1/27. Apnea syndrome in a patient with Alzheimer dementia under chlormethiazole treatment: a clinical experience report.sleep apnea syndromes in conjunction with dementia have attracted considerable interest among geropsychiatrists in recent years. This clinical case report describes a demented and delirious elderly patient with a history of alcoholism who developed a sleep apnea syndrome under treatment with chlormethiazole. The risk of chlormethiazole treatment may be underestimated in vulnerable patients, e.g. those suffering from severe respiratory diseases or dementia. Alternative treatments for delirious states need to be evaluated instead.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
2/27. Laryngeal sarcoidosis: treatment with the antileprosy drug clofazimine.sarcoidosis is a chronic systemic granulomatous disease that occasionally affects the larynx. When the larynx is affected, the symptoms are frequently mild, but severe airway obstruction can occur. Although systemic corticosteroids are helpful, patients may become refractory to further drug administration. The current methods of treatment are here summarized, and the patient literature is reviewed. We also report a case of a young patient suffering from laryngeal sarcoidosis successfully treated by the antileprosy agent clofazimine and propose it as an alternative treatment of laryngeal sarcoidosis in patients refractory to corticosteroids.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
3/27. Congenital central alveolar hypoventilation syndrome (Ondine's Curse): effectiveness of early home ventilation for normal development.An 8 month old Caucasian girl, with congenital central alveolar hypoventilation syndrome (Ondine's Curse), was discharged with her home ventilation managed by her parents. Her subsequent neurophysical development assessed at 22 months of age was satisfactory.- - - - - - - - - - ranking = 0.31810811828909keywords = physical (Clic here for more details about this article) |
4/27. The neuropsychiatric evolution of a case of progressive supranuclear palsy.The neuropsychiatric changes in a Chinese patient suffering from progressive supranuclear palsy led to a difficult diagnosis. polysomnography revealed sleep fragmentation and central apnoea.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
5/27. shy-drager syndrome: a case report with polysomnography.The authors report a case of shy-drager syndrome in a 53 year-old male patient. Autonomic failure was made evident by physical examination as well as laboratory tests. A sleep recording showed decreased percentage of REM sleep and apneas of the central type. The possible mechanisms for this sleep disorder are discussed.- - - - - - - - - - ranking = 0.31810811828909keywords = physical (Clic here for more details about this article) |
6/27. Exacerbation of sickle cell disease by obstructive sleep apnea.It is difficult to recognize and treat the factors that exacerbate the vascular crises of sickle cell disease. We describe a 12-year-old black girl with sickle cell anemia who, since the age of 9 years, has been repeatedly hospitalized for pain associated with vaso-occlusive disease. A diagnosis of obstructive sleep apnea was suggested by the history and physical examination and was confirmed by polysomnography. Following preoperative transfusion, the patient underwent elective tonsillectomy and adenoidectomy. She has been free of vaso-occlusive pain and crises for over two years and has not been hospitalized since her surgery. Post-operative polysomnography has shown no evidence of obstructive sleep apnea. It is our hypothesis that repeated oxygen desaturation during periods of obstructive sleep apnea was the cause of this patient's frequent vaso-occlusive crises. She not only obtained complete relief of her symptoms, but objective sleep study measurements were normal following surgery. Obstructive sleep apnea is a recent diagnosis, and its pathologic effects are only beginning to be known. physicians taking care of patients with hemoglobinopathies need to be aware of possible contributing factors to their patients' disease, and an aggressive approach to their diagnosis and possible relief should be sought.- - - - - - - - - - ranking = 0.31810811828909keywords = physical (Clic here for more details about this article) |
7/27. Recurrent hypothermia, hypersomnolence, central sleep apnea, hypodipsia, hypernatremia, hypothyroidism, hyperprolactinemia and growth hormone deficiency in a boy--treatment with clomipramine.A boy referred at the age of 4 years because of obesity and under observation for 16 years, was found to be suffering from a hypothalamic syndrome of unknown origin characterized by progressive obesity, polyphagia, deficiency of growth and thyroid hormone, hyperprolactinemia, hypodipsia, hypernatremia and hyperosmolality without diabetes insipidus. At ages 11 and 16 there were 3 day episodes of spontaneous muscular weakness, hypersomnolence and hypothermia associated with central sleep apnea and severe bradycardia. Subsequently, decreased ventilatory responsiveness to carbon dioxide (CO2) was found as a consequence of blunted neural drive. Therapy with clomipramine HCl (Anafranil Ciba-Geigy) for 6 months led to a normalization of serum sodium levels, pulse rate, ventilatory response to dioxide with no recurrence of the central apnea within 4 following years.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
8/27. Myocutaneous fenestration in sleep apnea patients.We present a patient with severe obstructive sleep apnea syndrome (OSAS), including O2 desaturations to 11%, who was successfully managed with myocutaneous fenestration tracheostomy. The myocutaneous fenestration technique employs bilateral horizontal skin-platysma advancement flaps sutured directly to a tracheal fenestra created between rings two to four. It conforms ideally to the unique physical and psychological demands of the sleep apnea patient. Rapid healing time and minimal granulation tissue, combined with a permanently functional, yet reversible and minimally disfigurative stoma, highlight the advantages of the technique over standard tracheostomy. The myocutaneous fenestration tracheostomy is uniquely applicable to the surgical treatment of patients with moderate to severe obstructive sleep apnea.- - - - - - - - - - ranking = 0.31810811828909keywords = physical (Clic here for more details about this article) |
9/27. Silence as resistance to medical intervention.A group of 47 individuals initially silent about their physical symptoms and/or dysfunction were studied after they finally had come to medical attention. They were then interviewed, using the associative anamnesis technique, to evaluate the psychologic aspects of their silence. It was found to be a key element in the defensive complex directed against intense neurotic feelings activated by the patient's current physical condition. The tendency toward silence appeared to have been reinforced by emotionally traumatic experiences involving physical illness or injuries in early life. Also found associated with silence were such different factors as a series of ostrich-like denying rationalizations, a fanatic commitment to cultist beliefs, a conviction that emotional conflict is the primary cause of organic illness, and motivations linked to retention of power in reality situations. Clinical examples drawn from these categories are given. Means of increasing the awareness that such silence exists and methods of dealing with it are discussed.- - - - - - - - - - ranking = 0.95432435486728keywords = physical (Clic here for more details about this article) |
10/27. phrenic nerve pacing for the treatment of central hypoventilation syndrome - state of the art and case report.The application of phrenic nerve pacing is an effective method of respiratory support in adults with certain forms of acquired failure of automatic ventilation. The experience with one infant suffering from congenital central hypoventilation (Ondine's syndrome) is summarized in this report. Stimulation electrodes were implanted on the thoracic portion of each phrenic nerve. After a cumbersome period of intensive medical care and conditioning of the phrenic nerve-diaphragm-system, the patient could be weaned off the respirator. Severe upper airway obstruction, however, required tracheostomy. Bilateral simultaneous pacing has been effective now for more than 2 years providing the desired normal ventilation during sleep. The state of the art of phrenic nerve pacing is described.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
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