The West Virginia medical journal最新文献_第10页

Case Report of Shared Psychotic Disorder or ‘Folie a Deux’ in Two Geriatric Sisters 两名老年姐妹的共同精神障碍或“双人舞”病例报告

The West Virginia medical journal Pub Date : 2017-11-20 DOI: 10.21885/WVMJ.2017.19

K. Patel, A. Schindzielorz, S. Holroyd

{"title":"Case Report of Shared Psychotic Disorder or ‘Folie a Deux’ in Two Geriatric Sisters","authors":"K. Patel, A. Schindzielorz, S. Holroyd","doi":"10.21885/WVMJ.2017.19","DOIUrl":"https://doi.org/10.21885/WVMJ.2017.19","url":null,"abstract":"Folie a Deux or shared psychotic disorder is a rare and poorly understood disorder characterized as transfer of delusional beliefs from one person, the primary patient, to another, the secondary patient, who are closely related. The disorder is mainly seen within a family, most often between spouses or between siblings, although it has been noted in other relationships. Females are more likely than males to both primary and secondary partner. We present a case of a 77-year-old female who was admitted for myasthenia gravis exacerbation with a two-day history of generalized weakness, multiple falls, decreased appetite and blurred vision. However, she also described a detailed and unbelievable story of kidnapping and extortion which, surprisingly, was validated by the patient’s younger sister. Investigation of the story by police and others confirmed it to be false. A diagnosis of shared psychotic disorder was made. The delusions appeared to occur with a rapid onset and resolution. This case highlights the unusual presentation of shared psychotic disorder in two elderly women, well outside the typical age of onset for the disorder as well as its rapid onset and resolution, rather than in the setting of a chronic psychiatric illness such as delusional disorder or schizophrenia.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"35 1","pages":"2701"},"PeriodicalIF":0.0,"publicationDate":"2017-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80035155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Pigeon Breeder's Lung: A case report of hypersensitivity pneumonitis 鸽饲养员肺:过敏性肺炎1例报告

The West Virginia medical journal Pub Date : 2017-11-20 DOI: 10.21885/WVMJ.2017.20

L. Winkler, Z. Patel, Racine Gue

引用次数: 1

Severe Hypercalcemia Following the Implantation of Antibiotic Impregnated Calcium Sulfate Beads for Prosthetic Joint infection 人工关节感染植入抗生素浸渍硫酸钙微球后的严重高钙血症

The West Virginia medical journal Pub Date : 2017-11-16 DOI: 10.21885/wvmj.2017.18

M. Forte, R. Pellegrino

{"title":"Severe Hypercalcemia Following the Implantation of Antibiotic Impregnated Calcium Sulfate Beads for Prosthetic Joint infection","authors":"M. Forte, R. Pellegrino","doi":"10.21885/wvmj.2017.18","DOIUrl":"https://doi.org/10.21885/wvmj.2017.18","url":null,"abstract":"Prosthetic joint infections are a significant cause of morbidity and mortality, which affect only a small number of joint replacements annually. Antibiotic impregnated beads are increasingly used to combat these infections. This delivery system is believed to be safe, however, we present a case of a patient who developed severe hypercalcemia several days after implantation of calcium sulfate beads during a revision of an infected total knee athroplasty. \u0000\u0000A 70-year-old male was admitted to our institution due to infected prosthetic total knee arthroplasty. All of the patient’s pre-operative labs were within normal limits. He was taken for irrigation, debridement and poly exchange of the infected knee by orthopedics. During the procedure, 10 mL of 10 ml of calcium sulfate beads impregnated with Vancomycin and 10 mL of calcium sulfate beads impregnated with Tobramycin was implanted in the knee. Approximately 48-72 hours post-operatively, the patient became more lethargic, confused and had a poor appetite. He was found to be severely hypercalcemic at 14.0 mg/dL An extensive workup for hypercalcemia was unremarkable and the only logical explanation was tbe implanted beads. He was started on aggressive intravenous hydration with IVF and Lasix for volume control with resolution of his symptoms and hypercalcemia. He had no further occurrence of hypercalcemia during follow up period. \u0000\u0000Hypercalemia is a medical emergency seldomly encountered by internists, but requires acute interventions. This case demonstrates a possible new cause of hypercalcemia in surgical patients, antimicrobial impregnated calcium sulfate beads. Nonetheless, clinicians should be aware of this etiology of hypercalcemia, given the increased utilization of these types of treatments.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"43 1","pages":"2698"},"PeriodicalIF":0.0,"publicationDate":"2017-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73876261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

