Psychedelic medicines for existential distress associated with life-threatening illnesses

This presentation will review the history of scientific research into the use of psychedelic medicines for the treatment of existential distress due to life-threatening illnesses, it will then outline the current state of affairs in North America, and conclude with exploring the implications it will have on the future of palliative care. Despite the significant advances in the field of palliative care with regards to symptom management, and pain control in particular, we have yet to devise an effective treatment strategy for individuals facing the existential distress associated with the inevitable reality of facing death. Psychedelic-assisted therapy, which involves the use of various psychoactive substances in the right set and setting to experience an altered state of consciousness, could serve as a powerful tool to alleviate the anxiety that many face after receiving a life-threatening diagnosis.

PRIMARY CNS LYMPHOMA MIMICKING TUBERCULOSIS INFECTION - A CASE REPORT

Primary central nervous system lymphoma (PCNSL) is a rare variety of extra nodal non-Hodgkin lymphoma that reportedly involves leptomeninges, the brain, spinal cord, eyes, or may involve other organs systemically. We present a case of 46-yearold woman with complaints of headache and fever for three weeks, associated with right-sided weakness & altered state of consciousness for one week. The most common presentation of primary central nervous lymphoma is diffuse or multifocal supratentorial masses causing cognitive deterioration and involvement of vitreous, retina, and optic nerve. Most cases ofPCNSL are left undiagnosed due to uncommon

Divine Mania: Alteration of Consciousness in Ancient Greece by Yulia Ustinova

What role did altered states of consciousness play in the life of ancient Greek society? With consummate skill and scholarship, Yulia Ustinova answers this question in her book, Divine Mania: Alteration of Consciousness in Ancient Greece. It appears that the secret of the extraordinary creativity of the ancient Greeks was their receptivity to, and approval of, a particular altered state of consciousness they cultivated. Mania is the name for this but it must be qualified as “god-given.” Mania is a word that touches on a cluster of concepts: madness, ecstasy, and enthusiasm, engoddedness, to use Ustinova’s more vivid coinage. It seems a paradox that this special, strange and often quite frightening state of dissociation should be so closely linked to one of the most creative civilizations. Unlike the Roman and Egyptian, the Greek approved and recognized the value of god-inspired mania. Plato makes Socrates say in the Phaedrus that through mania we may obtain the “greatest blessings.” Whereas resistance to divine ecstasy can end in disaster, as Euripides illustrates in The Bacchants when Pentheus, a repressive authoritarian, tries to inhibit a posse of women from their ecstatic mountain dances. He is torn to shreds by his mother and her maniacal cohorts. This mindset of the ancient Greeks may have long ago petered out, but similar tendencies are constants, expressed in one form or another, throughout history.

ACUTE TOMOGRAPHIC CHANGES OF METABOLIC ORIGIN MIMICKING BASAL GANGLIA HEMORRHAGE, CASE REPORT

Patients with acute neurological changes, especially with focal neurological deficit, require images for its initial approach,generally skull tomography due to its availability.Here we report a case of an 80-year-old patient with altered state of consciousness and a seizure episode who was admitted on suspicion of cerebral hemorrhage. Her initial blood glucose was high and a hyperdense lesion was found in the right basal ganglion on brain computed tomography, laboratories in which no other metabolic alteration was identified apart from the acute decompensation of Diabetes, however, with a neuroradiology and clinical team, the diagnosis of diabetic striatopathy was made. The patient was treated with a fluid infusion, and serum glucose level was controlled with insulin. The patient gradually recovered consciousness and was alert to his baseline state within 24 hours,without neurological complications. Patients with risk factors and with findings suggesting stroke,the tomographic high densities,may suggest intracerebral hemorrhage;however,other metabolic and toxic pathologies may have similar tomographic changes. Our intention,is show to emergency physicians the presence of ganglio basal hyperintensities,mimics for gangliobasal hemorrhage should be studied according to history and clinical context and establish appropriate treatment in a timely manner.

Damage control in the emergency department, a bridge to life

Patients with hemodynamic instability have a sustained systolic blood pressure less or equal to 90 mmHg, a heart rate greater or equal to 120 beats per minute and an acute compromise of the ventilation/oxygenation ratio and/or an altered state of consciousness upon admission. These patients have higher mortality rates due to massive hemorrhage, airway injury and/or impaired ventilation. Damage control resuscitation is a systematic approach that aims to limit physiologic deterioration through a group of strategies that address the physiologic debt of trauma. This article aims to describe the experience earned by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia in the management of the severely injured trauma patient in the emergency department following the basic principles of damage control surgery. Since bleeding is the main cause of death, the management of the severely injured trauma patient in the emergency department requires a multidisciplinary team, which should perform damage control maneuvers aimed at rapidly control bleeding, hemostatic resuscitation and/or prompt transfer to the operating room, if required.

