis of mania, or gave rise to an atypical presentation. There have been seven case reports of mania in people with Down's syndrome and all these cases are reviewed. The clinical features of mania are noted to be similar to those previously described in individuals with learning disabilities due to other causes. However, all reported cases are male and none has a family history of affective disorder. In two of the seven men reported, the illness followed a rapid cycling pattern. Hypothyroidism and monoamine biochemistry in people with Down's syndrome are discussed in the context of these atypical features.

Clinical Features, Prognosis and Treatment of Follicular Lymphoma

Hematology ◽  
2007 ◽  
Vol 2007 (1) ◽  
pp. 216-225 ◽  
Author(s):  
Gilles A. Salles
Keyword(s):  
Follicular Lymphoma ◽  
Clinical Features ◽  
Expression Profiles ◽  
Treatment Options ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Gene Expression Profiles ◽  
Complex Interactions ◽  
History Of ◽  
Immunohistochemical Studies

AbstractFollicular lymphoma constitutes the most frequent indolent lymphoma, well characterized by its clinical presentation related to nodal involvement and its morphologic and biologic features. Some rare locations of extranodal involvement, such as the gastrointestinal tract or skin, were recently further refined. The description of the Follicular Lymphoma International Prognostic Index (FLIPI) represents an important step in identifying patient subgroups with predictable outcome and comparing the results of clinical trials, although its use in clinical practice remains to be established. Analyses of gene expression profiles or constitutive gene variations may also provide additional insights for prognostication in the near future. Furthermore, these data underline the complex interactions between the tumor cells and their microenvironment; recent attempts to translate these findings with immunohistochemical studies remain unable to robustly predict patient outcome. The therapeutic strategies in follicular lymphoma have been transformed by monoclonal antibodies, used alone or in combination with chemotherapy. Treatment options should be adapted to the clinical features at diagnosis and appear to be able to modify the overall survival of some subgroups of patients. Further efforts may focus on strategies that can alter the natural history of this disease.

Severe Sepsis Caused by Arcanobacterium haemolyticum: A Case Report and Review of the Literature

2008 ◽  
Vol 42 (11) ◽  
pp. 1697-1702 ◽  
Author(s):  
Bridgette L Therriault ◽  
Lindsay Mayer Daniels ◽  
Yvonne L Carter ◽  
Ralph H Raasch
Keyword(s):  
Severe Sepsis ◽  
Case Reports ◽  
Treatment Options ◽  
Penicillin G ◽  
Left Lower Extremity ◽  
Bronchoalveolar Fluid ◽  
History Of ◽  
Pharmacologic Management ◽  
Arcanobacterium Haemolyticum ◽  
Systemic Infections

Objective: To describe a case of severe sepsis, cavitary pneumonia, and pyomyositis caused by Arcanobacterium haemolyticum. Case Summary: An 18-year-old male with a medical history significant for mild asthma presented to the emergency department complaining of a 7-day history of fever, diffuse myalgias, nausea, vomiting, diarrhea, and pain in his right upper quadrant, right shoulder, and left thigh. Cultures of blood, bronchoalveolar fluid, and suríace and surgical swabs from the patient's left lower extremity grew A haemolyticum. The patient was successfully treated with intravenous penicillin G 4 million units every 4 hours and azithromycin 500 mg onca daily for 14 days. Within 36 hours after initiation of focused therapy, he became afebrile, pain decreased, and pulmonary symptoms abated. Oral azithromycin 500 mg/day for an additional 3 weeks was prescribed on discharge, and the patient showed no relapse at 2-month follow-up. Discussion: A. haemolyticum Is a weakly acid-fast, branching gram-positive bacillus most commonly implicated in pharyngitis in healthy adolescents and skin and soft-tissue infections in older, immunocompromised patients. Systemic infections are rarely reported in the literature. This organism remains susceptible to most classes of antimicrobials, Including penicillins, cephalosporins, carba-penems, macrolides, tetracyclines, clindamycin, and vancomycin. Routine resistance has been reported only with trimethoprim/sulfamethoxazole. Conclusions: To our knowledge, there are no published case reports of severe sepsis caused by A. haemolyticum. While treatment options are numerous, we recommend (he use of intravenous penicillin or a cephalosporin as first-line pharmacologic management of deep-seated infections caused by this rare organism.

scholarly journals Takotsubo Syndrome: A Complex and Varied Clinical Syndrome

2016 ◽  
Vol 5 ◽  
Author(s):  
Louise Shewan ◽  
Michael Henein ◽  
Andrew Coats
Keyword(s):  
Clinical Presentation ◽  
Myocardial Dysfunction ◽  
Case Reports ◽  
Treatment Options ◽  
Clinical Score ◽  
Clinical Syndrome ◽  
Original Research ◽  
Takotsubo Syndrome ◽  
History Of