A Case of Significant Malnutrition Presenting as Acute Sensorimotor Axonal Neuropathy 以急性感觉运动轴索神经病表现的严重营养不良1例

The West Virginia medical journal Pub Date : 2017-11-13 DOI: 10.21885/WVMJ.2017.17

Vincent Arnone, S. Sultan

{"title":"A Case of Significant Malnutrition Presenting as Acute Sensorimotor Axonal Neuropathy","authors":"Vincent Arnone, S. Sultan","doi":"10.21885/WVMJ.2017.17","DOIUrl":"https://doi.org/10.21885/WVMJ.2017.17","url":null,"abstract":"Nutritional status is an important, but often overlooked, component of care for patients being seen in any number of subspecialty clinics. The neurologic ramifications of nutritional deficiencies tend to present in the later stages of prolonged malnutrition. A 34 year-old woman with a history of alcoholism presented to the emergency department with two weeks of worsening gait imbalance, diffuse paresthesia, allodynia, and weakness of all extremities. The physical examination yielded diffuse loss of sensation to all sensory modalities in a length-dependent manner and complete lack of deep tendon reflexes in all extremities. There was also mild 4/5 weakness of proximal musculature of upper and lower extremities. Nerve conduction studies showed a diffuse sensorimotor axonal neuropathy that was worse in the lower extremities compared to the upper extremities. Laboratory evaluation yielded significant deficiencies that included calcium, pyridoxine, vitamin E, folate, borderline low thiamine, and elevated homocysteine levels. This was a unique case of severe malnutrition manifesting as an acute diffuse axonal neuropathy. Lower socioeconomic status with concurrent alcohol use can lead to a bevy of neurologic conditions as seen in our patient.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"32 1","pages":"2697"},"PeriodicalIF":0.0,"publicationDate":"2017-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88436975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Symptomatic Hyponatremia as the Initial Presentation of Small Cell Lung Carcinoma: A Case Report of Delayed Diagnosis 症状性低钠血症作为小细胞肺癌的初始表现:延迟诊断1例报告

The West Virginia medical journal Pub Date : 2017-11-08 DOI: 10.21885/WVMJ.2017.16

Ciara A. Brown, Dolat Singh

引用次数: 0

Musical Hallucinations Treated with Atypical Antipsychotics in a Geriatric Population – A Case Series 用非典型抗精神病药物治疗老年人群中的音乐幻觉-一个病例系列

The West Virginia medical journal Pub Date : 2017-11-06 DOI: 10.21885/WVMJ.2017.15

Adam Adam Schindzielorz, MD, D. Scott Murphy, MD, Suzanne Holroyd, MD

{"title":"Musical Hallucinations Treated with Atypical Antipsychotics in a Geriatric Population – A Case Series","authors":"Adam Adam Schindzielorz, MD, D. Scott Murphy, MD, Suzanne Holroyd, MD","doi":"10.21885/WVMJ.2017.15","DOIUrl":"https://doi.org/10.21885/WVMJ.2017.15","url":null,"abstract":"Musical hallucinations have been likened to the auditory equivalent of Charles Bonnet Syndrome, which involves complex visual hallucinations, most often in the context of visual impairment. Musical hallucination frequently take the form of hymns, carols, and show-tunes and are strongly associated with hearing loss, with some studies suggesting a prevalence of 2.5–3.6% in the hearing impaired. Musical hallucinations are typically treated with anticonvulsant and anticholinesterase medications, with some studies having evaluated the efficacy of sedative hypnotics, antipsychotics and antidepressants in various psychiatric and medical subpopulations suggesting a heterogeneous spectrum of causes for this disorder.\u0000\u0000We present two cases of musical hallucinations in both a 70-year-old African American female with past psychiatric history of major depressive disorder who developed hymnal auditory hallucinations during an acute medical and psychiatric admission and an 86-year-old Caucasian female, who complained of hearing gospel music with eventual onset of visual hallucinations after a fall at age 80. Our patients were successfully treated in both the inpatient and outpatient settings with atypical antipsychotics. \u0000\u0000The presented cases add to the paucity of literature regarding utilization of atypical antipsychotics for treatment of musical hallucinations and demonstrate efficacy to this effect. This study lends further validity to the use of psychopharmacologic agents for novel purposes that have yet to be fully explored.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"10 6 1","pages":"2690"},"PeriodicalIF":0.0,"publicationDate":"2017-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74776625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Curious Case of Multiple Myeloma Hidden in a Cloud of Severe Cryoglobulinemia 一例隐藏在严重冷球蛋白血症云团中的多发性骨髓瘤

