Worsening Of Symptomatology Research Articles

Kearns-Sayre syndrome with optic nerve atrophy phenotype: A possible biological and clinical concurrence of two mutations?

The authors report about the association of progressive external ophthalmoplegia, atypical pigmentary retinopathy, ataxia phenotype with onset in first months of life (Kearns-Sayre syndrome) and with optic nerve atrophy and deafness. The localization of retinal lesions was coincident with that reported by multifunctional electroretinogram (mfERG) in OPA 1 mutation. The authors hypothesize that Kearns-Sayre mitochondrial mutation may be associated with OPA 1 missense mutation, with worsening of symptomatology, as occurs in the reported case. The prolonged rehabilitation and treatment with coenzyme Q10 for many years gave positive results, with amelioration of ophthalmoplegia, stopping of aggravation of retinal damage and optic nerve atrophy, maintaining of vision some meters away, possibility of socialization and proprioceptive ability amelioration.

COVID-19 as a “nightmare” for persons with obsessive-compulsive disorder: A case report from India

The impact of coronavirus disease 2019 (COVID-19) on patients with psychiatric illnesses has also been worrisome for psychiatrists. Most of the mental health organizations have mentioned that of all the psychiatric disorders, COVID-19 could worsen the symptoms of people with preexisting obsessive-compulsive disorder (OCD). Fear of contamination with germs is one of the most common intrusive obsessive thoughts with subsequent ritualistic and compulsive handwashing in patients with OCD. The current guidelines and the only safety strategy employed for infection control is frequent hand hygiene. In this regard, there is every possibility that those with preexisting OCD can have worsening of symptomatology, or many individuals can develop new-onset obsessive-compulsive symptoms that need to be addressed and appropriately evaluated. We report an individual with OCD on treatment who relapsed following the outbreak of the COVID-19 pandemic. This case would help to raise awareness among mental health professionals to have a different approach to patients with OCD during the ongoing pandemic.

DWI Reversibility after Intra-Arterial Thrombolysis

We report our case and review the literature on reversal DWI lesions, ADC thresholds and correlation between DWI lesion and outcome measured with clinical scales. A 30-years old woman was admitted to our hospital 18 hours after stroke onset. Considering the absence of alterations on CT and the worsening of symptomatology, the patient underwent MRI, which showed a slightly hyperintense signal in FLAIR images in the left portion of the pons and midbrain and a more evident bilateral DWI hyperintensity of the pons. The patient was treated with mechanical and pharmacological intra-arterial thrombolysis. The patient showed a rapid improvement of symptoms. Two weeks after the treatment her clinical conditions were characterized by a residual right hemiparesis and complete recovery of right motility, respiratory and swallowing difficulties. MR examination demonstrated a slight signal alteration of the pons left hemiportion and a disappearance of the mesencephalic signal alteration and of the right portion of the pons. DWI lesions represent irreversibly damaged tissue but new evidence suggests that DWI lesions may be reversible, especially with reperfusion, by now well demonstrated in animal models. Therefore acute DWI lesions probably contain not only irreversibly injured tissue but also parts of the penumbra. The debate on the capability of ADC maps to discriminate irreversibly from reversibly damaged tissue is a matter of controversy. ADC values in human stoke are not an independent indicator of tissue viability. The use of thresholds may improve reproducibility but not validity.

Quick Review: Uterine Fibroids

Quick Review: Uterine Fibroids

The effect of Zotepine on productive and negative symptoms in schizophrenic patients

RésuméZotepine was studied in 15 schizophrenic patients over a period of 28 days with regard to its antipsychotic efficacy, effect on negative schizophrenic symptoms, tolerability and adverse effects. Nine patients received Zotepine in a high dosage of 230 mg/die±52 mg, 6 patients in a low dosage of 168 mg/die ± 18 mg. Two patients receiving the high dosage dropped out after 21 days because of worsening of symptomatology and suicide attempts. Zotepine had rapid antipsychotic effects with sedative properties during the initial days of treatment. Minimal adverse effects and extra-pyramidal motor disturbances as well as dose-dependent positive effects on negative schizophrenie symptoms were found.