<p class="normal">This special issue includes expert reviews and original research on Takotsubo syndrome (TTS) including the history of its identification and the unravelling of the pathophysiology of the different variants of the syndrome. The role of neurological stress or catecholaminergic overload are reviewed, as is the role of CNS disorders triggering TTS. Clinical presentation patterns of TTS and the most useful diagnostic tests are reviewed, including original research into a novel clinical score the ‘GET QT' score to help in rapid differentiation of TTS from STEMI. There is also a review of TTS in the intensive care unit setting.  The mechanisms of TTS including the role and assessment of the microcirculation in generating the classical myocardial dysfunction are reviewed in detail, as are the pathophysiological pathways of recurrent TTS. Lastly Singh, Akashi and Horowitz review the emerging treatment options for TTS. They issue also includes multiple elegant and fascinating case reports. TTS has come of age and now urgently adequate sized RCT’s.  </p>

scholarly journals A Subset of Primary Polydipsia, “Dipsogneic Diabetes Insipidus”, in Apparently Healthy People Due to Excessive Water Intake: Not Enough Light to Illuminate the Dark Tunnel

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 406
Author(s):  
Krishnaraju Venkatesan ◽  
Kumarappan Chidambaram ◽  
Premalatha Paulsamy ◽  
Ramasubbamma Ramaiah ◽  
Ali Al-Qahtani ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
Psychiatric Illness ◽  
Case Reports ◽  
Treatment Options ◽  
Urine Osmolality ◽  
Healthy People ◽  
Psychiatric Disease ◽  
Primary Polydipsia ◽  
History Of ◽  
Excessive Intake

Dipsogenic diabetes insipidus (DDI) is a subtype of primary polydipsia (PP), which occurs mostly in healthy people without psychiatric disease. In contrast, PP is characterized by a polyuria polydipsia syndrome (PPS) associated with psychiatric illness. However, the pathogenesis of DDI is not well established and remains unexplored. In order to diagnose DDI, the patient should exhibit excessive thirst as the main symptom, in addition to no history of psychiatric illness, polyuria with low urine osmolality, and intact urine concentrating ability. Treatment options for DDI remain scarce. On this front, there have been two published case reports with successful attempts at treating DDI patients. The noteworthy commonalities in these reports are that the patient was diagnosed with frequent excessive intake of water due to a belief that drinking excess water would have pathologic benefits. It could therefore be hypothesized that the increasing trend of excessive fluid intake in people who are health conscious could also contribute to DDI. Hence, this review provides an overview of the pathophysiology, diagnosis, and treatment, with a special emphasis on habitual polydipsia and DDI.

scholarly journals Submandibular sialolithiasis: A series of three case reports with review of literature

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Sandeep Pachisia ◽  
Gaurav Mandal ◽  
Sudipto Sahu ◽  
Sucharu Ghosh
Keyword(s):  
Salivary Glands ◽  
Submandibular Gland ◽  
Clinical Features ◽  
Surgical Management ◽  
Case Reports ◽  
Palliative Therapy ◽  
Review Of Literature ◽  
History Of ◽  
History Of Pain ◽  
Treatment Procedures

One of the most common disorders of the salivary glands is sialolithiasis. A history of pain or/and swelling in the salivary glands, especially during meal suggests this diagnosis. For small and accessible stones conservative therapies like milking of ducts with palliative therapy can produce satisfactory results. Surgical management should be considered when the stone/stones are inaccessible or large in size as conservative therapies turned out to be unsatisfactory. In this paper, we present three cases of sialolithiasis in the submandibular gland along with a review of existing literature. The purpose of this paper is to add three more cases to the literature and review the theories of etiology, clinical features, available diagnostic and treatment procedures.

scholarly journals Contracturing Granulomatous Myositis with Recurrent Malignant Thymoma and Myasthenia Gravis: A Case Report

2021 ◽  
pp. 1-5
Author(s):  
Ching On Luk ◽  
Wai Ting Joyce Lo ◽  
Kitty Yan Kwok ◽  
Moon Ho Leung ◽  
Wing Chi Fong ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Features ◽  
Case Reports ◽  
Immunoglobulin A ◽  
Chemotherapy Treatment ◽  
Malignant Thymoma ◽  
History Of ◽  
Antibody Levels ◽  
Granulomatous Myositis ◽  
Anti Acetylcholine