The West Virginia medical journal Pub Date : 2017-11-02 DOI: 10.21885/wvmj.2017.14

N. Fei, A. Kanate

引用次数: 0

Women In An Opioid Addiction Treatment Program Do Not Know How To Obtain Naloxone 在阿片类药物成瘾治疗项目中的妇女不知道如何获得纳洛酮

The West Virginia medical journal Pub Date : 2017-06-26 DOI: 10.21885/WVMJ.2017.13

Facog David C. Jude, P. Nieuwenhuizen, Bs Benjamin D. Jude, Facog Brenda Mitchell

{"title":"Women In An Opioid Addiction Treatment Program Do Not Know How To Obtain Naloxone","authors":"Facog David C. Jude, P. Nieuwenhuizen, Bs Benjamin D. Jude, Facog Brenda Mitchell","doi":"10.21885/WVMJ.2017.13","DOIUrl":"https://doi.org/10.21885/WVMJ.2017.13","url":null,"abstract":"West Virginia leads the nation in death rates due to opioid abuse. Providing naloxone to people who use drugs, their friends, and families has been shown to decrease the number of deaths from overdose. In 2016, West Virginia passed legislation allowing access to naloxone (Narcan®) without a prescription. We report on the knowledge and availability of naloxone in a cohort of pregnant women in a medication assisted treatment program. Twenty-six consecutive opioid addicted gravidas enrolling in a medication assisted treatment program were queried regarding their knowledge about and access to naloxone. They were also asked if they lived with or were frequently around people who use drugs without a prescription. Of the twenty-six respondents, twenty-four (92.3%) either lived in a home or had regular contact with someone who used drugs obtained illegally. Twenty-three (88.5%) had knowledge of naloxone. Only two (7.7%) reported knowing how to access naloxone. In our small sample size, people at the highest risk of needing naloxone to prevent overdose in themselves or close contacts did not know how to obtain naloxone.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"15 1","pages":"1880"},"PeriodicalIF":0.0,"publicationDate":"2017-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86299824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Pilot Program to Improve Recognition of Cogntive Impairment in Acute Care 提高急性护理中认知障碍识别的试点项目

The West Virginia medical journal Pub Date : 2017-06-19 DOI: 10.21885/wvmj.2017.12

S. Neitch, Carolyn Canini, R. Edwards, Jane Marks

引用次数: 0

Large highly mobile complex ascending aortic atheroma causing left middle cerebral artery stroke in patient without any history of cardiac disease. 无心脏病史的患者出现大的、高度移动的复杂升主动脉粥样硬化，导致左大脑中动脉卒中。

The West Virginia medical journal Pub Date : 2017-06-15 DOI: 10.21885/WVMJ.2017.10

Kinjan P Patel, P. Farjo, Ahmed Almustafa, J. Mills

{"title":"Large highly mobile complex ascending aortic atheroma causing left middle cerebral artery stroke in patient without any history of cardiac disease.","authors":"Kinjan P Patel, P. Farjo, Ahmed Almustafa, J. Mills","doi":"10.21885/WVMJ.2017.10","DOIUrl":"https://doi.org/10.21885/WVMJ.2017.10","url":null,"abstract":"Introduction: A complex atheroma of the aortic arch puts a patient at risk for an embolic stroke. We present a patient with no cardiac history who came with acute stroke-like symptoms from a large, complex aortic atheroma. Case presentation: A 60-yearold woman with known thoracic aortic aneurysm presented with acute right-sided weakness. An MRI of the brain showed a left middle cerebral artery (MCA) embolic stroke. A CT angiogram (CTA) showed the known, stable thoracic aneurysm and concern for type A aortic dissection. Later gated CT scan revealed a focal filling defect in the proximal aortic arch, compatible with a floating thrombus. A transesophageal echocardiogram (TEE) then demonstrated a 18mm by 14mm, highly mobile atheroma in this area. Specialty team concluded that the stroke was due to the atheroma and suggested anticoagulation and statin therapy. Discussion: A large and mobile aortic atheromas are recognized as a potential cause of embolic events in the elderly population. These patients will benefit from an anticoagulation and statin therapy to reduce the risk of stroke recurrence. Conclusion: A complex aortic atheroma is likely an independent risk factor for embolic stroke and may be an indication for prophylactic anticoagulation and statin therapy.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75312016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0