Case Report: Trance in Mental Retardation

BACKGROUND: Mental retardation (MR) is a developmental condition that is associated with significant intellectual and adaptive behavioral limitations, whereas dissociative trance disorder (DTD) is a dissociative condition characterized by a temporary altered state of consciousness formed by one’s culture. Comorbidity between these two disorders has rarely been reported. CASE REPORT: We found a case of MR in a 32-year-old woman, Mrs. S, with a DTD who killed her five children during her trance. CONCLUSION: It was found that there is a relationship between psychosocial stressor factors, trauma, underlying psychiatric conditions, culture, and communication that influence trance conditions. Further research is needed to study and understand more about these disorders and comorbidities.

Active Imagination as an Alternative to Lucid Dreaming: Theory and Experimental Results

Lucid dreaming (LD) is a fun and interesting activity, but most participants have difficulties in attaining lucidity, retaining it during the dream, concentrating on the needed task and remembering the results. This motivates to search for a new way to enhance lucid dreaming via different induction techniques, including chemicals and electric brain stimulation. However, results are still unstable. An alternative approach is to reach the lucid dreaming-like states via altered state of consciousness not related to dreaming. Several methods such as guided visualization, internal dialog, creative writing, hypnosis, hypnagogia, daydreaming, DMT trips, voice dialog, shamanic journey, rebirthing, and “forcing” tulpas can help in attaining such states. One of the most promising of them is Jungian “active imagination” (AIM) technique, which allows unconscious content to build up inside some mental frames. This article explores the hypothesis of replacing lucid dreaming research with active imagination, and the conditions and ways to accomplish it. Method: An open label pilot experiment was performed in 2004-2005 in Moscow, Russia with 100 participants. Results: The results show that there are two groups of people: ones with “visual imagination screen” and others have “mental imagination screen”. AIM works perfectly as a replacement for lucid dreams only for the first group of people. For the second group, it created interesting content, but not visual or emotional intensity equal to enter lucid dreaming like state. No known instruments helped to move the person from one group to another. The first group consisted of young females, while the second mostly contained males with rational and mathematical type of personality. Conclusion: AIM partly works as a replacement for LD, as it works great only for half of people, and it requires a sitter. However, AIM outperforms LD in reliability and availability in any circumstance: it could be performed even by text chat or in a crowd. It is also better than LD in retaining concentration on topic and the easiness of memorizing the results (which could be recorded). Self-performed AIM is less effective. AIM can be improved by intelligent chat bots as sitters and weak brain stimulation that can increase the probability of attaining something like hypnogogic state.

MIOCARDITIS SECUNDARIA A INFLUENZA

Influenza viruses induce uncomplicated infections in most cases, in individuals without known predisposing factors, acute febrile illness is usually limited to upper respiratory symptoms and constitutional symptoms. However, some patients are at risk of serious and fatal complications, myocardial involvement is mentioned in the literature, but clinical myocarditis due to influenza is apparently rare. There are few reports of fulminant influenza myocarditis. In the present case report, a patient who experienced myocarditis associated with H3N2 influenza infection, with recent Left Branch Blockage, acute pulmonary edema, and altered state of consciousness in the Vozandes Hospital in Quito during 2019 is reported; his clinical condition at discharge was favorable.

Moving beyond the concept of altered state of consciousness: the Non-Ordinary Mental Expressions (NOMEs)

Aim of this paper is to review the state of the art of so-called altered states of consciousness, anomalous experiences, and exceptional human experiences, showing the need for reappraising the whole topic and gather them under one roof. The term Non-Ordinary Mental Expressions (NOMEs) and a new classification of non-pathological ostensibly odd phenomena is introduced, emphasizing their epistemological, transcultural and interdisciplinary implications with their huge implications in medical and psychotherapeutical clinical practice.

Acute Ischemic Stroke in COVID-19 Patient with Lung Collapse: A Case Report

Novel corona virus 2019 also known as severe acute respiratory syndrome coronavirus 2 [SARS COV2] is enveloped non segmented ribonucleic acid (RNA) virus. Acute ischemic stroke remains emergency during covid19 pandemic [1] Here we present a case of a woman with COVID 19 who presented to us with symptoms of altered state of consciousness (ASOC), cough, fever, dysarthria, right sided body weakness and massive bilateral middle cerebral artery (MCA)/ anterior. Our case was unique in the sense that it showed drastic central nervous system (CNS) damage in the presence of coronavirus infection. There are a few cases of patients who develop stroke after COVID 19 infection. Aims: Clinicians need to be aware of possible causes of unconsciousness in coronavirus disease (COVID 19) patients, particularly as delirium appears to be common complications to find out the association between stroke and COVID 19 and its impact and mortality. Case Presentation: A 70 years old lady presented to us with symptoms of stroke like ASOC, right sided body weakness, dysarthria, and symptoms of pneumonia like mild cough and fever later which turned out to be COVID 19. Clinicians need to be aware of possible causes of unconsciousness in coronavirus disease (COVID 19) patients, particularly as delirium appears to be common complications to find out the association between stroke and COVID 19 and its impact and mortality. Discussion: Bilateral ischemic stroke is relatively uncommon presentation in general population and is usually the result of cardio embolic cause such as atrial fibrillation and recent myocardial infarction. While this patient had pre existing risk factors for stroke such as type 2 diabetes mellitus, hypertension and old age and her electrocardiography showed sinus rhythm. Conclusion: COVID-19 may be a risk factor or aggravating factor for stroke.