Contracturing granulomatous myositis (CGM) is a very rare myopathic syndrome where patients present with slowly progressive muscle pain or weakness affecting mainly proximal muscles together with flexion contractures of the limbs. To date, there have only been several case reports of CGM, which have been reported to occur most commonly in association with sarcoidosis. We report a case of CGM associated with recurrent malignant thymoma and myasthenia gravis (MG). A gentleman with history of treated malignant thymoma presented with new onset proximal muscle weakness and pain that later evolved into contractures that persisted despite treatment with steroids and intravenous immunoglobulin. A malignancy workup revealed recurrence of his malignant thymoma warranting chemotherapy treatment. His contractures only resolved after addition of chemotherapy treatment. He later developed clinical features of MG 1 year after his initial elevation in Anti-acetylcholine (Anti-AChR) antibody levels. We postulate CGM to be a paraneoplastic phenomenon of underlying malignant thymoma. Treatment of thymoma together with immunosuppressive therapies led to clinical improvement of our patient’s CGM. The sole elevation of Anti-AChR levels without the accompanying clinical features does not equate to a MG diagnosis, but should raise the clinician’s vigilance for future development of the condition.

Prevalence and Clinical Features Associated with Unrecognized Bipolar Disorder among Outpatients with Depressive Disorder in Thailand

2021 ◽  
Vol 104 (11) ◽  
pp. 1821-1827
Keyword(s):  
Bipolar Disorder ◽  
Depressive Disorder ◽  
Clinical Features ◽  
Suicide Attempts ◽  
Bipolar Depression ◽  
University Hospital ◽  
Cross Sectional ◽  
Atypical Depression ◽  
History Of ◽  
Self Harm

Objective: To determine the prevalence of unrecognized bipolar disorder and explore the clinical features of outpatients with depressive disorder associated with bipolar disorder. Materials and Methods: The present study was a cross-sectional study. One hundred six volunteer participants, diagnosed with depressive disorder at Naresuan University Hospital, Buddhachinaraj Phitsanulok Hospital, and Phichit Hospital participated in this study. Psychiatrists interviewed the participants to collect basic data and clinical characteristics to determine unrecognized bipolar disorder using the Thai version of the Mini International Neuropsychiatric Interview (MINI). Results: The results showed that the prevalence of unrecognized bipolar disorder was 18.9%. When multivariable logistic regression was used, it was found that there were two statistically significant factors associated with unrecognized bipolar disorder. These factors were a history of self-harm or suicide attempts (AOR 4.40, 95% CI 1.24 to 15.60), and atypical depression seen with overeating and hypersomnia (AOR 11.73, 95% CI 2.32 to 59.35). Conclusion: There are several misdiagnoses of patients with bipolar disorder because the patients are usually in a depressive state when they decide to consult a doctor. Therefore, doctors should further probe especially in patients with atypical depression, history of self-harm or attempted suicide. Keywords: Bipolar depression; Bipolar disorder; Diagnosis; Epidemiology; Prevalence

Erotomania – A Review of De CléRambault's Syndrome

2016 ◽  
Vol 33 (S1) ◽  
pp. S533-S533
Author(s):  
C. Oliveira ◽  
S. Alves ◽  
C. Ferreira ◽  
C. Agostinho ◽  
M.J. Avelino
Keyword(s):  
Social Economic ◽  
Case Reports ◽  
Treatment Options ◽  
Dsm 5 ◽  
Political Status ◽  
History Of ◽  
Competing Interest ◽  
New Treatment ◽  
The Individual ◽  
Clinical Cases

IntroductionErotomania (also known as De Clerambault's syndrome) is usually described as a rare delusional syndrome characteristically involving an individual who believes that another person, typically of higher social, economic or political status, is in love with the individual. De Clerambault's syndrome remains a ubiquitous nosological psychiatric entity with uncertain prognosis that remains recognised as a subtype of delusional disorder in DSM 5.Objectives and aimsTo review the history of Erotomania as a nosological psychiatric entity, its clinical characteristics and course. Also to report some selected clinical cases.MethodsThe authors have conducted an online search on PubMed with MeSH words“erotomania”, “erotomaniac delusion” and “Clerambault” and systematically reviewed some case reports.ResultsErotomania is a relatively uncommon and misunderstood disorder characterised by the presence of a persistent erotic delusion. The individual (usually described as a woman) has had little or no contact with the other person who is perceived as watching over, protecting or following the individual. Despite various authors have described and named this syndrome, it was Clérambault who first classed the symptoms into the disorder he referred to as “psychose Passionelli” (1942). There are numerous theories as to the aetiology of this illness that is not uniquely associated with any specific disorder. We reviewed some clinical cases.ConclusionsErotomania is a relatively uncommon psychiatric disorder. An increased awareness and understanding of this illness will assist in the recognition of patients affected, opening doors for future progress on its aetiology and, therefore, the development of new treatment options.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Sign in / Sign up

Export Citation Format

Share Document